Transcatheter aortic valve replacement (TAVR) has emerged as the first-line treatment for aortic valve stenosis. Coronary obstruction is a severe complication of TAVR, with mortality rates exceeding 30%. Coronary obstruction can be classified as acute or delayed based on the timing of the onset, and as direct or indirect obstruction according to the underlying mechanism. Risk factors for predicting coronary obstruction include a small sinus of Valsalva diameter, excessively long native leaflets, low coronary height, and small sinotubular junction height and diameter. Accurate preoperative assessment of these anatomical parameters using CT is crucial for selecting the appropriate valve type, size, and implantation depth. Preventive technical strategies for coronary obstruction include intraoperative interventional treatments (such as the "Chimney" stenting technique), leaflet modification (such as the BASILICA technique), and alignment of the annulus and coronaries. These techniques have demonstrated significant efficacy in reducing the incidence of coronary obstruction and associated mortality. This paper reviews the epidemiology, classification, and mechanisms of coronary obstruction, with a particular focus on the identification, prevention, and treatment of high-risk patients. The aim is to highlight the importance of recognizing and managing coronary risks during TAVR and to provide actionable recommendations for the prevention and treatment of coronary obstruction in clinical practice.
Humans ; Transcatheter Aortic Valve Replacement/methods* ; Risk Factors ; Aortic Valve Stenosis/surgery* ; Postoperative Complications/prevention & control* ; Coronary Occlusion/etiology*

Diabetic neuropathy is a common chronic complication of diabetes and is characterized by high in-cidence and disability rates.It is the result of various metabolic imbalances,including disorders of glucose metabolism,lipid metabolism,and insulin signaling abnormalities caused by insulin deficiency or resistance.The pathogenesis of dia-betic neuropathy is closely related to lipid metabolism disorders.Disorders of lipid metabolism,especially abnormal changes in fatty acids,sphingolipids and cholesterol,are key causal factors and new therapeutic targets for diabetic neu-ropathy.This article reviews the disorder of lipid metabolism under diabetic conditions,and its role and mechanism in the occurrence and development of diabetic neuropathy,with the aim of providing new ideas for diabetic neuropathy treatment.

Objective:To evaluate the role of monocyte chemoattractant protein-induced protein-1 (MCPIP-1) in acute lung injury in septic rats.Methods:Forty-eight healthy male Sprague-Dawley rats, aged 8-12 weeks, weighing 230-270 g, were divided into 6 groups ( n=8 each) using the random number table method: sham operation group (S group), different doses of ubiquitin-proteasome inhibitor groups (M 1 and M 2 groups), cecal ligation and perforation (CLP) group, and different doses of ubiquitin-proteasome inhibitor + CLP groups (M 1-CLP and M 2-CLP group). Sepsis was induced by CLP in anesthetized animals.Ubiquitin-proteasome inhibitor MG-132 5 and 10 mg/kg were intraperitoneally injected at 30 min before sham operation in M 1 and M 2 groups, respectively.MG-132 5 and 10 mg/kg were intraperitoneally injected at 30 min before CLP in M 1-CLP and M 2-CLP groups, respectively.The rats were sacrificed at 6 h after operation, bronchoalveolar lavage (BALF) was collected for determination of the concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and IL-6 in BALF (by enzyme-linked immunosorbent assay) and lung tissues were obtained for microscopic examination of pathological changes which were scored and for determination of wet/dry lung weight ratio (W/D ratio) and expression of MCPIP-1 protein and mRNA (by Western blot and real-time polymerase chain reaction). Results:Compared with S group, the lung injury scores, W/D ratio, and concentrations of TNF-α, IL-1β and IL-6 in BALF were significantly increased in CLP group ( P<0.05), and no significant changes were found in the parameters mentioned above( P>0.05), and the expression of MCPIP-1 protein and mRNA in lung tissues was significantly up-regulated in M 1 and M 2 groups ( P<0.05), and no significant change was found in the expression of MCPIP-1 protein and mRNA in lung tissues in CLP group ( P>0.05). Compared with CLP group, the lung injury scores, W/D ratio, and concentrations of TNF-α, IL-1β and IL-6 in BALF were significantly decreased, and the expression of MCPIP-1 protein and mRNA in lung tissues was up-regulated in M 1-CLP and M 2-CLP groups ( P<0.05). Conclusions:MCPIP-1 exerts an endogenous protective mechanism during acute lung injury in septic rats.