Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneu-rysms and summarize the experience.Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 pa-tients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed.Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0(121.5,307.5)min.Intraoperative bleeding volume varied with-in 30-400 mL,with a median of 90(50,125)mL.The time of carotid artery blocking and vertebral artery bloc-king varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0(11.5,16.3)min and 25.0(15.0,22.5)min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage oc-curred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5(5.3,17.0)months.One patient with subclavian artery aneurysm developed artificial vessel oc-clusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery.Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.

Objective:To investigate soft-and hard-tissue changes after simultaneously labial and lingual augmented corticotomy in patients with insufficient alveolar bone thickness of lower anterior teeth both in labial and lingual side during orthodontic treatment.Methods:From January 2021 to June 2022, 10 patients [2 males and 8 females, (26.2±3.1) years old] who received orthodontic and orthognathic combined treatment from the Fourth Clinical Division, Peking University School and Hospital of Stomatology were selected. The alveolar bone thickness of lower anterior teeth both in labial and lingual side in these patients was less than 0.5 mm according to cone-beam CT examination before or during treatment, and 60 lower anterior teeth were included. The 10 patients were treated with simultaneously labial and lingual augmented corticotomy. The differences in gingival recession, papilla index and the differences in labial and lingual alveolar bone thickness of lower anterior teeth were compared.Results:Six months after surgery, the alveolar bone thicknesses at the 4 mm under cemento-enamel junction (CEJ), 8 mm under CEJ and at the apical level [labial side: (1.02±0.39), (2.22±0.89) and (4.87±1.35) mm; lingual side: (1.07±0.46), (2.31±1.04) and (3.91±1.29) mm] were significantly higher than that before surgery [labial side: (0.02±0.09), (0.06±0.21) and (2.71±1.33) mm]; lingual side: (0.14±0.29), (0.40±0.52) and (2.13±1.02) mm] ( P<0.001), respectively. The increases in alveolar bone thickness of central incisors [apical level on labial side: (2.53±1.20) mm, 8 mm under CEJ on lingual side: (2.27±1.24) mm, apical level on lingual side: (2.66±1.49) mm] and lateral incisors [apical level on labial side: (2.42±1.30) mm, 8 mm under CEJ on lingual side: (2.28±0.92) mm, apical level on lingual side: (1.94±1.15) mm] were significantly higher than that of canines [apical level on labial side: (1.52±1.47) mm, 8 mm under CEJ on lingual side: (1.17±1.09) mm,apical level on lingual side: (0.74±1.37) mm] ( P<0.01). There were no significant differences in the degree of gingival recession [labial side before surgery: (0.72±0.88) mm, lingual side before surgery: (0.80±1.09) mm; labial side 6 months after surgery: (0.72±0.81) mm,lingual side 6 months after surgery: (0.89±0.21) mm] and gingival papilla index [before surgery: 1.00(0.75, 2.00); 6 months after surgery: 1.00(1.00, 2.00) ] between pre-operation and 6 months after surgery ( P>0.05). No serious complications occurred. Conclusions:The method used in this article for simultaneously labial and lingual augmented corticotomy was safe and feasible. This surgery has positive clinical significance for the stability of the periodontal tissue in orthodontic treatment for patients with alveolar bone thickness less than 0.5 mm of lower anterior teeth both in labial and lingual side.

Objective:To evaluate the clinical effect of alveolar bone augmentation in teeth with severe periodontitis using orthodontic forced eruption.Methods:Twelve patients (5 males and 7 females) with severe periodontitis and malocclusion who visited the Department of Orthodontics and Department of Periodontology, Peking University School and Hospital of Stomatology from October 2018 to May 2022 were included in this retrospective study. The age was (38.8±6.6) years (24-49 years). A total of 16 maxillary incisors that could not be retained due to severe periodontitis were included. The orthodontic fixed appliance was used to extrude the teeth. Cone-beam CT (CBCT) images of the patients before and after orthodontic forced eruption were collected. The voxel-based registration was used to superpose the images before and after orthodontic forced eruption. The height, thickness, and apical alveolar bone area were measured on the sagittal plane. The alveolar bone volume before and after orthodontic forced eruption was measured using three-dimensional reconstruction technique, and the influencing factors related to the alveolar volume change were analyzed.Results:The results of this study showed that the eruption distance of the teeth was (2.37±0.82) mm, and the alveolar bone height increased by (1.11±0.79) and (0.98±0.79) mm ( t=3.73, P=0.010; t=4.85, P<0.001). The proximal and distal alveolar bone height increased by (1.10±0.78) and (0.86±1.08) mm, respectively ( t=5.59, P<0.001; t=3.18, P=0.006). The alveolar bone thickness decreased (0.30±0.31) mm ( t=-3.75, P=0.002) and alveolar bone area increased (6.84±5.86) mm 2 ( t=3.71, P<0.001). The alveolar bone volume increased (53±49) mm 3 ( t=4.38, P<0.001). The alveolar bone volume was moderately positively correlated with eruption distance, apical and mesial alveolar bone thickness ( r=0.55, P=0.028; r=0.63, P=0.008; r=0.67, P=0.005). Conclusions:Orthodontic forced eruption results in a favorable increase of the alveolar bone in the upper incisor that cannot be retained due to severe periodontitis, which provides better periodontal hard tissue conditions for subsequent dental implant.

OBJECTIVE To optimize the cladding process of volatile oil saturated and aqueous solution method of classic prescription Sanhua decoction. METHODS β-Cyclodextrin was used as the wrapping material, through Plackett-Burman combined with Box-Behnken design tests, the optimal packaging process of Sanhua decoction’s total volatile oil was screened. The clathrate was verified by microscopy, thin layer chromatography, and ultraviolet spectrophotometry, and the change of volatile composition before and after the envelope was determined by headspace-gas chromatography-mass spectrometry. RESULTS The best coating process of the total volatile oil of the classic prescription Sanhua decoction was as follows: speed 2 000 r·min-1, wrapping 1 h, feed-liquid ratio 1∶10, baling temperature 30 ℃, material ratio 1∶9. The comprehensive scores of the three validation experiments were 0.981 0, 0.999 9 and 0.963 4, and the average value was 0.981 4, which was 2.87% different from the predicted value of the model. CONCLUSION The saturated aqueous solution method is simple and stable, and the volatile components are basically unchanged before and after the encapsulation, which provides a reference for the development of Sanhua decoction and the research on the volatile oil in the classic recipe.

Objective:To summarize the clinical efficiency of paclitaxel drug coated balloon (DCB) in femoral popliteal artery disease.Methods:Retrospective analysis was made on 125 patients (141 limbs) admitted from Jun 2016 to Jul 2019 for femoral popliteal disease treated with DCB.Results:Median follow-up time was 19 months. The average lesion length was (138±78) mm, with an overall cumulative primary patency rate of 81.4% and 60.8% at 12 and 24 months postoperatively and f-TLR rates of 90.1% and 83.0%, respectively. In a total of 109 primary lesions, subgroup analysis showed that among the TASC C/D primary lesions, the primary patency rate was significantly lower in those with combined severe calcification and the f-TLR rate in those with popliteal involved lesions. TASC grade C/D lesions, severe calcified lesions were independent risk factors for patency, while hypertension was an independent protective factor.In-stent restenosis (ISR) target lesions involving the popliteal segment had a significantly worse prognosis than ISR of the superficial femoral artery.Conclusion:DCB in the treatment of lower femoral popliteal artery lesions can achieve a satisfactory medium-term patency outcome, while the efficacy for complex lesions still needs further improvement.

Objective:To examine the outcomes of surgical repair for patients with total subclavian artery occlusion.Methods:A retrospective analysis was performed on 67 patients with subclavian artery occlusion disease admitted at Ward 1 of Aortic and Vascular Surgery Center, Fuwai Hospital from January 2016 to July 2019. The age was, and There were 51 male patients and 16 females with an age of (61.7±8.2) years (range: 37 to 79 years). The t-test, Mann-Whitney U-test, χ 2 test, and Fisher's exact test were used to analyze the factors related to the technique success. The Kaplan-Meier curve was used to calculate the cumulative patency rate and plot the corresponding survival curves, and the Log-rank test was used for comparison. The length from the subclavian artery ostial to the occlusion area was used as a variable to plot the receiver operating characteristic curve, and the optimal cut-off value was determined by the Youden index. Results:Eighteen patients received open surgery. Forty-nine patients with subclavian artery occlusion accepted endovascular repair, of which 38 patients succeeded (31 cases on left side and 3 cases on right side). Fifteen patients failed with endovascular therapy, of which 10 cases received elective surgery and 5 cases received conservative therapy. The success rate of endovascular repair was 69.4%(34/49). Among them, the success rate of left subclavian artery occlusion was 81.6%(31/38), while the right side was 3/11. Patients with the length from the subclavian artery ostial to the occlusion area ≥6 mm were more likely to get success (23/34 vs. 4/15, χ 2=5.506, P=0.019). In the endo-group, one patient had hemorrhage in the left chest. In the open-group, one patient had lymphatic leakage. Follow-up period ranged from 3 to 46 months with a median of 22 months. The patency of endovascular repair group and the open surgery group was 92.6% and 90.8% at 12-month, while 82.9% and 84.3% at 24-month, respectively. The cumulative patency rates of smoking patients and non-smoking patients after endovascular treatment were 70.2% vs. 100% ( P=0.048) at 24-month. No independent prognosis factors were identified through the Cox proportional risk model which significantly affected postoperative patency rates for patients with subclavian artery occlusion. Conclusions:Part of patients with subclavian artery occlusion can be treated by endovascular therapy. The success rate of left subclavian artery occlusions is higher than right sides. The length from the subclavian artery ostial to the occlusion area affected the success rate of repair.

Objective:To examine the outcomes of surgical repair for patients with total subclavian artery occlusion.Methods:A retrospective analysis was performed on 67 patients with subclavian artery occlusion disease admitted at Ward 1 of Aortic and Vascular Surgery Center, Fuwai Hospital from January 2016 to July 2019. The age was, and There were 51 male patients and 16 females with an age of (61.7±8.2) years (range: 37 to 79 years). The t-test, Mann-Whitney U-test, χ 2 test, and Fisher's exact test were used to analyze the factors related to the technique success. The Kaplan-Meier curve was used to calculate the cumulative patency rate and plot the corresponding survival curves, and the Log-rank test was used for comparison. The length from the subclavian artery ostial to the occlusion area was used as a variable to plot the receiver operating characteristic curve, and the optimal cut-off value was determined by the Youden index. Results:Eighteen patients received open surgery. Forty-nine patients with subclavian artery occlusion accepted endovascular repair, of which 38 patients succeeded (31 cases on left side and 3 cases on right side). Fifteen patients failed with endovascular therapy, of which 10 cases received elective surgery and 5 cases received conservative therapy. The success rate of endovascular repair was 69.4%(34/49). Among them, the success rate of left subclavian artery occlusion was 81.6%(31/38), while the right side was 3/11. Patients with the length from the subclavian artery ostial to the occlusion area ≥6 mm were more likely to get success (23/34 vs. 4/15, χ 2=5.506, P=0.019). In the endo-group, one patient had hemorrhage in the left chest. In the open-group, one patient had lymphatic leakage. Follow-up period ranged from 3 to 46 months with a median of 22 months. The patency of endovascular repair group and the open surgery group was 92.6% and 90.8% at 12-month, while 82.9% and 84.3% at 24-month, respectively. The cumulative patency rates of smoking patients and non-smoking patients after endovascular treatment were 70.2% vs. 100% ( P=0.048) at 24-month. No independent prognosis factors were identified through the Cox proportional risk model which significantly affected postoperative patency rates for patients with subclavian artery occlusion. Conclusions:Part of patients with subclavian artery occlusion can be treated by endovascular therapy. The success rate of left subclavian artery occlusions is higher than right sides. The length from the subclavian artery ostial to the occlusion area affected the success rate of repair.

Objective To establish a human HepG2 cell growth model under the low oxygen environment induced by cobalt chloride in order to observe the impacts of human HepG2 cell proliferation,cellular cycles and apoptosis,namely cellular growth conditions,under the low oxygen environment induced by cobalt chloride with different concentrations and to study the HepG2 cell growth mechanism under the low oxygen environment induced by cobalt chloride.Methods The human HepG2 cells in the logarithmic phase were randomized grouping as control group and CoCl2 experimental group with different concentrations (50 μm/L,100 μm/L,150 μm/L and 200 μm/L).① HepG2 cell proliferation was tested by MTT assay to calculate cell's suppression rate and draw HepG2 cell growth inhibition curves.② The move ability of HepG2 cells was observed by scratch test.③ The cellular apoptosis and periodic changes were detected using the flow cytometer Annexin-V FITC/PI double-staining and PI single staining methods.④HepG2 cell's Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and Bcl-2 protein expression were detected by Western Blot.Results ① The test results obtained via MTT assay showed that CoCl2 suppressed the human HepG2 cell proliferation within a certain amount of time and concentration and presented a time-dose dependent relation.② Scratch damage trial suggested that the cobalt chloride suppressed the HepG2 cell migration and wound repair capacity and presented a concentration dependent relation.③ Flow cytometer' s test results revealed that the apoptosis rates (％) in control group and experimental group with different concentrations (50 μm/L,100 μm/L,150 μm/L and 200 μm/L) were 3.42,7.74,13.07,20.56,28.53 and 44.45 (P ＜0.05),respectively.The apoptosis rate of the experimental group was significantly increased compared with the control group,as well as showing a concentration dependency.The results of cellular cycles revealed that the cobalt chloride significantly suppressed the HepG2 cell's periodic changes along with increases of concentration,as well as blocked the cell cycle staying in phase G1,thereby suppressing cell proliferation.④Western Blot test:Compared with the control group,the Bcl-2 protein expression was significantly decreased in the experimental group after treatment of cobalt chloride with different concentrations.Conclusion Within a certain range,CoC12-indiuced low oxygen environment can suppress the human HepG2 cell proliferation and healing migration capacity,induce apoptosis and present a time-dose dependent relation.The mechanism is likely associated with decreases of Bcl-2 protein expression.

OBJECTIVETo explore the significance of multi-detector CT (MDCT) in differential diagnosis of papillary renal cell carcinoma and chromophobe renal cell carcinoma.

METHODSClinical data of forty-one cases of renal cancers confirmed pathologically were collected, including 21 cases of papillary renal cell carcinoma (PRCC) (14 type I, 7 type II) and 20 cases of chromophobe renal cell carcinoma (ChRCC). Their morphological and MDCT characteristics were retrospectively analyzed. Receiver operator characteristic curve (ROC) was used to analyze the value of MDCT in differential diagnosis of PRCC and ChRCC. Two senior radiologists analyzed the morphological and the dynamic enhancement characteristics of the images. The attenuation of the lesions and the adjacent renal parenchyma were measured. The morphological indexes were compared with chi-square test and the quantitative indexes were compared with independent sample T-test. Receiver operator characteristic curve (ROC) was used to analyze the sensitivity, specificity and accuracy of diagnosis of PRCC and ChRCC.

RESULTSAngioid enhancement and filled enhancement were more common in ChRCC than in PRCC, while delayed enhancement was more often seen in PRCC than in ChRCC. Calcification was more common in type I than type II PRCC. The enhancement value (ΔCT value) in corticomedullary phase was (29.08 ± 20.12) Hu for PRCC, significantly lower than the (48.29 ± 26.70) Hu for ChRCC (t = -2.611, P = 0.013). The ΔCT value of type I PRCC in corticomedullary phase was (26.36 ± 18.16) Hu, showing a significant difference from that of ChRCC (t = -2.666, P = 0.012). The lesion to kidney ratio (LKR) in corticomedullary phase was 0.44 ± 0.19 for PRCC and 0.58 ± 0.15 for ChRCC, with a significant difference between them (t = -2.587, P = 0.014). The LKR of type I PRCC in corticomedullary phase was 0.39 ± 0.15, showing a significant difference from that of ChRCC (t = -3.628, P = 0.001). The difference value (D-value) of the attenuation of lesion between corticomedullary and nephrographic phases was (-3.69 ± 8.90) Hu for PRCC and (8.39 ± 21.98) Hu for ChRCC, with a significant difference between them (t = -2.285, P = 0.031). The D-value of type I PRCC was (-4.55 ± 9.82) Hu, showing a significant difference from that of ChRCC (t = -2.323, P = 0.028). There was no significant difference between the ΔCT, LKR and D-value of the type II PRCC and ChRCC (P > 0.05 for all). The area under the curve (AUC) for ΔCT value, LKR value in corticomedullary phase, and D-value were 0.718, 0.751 and 0.668, respectively, and there were no significant differences among them (z values were 0.896, 0.683 and 0.559, respectively, and P values were 0.370, 0.495 and 0.576, respectively). Using 49.350 Hu as the cutoff value for ΔCT value in corticomedullary phase, resulted in a sensitivity, specificity and accuracy of 50.0%, 90.5% and 70.7%, respectively. Corresponding values were 65.0%, 81.0% and 73.2%, when using a cutoff value of 0.532 for LKR in corticomedullary phase, and were 60.0%, 76.2% and 68.3%, when using a D-value of 0.400 Hu.

CONCLUSIONSThe ΔCT value, LKR value in corticomedullary phase, and the D-value are all useful indexes for the differentiation of PRCC and ChRCC.

Area Under Curve ; Calcinosis ; Carcinoma, Renal Cell ; diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; Kidney Neoplasms ; diagnosis ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity

Children's portal hypertension is a hemodynamic abnormalities syndrome,it refers to children with portal vein pressure exceeds 5 mmHg,or portal vein,hepatic venous pressure gradient exceeds 10 mmHg.Etiology of portal hypertension of children:portal vein obstruction,congenital hepatic fibrosis,biliary atresia.Current treatment methods are:drug treatment,varicose vein ligation or sclerosis,surgical treatment.Although the incidence of children's portal hypertension is relatively low,it can cause various serious complications,such as ascites,gastric variceal bleeding,hepatic encephalopathy and so on.To increase awareness,improve the cure rate and reduce complications,the artical will review the children's portal hypertension etiology,pathogenesis,diagnosis,and treatment progress.