Humans ; Ulcer ; Brucellosis/complications* ; Aorta, Abdominal

Humans ; Ulcer ; Brucellosis/complications* ; Aorta, Abdominal

OBJECTIVE: To analyze the effect of local unstable atherosclerotic plaque on plaque formation in the carotid and aortic arteries of rabbits. METHODS: Thirty New Zealand white rabbits were randomly divided into atherosclerosis model group, highfat diet feeding group, and normal chow feeding group (blank control group). In the model group, carotid artery balloon injury was induced after 4 weeks of high-fat diet feeding. Eight weeks later, all the rabbits were euthanized for histopathological examination of the carotid artery and abdominal aorta, and the mean intimal thickness and plaque to lumen area ratio were measured using image analysis software. Venous blood samples were collected from the rabbits for blood lipid analysis. RESULT: At the ends of 4, 8 and 12 weeks, the rabbits in the model group and high-fat feeding group, but not those in the blank control group, all showed significant weight gain compared with their body weight at 0 week (P < 0.05). The mean intimal thickness was significantly greater in atherosclerosis model group than in the other two groups (P < 0.05). In atherosclerosis model group, the mean intimal thickness and plaque to lumen area ratio in the injured carotid artery were significantly greater than those in the contralateral carotid artery and abdominal aorta (P < 0.05). At the end of the 12 weeks, the levels of triglyceride (TG), total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C) and highsensitivity C-reactive protein (CRP) were all significantly higher in the model group and high-fat feeding group than in the blank control group (P < 0.05); the levels of TG, TC, LDL-C, or HDL-C did not differ significantly between the model group and high-fat feeding group (P>0.05), but the level of CRP was significantly higher in arteriosclerosis model group (P < 0.05). CONCLUSION Local unstable atherosclerotic plaque can increase the level of CRP and promote the formation of atherosclerotic plaques in the carotid artery and abdominal aorta in rabbits.
Rabbits ; Animals ; Plaque, Atherosclerotic ; Aorta, Abdominal ; Cholesterol, LDL ; Atherosclerosis ; Carotid Arteries

It has been found that the incidence of cardiovascular disease in patients with lower limb amputation is significantly higher than that in normal individuals, but the relationship between lower limb amputation and the episodes of cardiovascular disease has not been studied from the perspective of hemodynamics. In this paper, numerical simulation was used to study the effects of amputation on aortic hemodynamics by changing peripheral impedance and capacitance. The final results showed that after amputation, the aortic blood pressure increased, the time averaged wall shear stress of the infrarenal abdominal aorta decreased and the oscillatory shear index of the left and right sides was asymmetrically distributed, while the time averaged wall shear stress of the iliac artery decreased and the oscillatory shear index increased. The changes above were more significant with the increase of amputation level, which will result in a higher incidence of atherosclerosis and abdominal aortic aneurysm. These findings preliminarily revealed the influence of lower limb amputation on the occurrence of cardiovascular diseases, and provided theoretical guidance for the design of rehabilitation training and the optimization of cardiovascular diseases treatment.
Amputation ; Aorta, Abdominal/surgery* ; Aortic Aneurysm, Abdominal/surgery* ; Blood Flow Velocity/physiology* ; Hemodynamics/physiology* ; Humans ; Lower Extremity ; Models, Cardiovascular ; Stress, Mechanical

OBJECTIVES: Placenta accreta spectrum disorders (PAS) refers to a group of abnormalities in placental adhesion and invasion, which may lead to serious complications such as intractable postpartum hemorrhage. The use of low-level extra-abdominal aortic temporary block during cesarean section may reduce intraoperative bleeding in patients with PAS, but it may also cause ischemia-reperfusion injury. In this study, we intend to investigate the efficacy of low extra-abdominal aortic block in cesarean section for placental implantation disease and its effect on malondialdehyde (MDA) level and superoxide dismutase (SOD) activity, and analyze the severity of ischemia-reperfusion injury caused by them. METHODS: Pregnant women with invasive placenta accreta spectrum disorders who delivered in the Department of Obstetrics and Gynecology of the Third Xiangya Hospital of Central South University from July 2017 to July 2021, were selected, and they were divided into 2 groups. Group A consisted of those who underwent low extra-abdominal aortic block during cesarean section (n=15) and group B consisted of those who did not undergo extra-abdominal aortic block (n=15). The intraoperative bleeding, blood transfusion, hysterectomy and complication rate, postoperative hospital stay and hospitalization expenses were compared between the 2 groups to analyze the efficacy of abdominal aortic block. The biochemical indexes related to ischemia-reperfusion, MDA content and total superoxide dismutase (T-SOD) activity, were measured at the corresponding time points in both groups. The time points of each test were: in group A, before the block of the low extra-abdominal aorta after delivery (A0), 0 h (A1, when the myometrium was started to be sutured), 0.5 h (A2), 2 h (A3), and 4 h (A4) after the open block; in group B, after delivery of the fetus (B0), 0 h (B1), 0.5 h (B2), 2 h (B3), and 4 h (B4) after the myometrium was started to be sutured. Total duration of abdominal aortic block in group A was also recorded. Both groups were observed for sings of edema, ischemia, necrosis and infection in the limbs after surgery. The severity of ischemia-reperfusion injury caused by abdominal aortic block were determined by detecting the relevant biochemical indexes at different moments of reperfusion. RESULTS: The intraoperative bleeding and blood transfusion in group A were less than those in group B, and the difference was statistically significant (P<0.05). There was no significant difference in postoperative hospital stay and hospitalization expenses between the 2 groups (P>0.05). Surgical complications: in group A, the uterus was preserved in all cases, there was 1 bladder injury and 2 pelvic infections; while in group B, there was 1 hysterectomy, 3 bladder injuries, and 3 pelvic infections. Changes in T-SOD and MDA values: compared with A0 before block, the MDA level was significantly elevated in blood at time points A1, A2, and A3, while SOD activity was significantly decreased (P<0.05), and the 2 observed indexes basically returned to A1 level (ischemic period) at 4 h after open block (A4). There was no significant difference in the changes of T-SOD and MDA in group B (P>0.05). Comparison of T-SOD and MDA levels between group A and B: the difference of the 2 indexes was not statistically significant between A0 and B0 (P>0.05), MDA level was not statistically significant between A1 and B1, T-SOD activity at A1 was lower than B1, the difference was statistically significant, at the rest of the same time point, MDA level in group A were higher than that in group B, T-SOD activity in group A were lower than that in group B, the difference was statistically significant (P<0.05). No postoperative limb edema, ischemia, necrosis, or infection occurred in both groups. CONCLUSIONS Low-level extra-abdominal aortic block effectively reduces bleeding and transfusion during cesarean section for placenta accreta spectrum disorders, resulting in a transient MDA elevation and a decrease of SOD activity, which means causing transient ischemia-reperfusion injury without complications such as limb edema, ischemia, necrosis, and infection.
Aorta, Abdominal/surgery* ; Cesarean Section ; Female ; Humans ; Ischemia ; Necrosis ; Pelvic Infection ; Placenta/metabolism* ; Placenta Accreta/surgery* ; Pregnancy ; Reperfusion Injury ; Superoxide Dismutase/metabolism*

Humans ; Aortic Aneurysm, Abdominal ; Aorta, Abdominal/pathology* ; Immunity, Innate

Objective: To examine the short and medium term effect of branch-first technique in total thoracic aorta replacement. Methods: The clinical data of eleven patients with ascending aortic aneurysms or type A aortic dissection+Crawford Ⅰ or Ⅱ total thoracoabdominal aortic aneurysm who were treated at Department of Cardiovascular Surgery in Henan Province Chest Hospital from January 2018 to July 2021 were retrospectively analyzed. There were 7 males and 4 females, aging (38±5) years (range: 28 to 45 years), 7 cases of whom were diagnosed with Marfan syndrome, 1 case was diagnosed with coarctation of aorta. Operations were performed under mild hypothermic and branch-first technique. Firstly, the middle and small incision in the chest was combined with the 6th intercostal incision in the left posterior lateral side. Secondly, four branches artificial blood vessels were anastomosed with the brachiocephalic artery to ensure the blood supply to the brain. After the circulation was blocked, intracardiac and aortic proximal operations were performed. Intercostal artery reconstruction and thoracic descending aorta replacement were completed after opening circulation. Results: The operative time of this group was (645.9±91.7) minutes (range: 505 to 840 minutes). One case had cerebral infarction and 1 case had chylothorax. The patients were followed up 4 to 47 months, 1 patient underwent thoracic and abdominal aorta+iliac artery resection and replacement due to the progression of abdominal aortic aneurysm 3 months after operation. Intercostal artery obstruction occurred in 2 cases, and the rest lived well. Conclusions: One-stage whole thoracic aorta replacement with branch-first technique has satisfactory results in the short and medium term, with no risk of residual aortic aneurysm rupture. It is an effective treatment for young and organs function well patients with complex aortic lesions.
Male ; Female ; Humans ; Aorta, Thoracic/surgery* ; Retrospective Studies ; Aortic Aneurysm, Thoracic/surgery* ; Aortic Dissection/surgery* ; Aorta, Abdominal/surgery* ; Blood Vessel Prosthesis Implantation

Type A aortic dissection (AD) is a critical and severe disease with high mortality. The Sun's operation is a standard surgical method for this kind of disease at present. For the procedure, an elephant trunk stent is inserted into the true lumen of the descending aorta and the aortic arch is replaced. A patient was admitted to the First Hospital of Lanzhou University due to sudden chest and back pain for 6 days. Computed tomography angiography (CTA) showed type A AD. Ascending aorta replacement, Sun's operation, and ascending aorta to right femoral artery bypass grafting were performed. After surgery, the patient's condition was worsened. The digital subtraction angiography (DSA) showed the elephant trunk stent was inserted into the false lumen of AD, leading to the occlusion of the large blood vessel at the distal part of the abdominal aorta and below. Although we performed intima puncture and endovascular aortic repair, the patient was still dead.
Aneurysm, Dissecting/surgery* ; Aorta, Abdominal ; Aorta, Thoracic/surgery* ; Blood Vessel Prosthesis Implantation/adverse effects* ; Humans ; Stents/adverse effects* ; Treatment Outcome

Abdominal aortic aneurysm(AAA)is a common aortic degenerative disease in the elderly,and its incidence is gradually increasing with the aging of the population.There are no specific drugs available to delay the expansion of AAA.Once the aneurysm ruptures,the mortality will exceed 90%,which seriously threatens the life of patients.Given the high incidence of AAA in the elderly,this review discusses the role of vascular aging in the pathogenesis of AAA,involving chronic inflammation,oxidative stress,mitochondrial dysfunction,protein homeostasis imbalance,increased apoptosis and necrosis,extracellular matrix remodeling,nutritional sensing disorders,epigenetic changes,and increased pro-aging factors.Meanwhile,several potential aging-related drug targets of AAA are listed.This review provides new ideas for basic and translational medical research of AAA.
Aged ; Aging ; Animals ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal/drug therapy* ; Disease Models, Animal ; Humans ; Muscle, Smooth, Vascular/metabolism* ; Oxidative Stress

Aneurysm, Dissecting ; Aorta ; Aortic Aneurysm, Abdominal ; Aortic Aneurysm, Thoracic ; Blood Vessel Prosthesis Implantation ; Humans ; Marfan Syndrome