Aortic dissection is one of the most devastating cardiovascular diseases. One of the most important pathological features of aortic dissection is local inflammatory response, including the infiltration of inflammatory cells, extracellular matrix degradation, and smooth muscle cell phenotype switch. Macrophages which are the core of the inflammatory response play an extremely pivotal role in the progression of inflammation and tissue remodeling. Macrophages can be artificially divided into M1 and M2 types, of which the M1-type promotes inflammation while the M2-type is associated with the regression of inflammation and tissue healing. Mastering the switch of phenotypic transformation of macrophages may be of great help in inhibiting the inflammation of aortic tissue and facilitating tissue healing, as well as the treatment of aortic dissection. In this paper, we focus on the polarization of macrophages and discuss the role of macrophages in aortic dissection, the polarization pathway and the effect of related polarizing agents on the treatment of aortic dissection.

Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.

Objective:To describe the epidemiological and clinical characteristics of patients with novel coronavirus (2019-nCoV) -infected pneumonia in Enshi, Hubei, and to improve the awareness of the disease, which is key for surveillance and control measures of 2019-nCoV pneumonia in the region.Methods:The first 66 laboratory-confirmed 2019-nCoV patients in Enshi between January 23, 2020 and February 1, 2020 were included. Their epidemiological data, demographic data, clinical data and therapeutic effect were retrospectively analyzed.Results:Among the first 66 patients with confirmed 2019-nCoV, patients had an average age of 46±9 years, 35 (53.0%) patients were male and 31 (47.0%) female; 38 (57.6%) patients were Han, 18 (27.3%) were Tujia, and 10 (15.1%) were Miao. Thirty-seven (56%) patients had chronic diseases such as coronary heart disease, chronic bronchus, inflammation, diabetes, hypertension, hypothyroidism, and rheumatoid arthritis. All the patients had a history of exposure or indirect exposure in Wuhan epidemic area, mainly history of Wuhan sojourner. The mean incubation period varied from 2.5-16 days, with the 95th percentile of the distribution at 7 days. The main clinical manifestation were fever [66 (100%) patients], dry cough [56 (84.8%)], chest tightness [21 (31.8%)], shortness of breath [8 (12.1%)], massive fatigue [23 (34.8%)], muscle ache [6 (9.1%)], headache [4 (6.1%)], sore throat [13 (19.7%) ], rhinorrhoea [11 (16.7%) ], and diarrhea [ 5 (7.6%)]. Six (9.1%) critically ill patients and 4 (6.1%) critically ill patients had dyspnea. White blood cell counts were normal or decreased in 51 (77.3%) patients, and increased in 15 (22.7%). Lymphocyte counts were reduced or normal in 58 (87.9%) patients, and increased in 8 (12.1%) patients. Most patients had elevated CRP and erythrocyte sedimentation, and some patients had normal ranges of liver function, renal function, and electrolytes. Ten severely ill patients had elevated liver enzymes and cardiac enzymes (especially K and CKMB). There were significant differences in inflammatory markers among patients of different nationalities. Arterial blood gas analysis in 56 (84.8%) mild patients showed no significant abnormalities. Chest CT scans of 66 patients showed single or multiple small patchy shadows and interstitial changes, which were evident in the extrapulmonary band. All patients were hospitalized and isolated for treatment. Of the 66 patients received oxygen therapy, most of them received antiviral therapy (abidol/Kaletra, 0.2 g po tid/2 pills po bid) and interferon (aerosol inhalation), few patient received antibacterial therapy (Tanreqing, 20 mL ivgtt qd) and glucocorticoid therapy (methylprednisolone, 40 mg ivgtt bid), and supplemented by traditional Chinese medicine treatment. Six (9.1%) severely ill patients and 4 (6.1%) critically ill patients treated with non-invasive or invasive ventilator.Conclusions:The patients in this study are all imported cases. Most patients have mild clinical symptoms. The lungs show single or multiple small patchy shadows and interstitial changes, which are obvious with extrapulmonary bands. Seek medical treatment as soon as possible, and the above-mentioned symptomatic treatment scheme is effective. The overall morbidity and mortality in this region are lower than those in other parts of the province, and the mortality and critical illness rate of ethnic minority patients are lower than those of Han patients. There are significant differences in inflammatory markers such as leukocytes and lymphocytes among patients of different nationalities.

Aortic dissection is a urgent and dangerous disease, and the endovascular treatments can cure it in an effective and efficient way. As an important indicator of aorta remodeling, false lumen thrombosis is related to the prognosis of aortic dissection after endovascular treatment. The relationships among false lumen thrombosis after endovascular treatment and prognosis of aortic dissection, and the clinical techniques that can promote the false lumen thrombosis are reviewed in this paper. The aim is to promote a comprehensive evaluation of aorta remodeling.

Objective: To understand the active screening of tuberculosis in schools in Guizhou province and analyze the results to provide reference for the prevention and control of tuberculosis in schools in Guizhou province. Methods: In 2017, the initiative screening and entrance examination were carried out among students in Guizhou in 2017, with "the provincial school tuberculosis screening questionnaire" issued by the provincial level.A total of 373 679 students(18.31%) from 290 schools(41.31%)were tested as strong positive by PPD test. Results: Rate of positive PPD skin test showed significant differences according to different types of school(χ2=679.62,P=0.00). the abnormal rate of X-ray chest had statistical significant difference between the students in boarding school or not(χ2=14.07,P=0.00), but had no statistical significant difference between the students in private schools and public schools(χ2=0.28,P=0.59). For the rate of suspicious symptom screening, statistical significant differences were found between the private schools and public schools(χ2=4.79,P=0.03) and boarding schools or not(χ2=23.47,P=0.00). PPD test screening was carried out among 166 691 students, 4 667 were tested as strong positive, 191 cases were found as tuberculosis (4.09%); X-ray chest X-ray screening of 104 024 people, abnormal chest radiograph of 298 people, 200 found that the number of tuberculosis cases, the detection rate was 67.11%. Symptom screening was carried out among 102 964 students, 2 272 had suspicious symptoms, 229 cases were pulmonary tuberculosis patients, the detection rate of 10.08%, three methods of screening for difference was statistically significant(χ2=262.44，P=0.00). Conclusion The school tuberculosis screening work in Guizhou province needs to be further improved, and the tuberculosis screening for college and boarding high school students should be strengthened to control the outbreak of school tuberculosis.

Abdominal aortic aneurysm (AAA) is a common lethal aortic disease in clinical practice. At present, the imaging diagnostic methods used for AAA mainly include Doppler ultrasound, computed tomography and magnetic resonance imaging (MRI), but these methods can only observe the morphological changes of the aorta. These techniques used for the risk assessment of aneurysms, such as aneurysm rupture have some certain limitations. With the continuous development of molecular imaging technology and the further understanding of the pathogenesis of AAA, positron emission tomography (PET), molecular MRI and single photon emission computed tomography (SPECT) techniques can be used to observe the pathological changes of the AAA and assess the risk of rupture from cell and molecular level. In this paper, the latest application of PET, molecular MRI, SPECT in the risk assessment was discussed.

Long noncoding RNA(IncRNA) represents a class of ＞200bp RNA genes that has no ability to code proteins.It was considered that IncRNA is "junk RNA" which have no function over the last couple of decades.However,an increasing number of studies have found that lncRNA play distinct biologic functions by particular mechanisms.Because the incidence rate and mortality rate of atherosclerosis is very high,people always pay a lot of attention on it.But lncRNA studies in atherosclerosis are just beginning.lncRNA may be a key target in the progression of atherosclerosis and may become a novel therapeutic target to prevent,diagnose and treat this disease.

Aortic dissection is a dangerous and critical disease with extremely high mortality and disability rate.In clinical practice,aortic dissection should be highly suspected when patients developed dying-like severe chest and back pain.CT and MRI have been the reliable tools for diagnosing aortic dissection.In recent years,endovascular therapy has become the preferred treatment for Stanford type B aortic dissection,and some patients with Stanford type A dissection who cannot receive open surgery may also be treated with endovascular therapy.In order to improve endovascular treatment,to develop new instruments and to study the pathogenesis of aortic dissection,the preparation of stable and reliable animal models is very necessary.This paper aims to make a brief review about the research status concerning the preparation of animal models of aortic dissection.

Objective To evaluate the application value of precise hepatectomy in primary liver cancer (liver cancer). Methods Clinical data of 60 patients with liver cancer undergoing hepatectomy in Zhongshan People's Hospital between January 2011 and December 2014 were retrospectively analyzed. According to the surgical procedures, all patients were divided into the precise hepatectomy group (precise group) and traditional hepatectomy group (traditional group). In the precise group, 30 patients were included, 18 males and 12 females, aged between 25 and 60 years with a median age of 45 years. In the traditional group, 30 patients were included, 20 males and 10 females, aged between 23 and 62 years with a median age of 46 years. The informed consents of all patients were obtained and the local ethical committee approval was received. In the precise group, selective hepatic blood inlfow occlusion was performed. The liver transection plane was determined according to the ischemic boundary and main branch of hepatic vein. The central venous pressure was controlled below 5 cmH2O (1 cmH2O=0.098 kPa). The liver tissues were separated by ultrasonic scalpel. The liver section planes were left without suture. In the traditional group, Pringle maneuver was performed to occlude the blood lfow of porta hepatis. The liver tissues were rapidly separated by vascular clamping. The liver section planes were sutured after surgery. The operation time, intraoperative hemorrhage volume, changes of liver function indexes at postoperative 7 d, postoperative length of hospital stay and postoperative complications were observed between two groups. Data of two groups were compared using t test and the ratio was compared using Chi-square test. Results Hepatectomy was successfully completed in all patients. The incisional margin was detected as negative after tumor resection. No patients died during perioperative period. In the precise group, the mean operation time was (302±47) min, signiifcantly longer compared with (209±30) min in the traditional group (t=4.016, P<0.05). In the precise group, intraoperative hemorrhage volume was (354±71) ml, significantly less than (598±109) ml in the traditional group (t=-2.376, P<0.05). In the precise group, the alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TB) at postoperative 7 d were (80±36) U/L, (61±18) U/L and (29±6)μmol/L, signiifcantly lower than (252±55) U/L, (233±62) U/L and (49±8)μmol/L in the traditional group (t=-2.173,-1.640 ,-2.240;P<0.05). In the precise group, postoperative length of hospital stay was (13±3) d, significantly shorter compared with (22±5) d in the traditional group (t=-2.045, P<0.05). The incidence of postoperative complications in the precise group was 7%(2/30), signiifcantly lower than 27%(8/30) in the traditional group (χ2=4.320, P<0.05). Conclusion Compared with traditional hepatectomy, precise hepatectomy has the advantages of less intraoperative hemorrhage, faster postoperative recovery of liver function, lower incidence of complications, faster postoperative recovery and shorter length of hospital stay.

Objective To investigate the therapeutic effect of early stage minimally invasive laparoscopic retroperitoneal approach of catheter drainage on early inflammatory response of severe acute pancreatitis ( SAP ) . Methods 37 SAP patients with peritoneal effusion were divided into the observation group (19 cases with early laparoscopic retroperitoneal approach of catheter drainage )and normal treatment group(18 cases with conventional drainage)using a random number table.All patients were given conventional therapy , such as fasting, gastroin-testinal decompression , anti-infection, fluid resuitation and using gastric acid and trypsin inhibitors .In addition to conventional therapy , the observation group received the early laparoscopic retroperitoneal approach of catheter drainage.The inflammatory indexes responding to acute inflammation such as TNF-α,IL-6,IL-8, IL-10 and C-re-active protein(CRP)were detected before and after treatment .Meanwhile, the date of resume diet, APACHEⅡscores and duration of systemic inflammatory response ( SIRS) , incidence of multiple organ dysfunction syndrome ( MODS) and the mortality were observed .Results The acute inflammatory response occurred in both groups . The plasma levels of TNF-a,IL-6,IL-8,IL-10 and CRP in the two groups decreased obviously after 3-day treat-ment.However, the plasma levels of inflammatory mediators in the normal treatment group increased while those early laparoscopic retroperitoneal approach of catheter drainage group kept decreasing after 7-day treatment .There was a significant difference between the two groups (P<0.01).Time for resuming to diets and duration of SIRS in the observation group were less than those in the normal treatment group ( P<0.01 ) , APACHEⅡscore were significantly less than those in normal treatment group also (P<0.01).The rates of MODS, overall postoperative complication rate and mortality were significantly lower in the observation group (P<0.05).Conclusions Early laparoscopic retroperitoneal approach of catheter drainage can effectively improve the prognosis in patients with SAP and decrease the production of inflammatory mediators .Early laparoscopic retroperitoneal approach of cathe-ter drainage is simple , feasible and micro-invasive with encouraging outcomes , therefore it is an effective and safe treatment option for patients with SAP .