AIM: To investigate the potential inhibitory effect of pterostilbene on the endothelial-to-mesenchymal transition(EndMT)induced by high glucose conditions in human retinal microvascular endothelial cells(HRMECs).METHODS: The optimal concentration of pterostilbene for treating HRMECs was determined using the CCK-8 assay, with 12.5 and 25 μmol/L concentrations selected for subsequent experiments. Four experimental groups were established: control group, high glucose group, high glucose combined with 12.5 μmol/L pterostilbene treatment group, and high glucose combined with 25 μmol/L pterostilbene treatment group. The expression levels of HDAC7 and EndMT-associated markers were detected via Western blot analysis. Cell migration ability was assessed using Transwell migration assays and scratch wound healing tests, while vasculogenic capability was evaluated through tube formation assays.RESULTS: The CCK-8 assay revealed that pterostilbene at a concentration of 22.07 μmol/L inhibited 50% of cell viability in HRMECs. Western blot analysis demonstrated that compared with the control group, the expression levels of HDAC7, ZEB1, Vimentin, and Snail were significantly upregulated in HRMECs cultured in high glucose(all P<0.01), while the expressions of VE-cadherin and CD31 were significantly reduced(all P<0.01). Compared to the high glucose group, the treatment with 12.5 and 25 μmol/L pterostilbene significantly reduced the expression of HDAC7, ZEB1, Vimentin, and Snail under high glucose conditions(all P<0.01). Notably, 25 μmol/L pterostilbene enhanced the expression of VE-cadherin and CD31(all P<0.01). Scratch wound healing tests revealed that HRMECs treated with high glucose exhibited a significantly increased cell migration rate compared to the control group(P<0.05), while the application of 25 μmol/L pterostilbene significantly suppressed HRMECs migration under high glucose conditions(P<0.01). Transwell migration assays demonstrated that the cell migration rate in the high glucose group was significantly higher than that in the control group(P<0.01), with cell migration rate markedly reduced following treatment with both of 12.5 and 25 μmol/L pterostilbene(all P<0.01). The tube formation assay revealed that the ability of HRMECs to form tubular structures was significantly enhanced under high glucose conditions(P<0.01), and both 12.5 and 25 μmol/L of pterostilbene effectively inhibited this effect(all P<0.01).CONCLUSION: Pterostilbene can inhibit HDAC7 expression, suppress EndMT-mediated migration of HRMECs, and impair tube formation under high-glucose conditions.

AIM: To investigate the potential inhibitory effect of pterostilbene on the endothelial-to-mesenchymal transition(EndMT)induced by high glucose conditions in human retinal microvascular endothelial cells(HRMECs).METHODS: The optimal concentration of pterostilbene for treating HRMECs was determined using the CCK-8 assay, with 12.5 and 25 μmol/L concentrations selected for subsequent experiments. Four experimental groups were established: control group, high glucose group, high glucose combined with 12.5 μmol/L pterostilbene treatment group, and high glucose combined with 25 μmol/L pterostilbene treatment group. The expression levels of HDAC7 and EndMT-associated markers were detected via Western blot analysis. Cell migration ability was assessed using Transwell migration assays and scratch wound healing tests, while vasculogenic capability was evaluated through tube formation assays.RESULTS: The CCK-8 assay revealed that pterostilbene at a concentration of 22.07 μmol/L inhibited 50% of cell viability in HRMECs. Western blot analysis demonstrated that compared with the control group, the expression levels of HDAC7, ZEB1, Vimentin, and Snail were significantly upregulated in HRMECs cultured in high glucose(all P<0.01), while the expressions of VE-cadherin and CD31 were significantly reduced(all P<0.01). Compared to the high glucose group, the treatment with 12.5 and 25 μmol/L pterostilbene significantly reduced the expression of HDAC7, ZEB1, Vimentin, and Snail under high glucose conditions(all P<0.01). Notably, 25 μmol/L pterostilbene enhanced the expression of VE-cadherin and CD31(all P<0.01). Scratch wound healing tests revealed that HRMECs treated with high glucose exhibited a significantly increased cell migration rate compared to the control group(P<0.05), while the application of 25 μmol/L pterostilbene significantly suppressed HRMECs migration under high glucose conditions(P<0.01). Transwell migration assays demonstrated that the cell migration rate in the high glucose group was significantly higher than that in the control group(P<0.01), with cell migration rate markedly reduced following treatment with both of 12.5 and 25 μmol/L pterostilbene(all P<0.01). The tube formation assay revealed that the ability of HRMECs to form tubular structures was significantly enhanced under high glucose conditions(P<0.01), and both 12.5 and 25 μmol/L of pterostilbene effectively inhibited this effect(all P<0.01).CONCLUSION: Pterostilbene can inhibit HDAC7 expression, suppress EndMT-mediated migration of HRMECs, and impair tube formation under high-glucose conditions.

Humans ; Cohort Studies ; Body Mass Index ; Percutaneous Coronary Intervention ; Coronary Artery Disease ; Inflammation ; Treatment Outcome ; Risk Factors

Objective:To analyze the effective and safety of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA) at one tertiary center, and to improve the outcomes of RAAA under fast-track protocol.Methods:Nineteen cases of RAAA in the 940th Hospital of Joint Logistic Support Force of PLA from January 2014 to December 2020 were reviewed retrospectively. EVAR-fist strategy was employed from the emergency room to the operating room by using fast-track protocol. Preoperative management, anatomic characteristics, choice of anesthesia, operative procedures and postoperative complications were collected and analyzed. Abdominal compartment syndrome (ACS) and hospital mortality were paid special attention.Results:Nineteen cases were undergone EVAR procedures. The age was (73.4 ± 7.4) years old, and the AAA size was (67.8 ± 13.6) mm. Two cases underwent cardiopulmonary resuscitation at emergency department. General anesthesia was used in 13 patients and local anaesthesia in 6 patients. Successful stent graft deployment was achieved in all cases. The duration from emergency room to operating room was (84.8 ± 22.4) min. The hospital stay time was (9.7 ± 5.7) d. The hospital mortality was 5/19. The 5 deaths were reviewed: 3 died for multiple organ failure, 1 for irreversible shock, and 1 for ongoing bleeding.Conclusions:Excellent results were confirmed by using EVAR-first strategy for RAAA. The management of hemodynamically unstable state, standardized endovascular procedure, fast-track program and multidiscipline team collaboration were the very important determining factors for the implementation of EVAR. Focused efforts to reduce RAAA mortality are warranted.

Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.

Objective:To explore the feasibility and safety of the prophylactic optic canal decompression in frontol-orbital fibrous dysplasia surgery by three-dimensional simulation design and computer assisted navigation.Methods:A retrospected study was conducted in Huashan Hospital affiliated to Fudan University.Patients with stable fronto-orbital fibrous dysplasia were recruited from January 2016 to June 2020. Preoperatively, three-dimensional simulation design was used to design the scope of resection. Then a subtotal resection of fibrous dysplasia lesion was performed by computer assisted navigation and reshaping of the orbit rim was achieved by preserving the fronto-orbital bandeau. Meanwhile, the intracanal and intraorbital parts of optic nerve canal decompression was performed. Follow-up of the pre-op and post-op difference of the frontal bulge point, the lateral forehead point and orbitofrontal point of the affected side, the degree of proptosis, visual acuity and fundus were analyzed by paired t test. Results:A total of 7 patients were recruited, including 2 males and 5 females, with an average age of 22.5 years. The average follow-up time was 11.4 months, and the difference in exophthalmos between the two sides improved from an average of (6.7±1.6) mm before operation to an average of(2.9±1.1) mm at 6 months after operation, which was statistically significant ( P<0.001). The difference between the pre-op and post-op of the frontal bulge point on the affected side also improved from (18.1±3.4) mm before surgery to (3.1±3.5)mm( P=0.001) immediately after surgery and (4.0±3.6) mm( P=0.001)at 6 months after surgery. The difference of lateral forehead point improved from(21.4±4.1) mm before surgery to (1.8±1.9) mm( P<0.001) immediately after surgery and (2.5±2.1) mm( P<0.001) at 6 months after surgery, and the difference of orbitofrontal point improved from(12.2±2.5) mm before surgery to (2.3±3.0) m( P=0.004) immediately after surgery and (2.7±2.9) mm( P=0.006) at 6 months after surgery. The average uncorrected visual acuity of the affected side before operation was 4.5, and it was 4.6 6 months after operation, with no statistical difference( P>0.05). Conclusions:Using 3D simulation to design the scope of resection and computer assisted navigation to decompress the optic canal in patients with stable fronto-orbital fibrous dysplasia, which can safely and effectively protect the optic nerve and accurately improve the frontal-orbital shape.

Objective:To explore the feasibility and safety of the prophylactic optic canal decompression in frontol-orbital fibrous dysplasia surgery by three-dimensional simulation design and computer assisted navigation.Methods:A retrospected study was conducted in Huashan Hospital affiliated to Fudan University.Patients with stable fronto-orbital fibrous dysplasia were recruited from January 2016 to June 2020. Preoperatively, three-dimensional simulation design was used to design the scope of resection. Then a subtotal resection of fibrous dysplasia lesion was performed by computer assisted navigation and reshaping of the orbit rim was achieved by preserving the fronto-orbital bandeau. Meanwhile, the intracanal and intraorbital parts of optic nerve canal decompression was performed. Follow-up of the pre-op and post-op difference of the frontal bulge point, the lateral forehead point and orbitofrontal point of the affected side, the degree of proptosis, visual acuity and fundus were analyzed by paired t test. Results:A total of 7 patients were recruited, including 2 males and 5 females, with an average age of 22.5 years. The average follow-up time was 11.4 months, and the difference in exophthalmos between the two sides improved from an average of (6.7±1.6) mm before operation to an average of(2.9±1.1) mm at 6 months after operation, which was statistically significant ( P<0.001). The difference between the pre-op and post-op of the frontal bulge point on the affected side also improved from (18.1±3.4) mm before surgery to (3.1±3.5)mm( P=0.001) immediately after surgery and (4.0±3.6) mm( P=0.001)at 6 months after surgery. The difference of lateral forehead point improved from(21.4±4.1) mm before surgery to (1.8±1.9) mm( P<0.001) immediately after surgery and (2.5±2.1) mm( P<0.001) at 6 months after surgery, and the difference of orbitofrontal point improved from(12.2±2.5) mm before surgery to (2.3±3.0) m( P=0.004) immediately after surgery and (2.7±2.9) mm( P=0.006) at 6 months after surgery. The average uncorrected visual acuity of the affected side before operation was 4.5, and it was 4.6 6 months after operation, with no statistical difference( P>0.05). Conclusions:Using 3D simulation to design the scope of resection and computer assisted navigation to decompress the optic canal in patients with stable fronto-orbital fibrous dysplasia, which can safely and effectively protect the optic nerve and accurately improve the frontal-orbital shape.

With the dramatically increasing detection rate of ground-glass nodules (GGN), exact understanding and treatment strategy of them has become the hottest issue currently. More and more studies have begun to explore the underlying mechanisms of their indolent characteristics and favorable prognosis from the perspectives of molecular evolution and immune microenvironment. GGN has different dominating gene mutations at different evolutional stages. The pure GGN has a lower tumor mutation burden and genomic instability, while a gradually evolutionary feature of genomic mutation along with the pathological progression can be observed. GGN has less infiltration of immune cells, and they are under the pressure of immune surveillance with weakened immune escape. With the increase of solid components, an inhibitory immune microenvironment is gradually established and immune escape is gradually enhanced, leading to rapid tumor growth. Further exploration of the molecular characteristics of GGN will help to more precisely distinguish these highly heterogeneous lesions, which could be helpful to make personalized treatment plans.

With the dramatically increasing detection rate of ground-glass nodules (GGN), exact understanding and treatment strategy of them has become the hottest issue currently. More and more studies have begun to explore the underlying mechanisms of their indolent characteristics and favorable prognosis from the perspectives of molecular evolution and immune microenvironment. GGN has different dominating gene mutations at different evolutional stages. The pure GGN has a lower tumor mutation burden and genomic instability, while a gradually evolutionary feature of genomic mutation along with the pathological progression can be observed. GGN has less infiltration of immune cells, and they are under the pressure of immune surveillance with weakened immune escape. With the increase of solid components, an inhibitory immune microenvironment is gradually established and immune escape is gradually enhanced, leading to rapid tumor growth. Further exploration of the molecular characteristics of GGN will help to more precisely distinguish these highly heterogeneous lesions, which could be helpful to make personalized treatment plans.

Objective:To explore the feasibility and safety of the prophylactic optic canal decompression in frontol-orbital fibrous dysplasia surgery by three-dimensional simulation design and computer assisted navigation.Methods:A retrospected study was conducted in Huashan Hospital affiliated to Fudan University.Patients with stable fronto-orbital fibrous dysplasia were recruited from January 2016 to June 2020. Preoperatively, three-dimensional simulation design was used to design the scope of resection. Then a subtotal resection of fibrous dysplasia lesion was performed by computer assisted navigation and reshaping of the orbit rim was achieved by preserving the fronto-orbital bandeau. Meanwhile, the intracanal and intraorbital parts of optic nerve canal decompression was performed. Follow-up of the pre-op and post-op difference of the frontal bulge point, the lateral forehead point and orbitofrontal point of the affected side, the degree of proptosis, visual acuity and fundus were analyzed by paired t test. Results:A total of 7 patients were recruited, including 2 males and 5 females, with an average age of 22.5 years. The average follow-up time was 11.4 months, and the difference in exophthalmos between the two sides improved from an average of (6.7±1.6) mm before operation to an average of(2.9±1.1) mm at 6 months after operation, which was statistically significant ( P<0.001). The difference between the pre-op and post-op of the frontal bulge point on the affected side also improved from (18.1±3.4) mm before surgery to (3.1±3.5)mm( P=0.001) immediately after surgery and (4.0±3.6) mm( P=0.001)at 6 months after surgery. The difference of lateral forehead point improved from(21.4±4.1) mm before surgery to (1.8±1.9) mm( P<0.001) immediately after surgery and (2.5±2.1) mm( P<0.001) at 6 months after surgery, and the difference of orbitofrontal point improved from(12.2±2.5) mm before surgery to (2.3±3.0) m( P=0.004) immediately after surgery and (2.7±2.9) mm( P=0.006) at 6 months after surgery. The average uncorrected visual acuity of the affected side before operation was 4.5, and it was 4.6 6 months after operation, with no statistical difference( P>0.05). Conclusions:Using 3D simulation to design the scope of resection and computer assisted navigation to decompress the optic canal in patients with stable fronto-orbital fibrous dysplasia, which can safely and effectively protect the optic nerve and accurately improve the frontal-orbital shape.