Objective To explore the efficacy of thoracic endovascular aortic repair(TEVAR)for the treatment of Stanford type B aortic dissection at different intervention timing.Methods The clinical data of 126 patients with Stanford B type aortic dissection,who were admitted to authors'hospital between January 2018 and April 2023,were retrospectively analyzed.Based on the time interval from the onset of disease to receiving surgery,the patients were divided into group A(＜24 h),group B(2-7 d)and group C(8-14 d).The incidences of perioperative adverse events,including endoleak,cerebral infarction,death,aortic rupture and total complications,were compared between each other among the three groups,and survival analysis was performed according to the follow-up findings.Results A total of 126 patients with Stanford type B aortic dissection were included in this study,including 50 patients of group A,43 patients of group B,and 33 patients of group C.No statistically significant differences in the general clinical data existed between each other among the three groups(P＞0.05).The differences in the incidences of perioperative acute cerebral infarction,endoleak,infection and death between each other among the three groups were not statistically significant(P＞0.05).The difference in the overall complication rate between each other among the three groups was statistically significant(P＜0.05).Log-rank testing was used to compare the survival curves of the three groups,which showed that the cumulative 5-year recurrence rate and survival rate in group A were lower than those in group B and in group C,and the differences were statistically significant(P＜0.05).Conclusion The results of this study indicate that the patients may have high incidence of adverse events and poor short-to-middle-term curative efficacy when TEVAR is performed within 24 hours after the onset of symptoms,while the patients may have better perioperative and short-to-middle-term curative efficacy if TEVAR is carried out in 2-14 days after the onset of symptoms(J Intervent Radiol,2024,33:523-528)

Objective:To establish a HPLC method for determinating 9 components simultaneously in Swertia chirayita. Methods:By useing water Sunfire C18 column (4.6 mm× 250 mm,5 μm); Gradient elution was carried out with methanol-0.05% phosphoric acid solution as mobile phase. Setting the column temperature at 30 ℃, the flow rate at 1.0 ml/min, and the detection wavelength at 254 nm.Results:9 components showed good linear relationship within the injection quality range. The recovery rates of wertiamarin, Gentiopicroside, Angelica glycosides,Mangiferin, Isolysine, Gentianoside, Diol glycoside, 8-hydroxy-1,3,5 trimethoxyketone, and Daisy leaf gentinone were 95.38%, 92.41%, 95.14%, 91.87%, 92.24%, 92.51%, 95.08%, 91.72%, 95.74% ( n=6). Conclusion:The method is simple, efficient, sensitive, accurate, economical and practical, with repeatability and stability. It could provide reference for the quality control and comprehensive utilization of Swertia chirayita.

Objective:To investigate the correlation between acoustic radiation force impulse imaging(ARFI) and reserve function of liver and the feasibility of liver reserve function assessment by ARFI.Methods:According to the inclusion criteria, 74 patients were screened and 71 patients were finally enrolled from Henan Province People′s Hospital during June 2017 and June 2019. The portal vein diameter (D PV), spleen length (L SP) were measured by two-dimensional ultrasound. The liver shear wave velocity (LSWV) and spleen shear wave velocity (SSWV) were measured by ARFI. Serological markers were checked, and the indocyanine green (ICG)15-minute retention rate (ICG R15) was measured by excretion test. The patients were divided into ICG R15<10% group and ICG R15≥10% group, the difference of the measurements between two groups were calculated, the correlations of the measurements and ICG R15 were analyzed. LSWV diagnostic performance for liver reserve function was evaluated by the ROC curve. Results:There were significant differences in LSWV, D PV, SSWV, L SP, aspartate transaminase(AST), alkaline phosphatase(ALP), y-glutamyl transpeptidase(γ-GGT) and albumin (ALB) between ICG R15<10% group and ICG≥10% group( P<0.05), but no significant differences in other measurements( P>0.05). The correlations between ICG R15 and LSWV( r=0.673, P<0.001), D PV( r=0.355, P<0.05), SSWV( r=0.384, P<0.05), L SP( r=0.403, P<0.001), ALP( r s=0.245, P<0.05) and ALB( r s=-0.390, P<0.05) were statistically significant. The ROC curve showed high diagnostic performance for liver reserve function assessment by LSWV. The area under the ROC curve was 0.903 (95% CI=0.810-0.961, P<0.01), and the cut-off value was 2.15 m/s (sensitivity 84.6%, specificity 86.7%). Conclusions:The LSWV can evaluate the reserve function and it is a useful supplement to the ICG excretion experiment.

Aim To prepare the novel pyridostigmine bromide nanoemusion(PPNE)and study its release in vitro, and to investigate the intestinal absorption. Methods Pyridostigmine bromide (PB)and PPNE were tested by HPLC in pH 1 .2 HCl,pH 6.8,pH 7.4,pH 7.8 PBS.Rat single pass intestinal perfusion method was employed to investigate the absorption mechanism of PB and PPNE.Results PB release rate was faster than PB in the four release media;the intes-tinal absorption rate constant(Ka )and apparent perme-ability coefficient(Papp)of PPNE were increased in the duodenum,jejunum,ileum and colon segments.PB and PPNE had significant difference in the duodenum, jejunum,ileum and colon segments by t test (P <0.05).Conclusions PPNE can improve the bioavail-ability of drugs,increase the drugs permeability,sig-nificantly improve the absorption of the drugs in the in-testinal segments. PPNE has obviously sustained effects.

Objective To investigate the clinical efficacy of Xinmailong on heart failure in coronary heart disease and on the levels of hs-C-reactive protein (hs-CRP)and N-terminal B-type natriuretic peptide (NT-proBNP).Methods 84 elderly patients diagnosed with heart failure in coronary heart disease were enrolled in this study at our hospital from October 2014 to October 2015.All patients were randomly divided into the control group with conventional treatment(n=42) and observation group with conventional plus Xinmailong treatment(n =42).The Lee's heart failure score,cardiac function grade,quality of life score and the changes of plasma hs-CRP and NT-proBNP after one week of therapy were compared between the two groups before versus after treatment.The adverse reactions were observed during the treatment.Results The clinical efficacy rate of heart failure after treatment was significantly higher in the observation group (83.3％,35 cases)than in control group(54.7 ％,23 cases) (x2 =8.016,P =0.033).The clinical efficacy of heart function after treatment was significantly higher in the observation group(80.9 ％,34 cases)than in the control group (59.5 ％,25 cases) (x2 =6.219,P =0.019).After treatment,the quality of life score was significantly lower in observation group (15.89 ± 3.39) than in the control group (23.80 ± 5.66) (t =7.266,P =0.026).The plasma levels of NT-proBNP and hs-CRP were significantly lower after than before treatment in NT-proBNP[(1 136.6±236.8)ng/L and (2 266.9±260.9)ng/L],and in hs-CRP[(3.06 ±0.26)mg/L and (3.56±0.29)mg/L] (t=6.608、5.106,P=0.019、0.009).There were no serious adverse reactions in both groups during the treatment.Conclusions Xinmailong can not only improve safely and effectively the quality of life of patients,but also block the atherosclerosis of the inflammatory response.

Background The pathogenic mechanism of thyroid associated ophthalmopathy (TAO) is still unclear,which is considered to be an autoimmune disease.It is confirmed that interleukin-17A (IL-17A) plays an important role in the occurrence and development of many autoimmune diseases.It is unclear that whether IL-17A participates in the pathogenesis of TAO.Objective This study was to explore whether IL-17A secreted by coculture system of peripheral blood mononuclear cells (PBMCs) and orbital fibroblasts (OFs) participates in the pathogenesis of TAO and its possible mechanism.Methods Periphery blood and orbital connective tissue were obtained from 12 patients with TAO and 8 patients who received prosthesis implantation for eyeball atrophy in Xiangya Hospital during April to December 2014.PBMCs were isolated by density gradient centrifugation,and OFs were cultured by explant culture method.The purity of T leukomonocyte in PBMCs was tested by flow cytometry,and OFs were identified by Giemsa staining and immunochemistry.OFs and PMBCs were incubated into 96-well plate in a 1:20 proportion to establish co-culture system.Different concentrations of phytagglutinin (PHA) (0,1.0,2.5,5.0,10.0 μg/ml) was added for 72 hours,and IL-6,IL-17A levels in the co-culture system supernatant and IL-17A receptor (IL-17RA) of the total cell membranes in the co-culture system were assayed by ELISA.The differences of IL-6,IL-17A,IL-17RA levels in co-culture system were compared between the TAO group and control group.Results The mean purity of T leukomonocyte in PBMCs was (81.10±0.21)％ in the TAO group and (80.05 ±0.38)％ in the control group respectively,with no significant difference between them(t =0.923,P＞0.05).Cultured OFs showed the positive response for Vimentin expression and Giemsa staining.After stimulated by 1.0 μg/ml PHA,the proliferation of both PBMCs and OFs were increased in the co-culture system.Apoptosis exist in PBMCs and the number of OFs decreased when PHA was higher than 1.0 μg/ml.The growth of PBMCs and OFs was faster in the TAO group than that in the control group in the same concentration of PHA.The contents of IL-6,IL-17A and IL-17RA in co-culture system were significantly different among various concentrations of PHA subgroups (IL-6:Fgroup =12.561,P=0.000;F ion =23.356,P =0.001.IL-17A:Fgroup =12.037,P =0.000;Fconcentration =19.206,P=0.000.IL-17RA:Fgroup =16.216,P=0.000;Fconcentraction =4.627,P=0.018).The production of IL-6,IL-17A and IL-17RA reached peak in both TAO group and the control group after 1.0 μg/ml PHA stimulated.However,the concentrations of IL-6,IL-17A and IL-17RA reduced with the increase of PHA concentration.The concentrations of IL-6,IL-17A and IL-17RA in co-culture system were significantly higher in the TAO group than those in the control group under the stimulation of the same concentration of PHA (all at P＜0.05).Conclusions The co-culture system of PBMCs and OFs stimulated with PHA can be the imitation of TAO pathogenesis in vitro,and PHA can amplify its immune reaction to imitate TAO pathogenic processes intuitively.The IL-6,IL-17A and IL-17RA secreted by PBMCs and induced by PHA are increased in TAO patients,implying that IL-17A participates in the pathogenesis of TAO through magnifying cellular immune response and inflammatory reaction.

Objective To investigate the influence of fast track surgery(FTS) on the concentrations of serum IL‐6 ,IL‐10 , and TNF‐αin pancreatic cancer patients ,and its clinical significance .Methods Eighty patients undergoing pancreatic cancer opera‐tion were divided into FTS nursing group and traditional nursing group .The concentrations of serum IL‐6 ,IL‐10 ,and TNF‐αin dif‐ferent times before and after operation ,and the same period between groups were measured .Results (1)The concentrations of ser‐um IL‐6 ,IL‐10 ,and TNF‐αwere no significantly difference in two groups before operation(P>0 .05);the concentrations of serum IL‐6 in the first and third postoperative day were higher than those before operation in the observation group (P<0 .05);there was no significant difference of the concentrations of serum IL‐6 between the fifth postoperative day and before operation(P>0 .05);the concentrations of serum IL‐6 after operation were higher than those before operation in the control group(P<0 .05);the concentra‐tions of serum IL‐6 in the same time after operation in the observation group were lower than those in the control group(P<0 .05);(2)The concentrations of serum IL‐10 in the first ,third and fifth postoperative day were higher than those before operation in the observation group(P<0 .05);the concentrations of serum IL‐10 in the first and third postoperative day were higher than those be‐fore operation in the control group(P<0 .05);the concentrations of serum IL‐10 in the same time after operation in the observation group were higher than those in the control group(P<0 .05);(3)The concentrations of serum TNF‐αin the first postoperative day were higher than those before operation in the observation group(P<0 .05);there was no significant difference of the concentra‐tions of serum TNF‐αbetween the third and fifth postoperative day and before operation(P>0 .05);the concentrations of serum TNF‐αin the first and third postoperative day were higher than those before operation in the control group(P<0 .05);there was no significant difference of the concentrations of serum TNF‐αbetween the fifth postoperative day and before operation in the control group(P>0 .05);the concentrations of serum TNF‐α in the first and third postoperative day in the observation were lower than those in the control group(P<0 .05) .Conclusion FTS could significantly reduce inflammatory reaction ,improve immunosuppres‐sion and helps to recover .

Pancreas is an integrated organ with both endocrine and exocrine functions. Insulin is secreted from the pancreas islet B cell and is the only hormone that could reduce blood sugar and play an important role in glucose homeostasis. Pancreatic disease can result in diabetes mellitus in some cases. Although acute pancreatitis is the most common disease of pancreas,the relationship between acute pancreatitis and new-onset diabetes has been ignored. However,many researches have shown recently that acute pancreatitis is associated with new-onset diabetes. Blood glucose monitoring is warranted for patients after acute pancreatitis with important significance.

Objective To understand the clinical and pathological characteristics of idiopathic membranous nephropathy,and to investigate their relationships in the elderly patients.Methods The clinical and pathological data of idiopathic membranous nephropathy diagnosed by renal biopsy in the recently 10 years in our hospital were retrospectively analyzed and compared.Results Sex composition variable was not significant between elderly and non-elderly groups,with male accounting for 57.4％ and 59.2％ respectively (P＞0.05).The ratio of idiopathic membranous nephropathy in primary glomerular disease was higher in the elderly than in non-elderly group (42.8％ vs.17.4％,x2 =119.058,P＜0.01).The course of the disease,the occurrence of edema,hypertension,levels of blood urea nitrogen,serum creatinine,blood IgG,IgA and IgG/IgM ratio were higher,while glomerular filtration rate and blood IgM level were lower in elderly group than in non-elderly group (all P＜0.05).The risk for membranous nephropathy was higher in elderly than in non-elderly group (Z=-5.853,P＜0.01).Nephrotic syndrome was common in the clinical diagnosis in the two groups,but it was more common in elderly group than in non-elderly group (x2 =6.825,P=0.033).Membranous nephropathy stage Ⅱ was common in the two groups,and there were no significant differences in the pathological stages,clinical manifestations and their relationships between the two groups (all P＞0.05).Conclusions The risk for idiopathic membranous nephropathy is higher in elderly group than in non-elderly group.Edema,hypertension and renal dysfunction occur more commonly in elderly patients with idiopathic membranous nephropathy.

Objective To investigate immunological changes in the serum of elderly patients with primary nephrotic syndrome (PNS).Methods We made a retrospective analysis of clinically relevant immunological parameters and pathological data of PNS patients 60 years old and above (elderly group)in our hospital for kidney biopsy between September 2010 and November 2013.The data of similar patients but younger than 60 years old (control group)were collected for comparison.Results ① The average levels of IgG in serum of the two groups were both lower than the normal level.And the patients with a decreased level accounted for 59.3% in the elderly group and 78.2% in the control group.The results exhibited a significant difference (P <0.05).The elderly group had higher proportions of IgA level in the serum and IgA and IgG/IgM ratio than the control group.The level of IgM in the aged patients,however,was significantly lower than that in the control group (P <0.05 ).The mean concentrations of C3 and C4 in the serum were both in the normal range,and no significant difference was observed (P >0.05).③ IgG had a negative correlation with urinary protein and cholesterol in serum (the values of r were-0.107,-0.238,respectively,P <0.05).However,there was a positive correlation between IgG and albumin (r=0.252,P <0.05).The results in both groups were consistent.④ Membranous nephropathy was the most common pathological type in aged patients while in control group IgA nephropathy was the most common.Conclusion ① The level of IgG in the serum decreases in most aged patients with PNC.The serum IgA and IgG/IgM ratio are elevated while concentrations of C3 and C4 change little.②The change of IgG is correlated with urinary protein, serum albumin and cholesterol in aged patients with PNS.