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.

Marine fungi are important members of the marine microbiome, which have been paid growing attention by scientists in recent years. The secondary metabolites of marine fungi have been reported to contain rich and diverse compounds with novel structures (Chen et al., 2019). Aspergillus terreus, the higher level marine fungus of the Aspergillus genus (family of Trichocomaceae, order of Eurotiales, class of Eurotiomycetes, phylum of Ascomycota), is widely distributed in both sea and land. In our previous study, the coral-derived A. terreus strain C23-3 exhibited potential in producing other biologically active (with antioxidant, acetylcholinesterase inhibition, and anti-inflammatory activity) compounds like arylbutyrolactones, territrems, and isoflavones, and high sensitivity to the chemical regulation of secondary metabolism (Yang et al., 2019, 2020; Nie et al., 2020; Ma et al., 2021). Moreover, we have isolated two different benzaldehydes, including a benzaldehyde with a novel structure, from A. terreus C23-3 which was derived from Pectinia paeonia of Xuwen, Zhanjiang City, Guangdong Province, China.
Acetylcholinesterase/metabolism* ; Animals ; Anthozoa/microbiology* ; Anti-Inflammatory Agents/pharmacology* ; Aspergillus/chemistry* ; Benzaldehydes/pharmacology* ; Mice ; RAW 264.7 Cells ; Signal Transduction

Objective:To study the application effect of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply.Methods:The clinical data of 14 patients undergoing carotid-subclavian artery blood vessel prosthesis bypass grafting to reconstruct cerebral blood supply in the Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University from March 2019 to March 2022 was retrospective collected. And the surgical indications, clinical effect and complications were analyzed.Results:There were 12 males and 2 females, aged from 47 to 74 years, with an average age of 60.5 years. Of 14 patients, 2 patients suffered from common carotid artery stenosis with posterior dilatation, 12 patients suffered from subclavian artery occlusion with vertebral artery steal. All the procedures were successfully performed without intraoperative cerebral infarction, cardiovascular accident, lymphatic leakage or artificial vascular infection. Phrenic nerve injury occurred in 1 patient after operation. During the follow-up of 3-27 months, average 14 months, there were no artificial vascular stenosis, anastomotic stenosis, vertebral artery steal, new cerebral infarction, upper limb ischemia or cerebral ischemia.Conclusion:Carotid-subclavian artery blood vessel prosthesis bypass grafting can be used in reconstructing the blood supply of both the anterior circulation, and the posterior circulation safely and effectively.

Objective:To establish a scoring system based on lumbar magnetic resonance imaging (MRI) images to evaluate bone mineral density and evaluate its correlation with T score of dual energy X-ray absorptiometry (DEXA).Methods:The clinical data of 82 patients with lumbar degenerative diseases who were admitted to the Clinical Medical College of Yangzhou University from January 2019 to August 2020 were analyzed retrospectively. According to the lower value of T value of femoral neck and total hip bone mineral density detected by DEXA, they were divided into normal bone mass group ( n=40) and abnormal bone mass group ( n=42). The vertebral body bone mass (VBQ) score of the patient was calculated by dividing the average signal intensity of L 1-4 vertebral body by the signal intensity of L 3 level cerebrospinal fluid on T 1 weighted image of MRI. The receiver operating characteristic (ROC) curve was drawn to evaluate the ability of VBQ score to distinguish between normal bone mass and abnormal bone mass and the accuracy of predicting the occurrence of abnormal bone mass. Further, the correlation between VBQ score and T value was determined by regression analysis. Results:The lowest T value measured by DEXA in the abnormal bone mass group were significantly lower than those in the normal bone mass group, and the VBQ score was significantly higher than that in the normal bone mass group(all P<0.001). The area under curve (AUC) of VBQ score for predicting abnormal bone mass was 0.93, the cut-off value was 2.98, with sensitivity 81.6%, and specificity 88.6%. The VBQ score was corrected with the lowest T value measured by DEXA ( r=-0.77). Conclusions:VBQ score could effectively distinguish normal bone mass from abnormal bone mass and was negatively correlated with the lowest T value of DEXA.

The robotic bronchoscopy system is a new technology for lung lesion location, biopsy and interventional therapy. Its safety and effectiveness have been clinically proven. Based on many advanced technologies carried by the robotic bronchoscopy system, it is more intelligent, convenient and stable when clinicians perform bronchoscopy operations. It has higher accuracy and diagnostic rates, and less complications than bronchoscopy with the assistance of magnetic navigation and ordinary bronchoscopy. This article gave a review of the progress of robotic bronchoscopy systems, and a prospect of the combination with artificial intelligence.

Objective    To investigate the safety and efficiency of robotic lung segmentectomy. Methods    The clinical data of 110 patients receiving robotic or thoracoscopic segmentectomy in our hospital between June 2015 and June 2019 were retrospectively analyzed. The patients were divided into a robotic group [n=50, 13 males and 37 females aged 53.0 (46.0, 60.0) years] and a thoracoscopic group [n=60, 21 males and 39 females aged 61.0 (53.0, 67.0) years]. A propensity score-matched analysis was adopted to compare the perioperative data between the two groups. Results    After the propensity score-matched analysis, 34 patients were included in each group. In comparison with the thoracoscopic group, patients in the robotic group had less blood loss [40.0 (20.0, 50.0) mL vs. 60.0 (40.0, 80.0) mL, P<0.001], more stations of lymph node dissection [7.0 (6.0, 8.0) vs. 4.0 (3.0, 6.0), P<0.001], larger number of lymph node dissection [15.0 (11.0, 21.0) vs. 10.0 (6.0, 14.0), P=0.002], and a higher total cost of hospitalization [97.0 (92.0, 103.0) thousand yuan vs. 54.0 (42.0, 59.0) thousand yuan, P<0.001]. Conclusion    In contrast with the thoracoscopic segmentectomy, robotic segmentectomy has a similar operative safety, but less blood loss and a thorough lymphadenectomy.

In this review, development and application of the minimally invasive esophagectomy(MIE) for esophageal cancer are discussed including the types of MIE procedures, short- and long- term outcome after MIE; as well the future of MIE is forecasted. Main procedures of MIE performed currently include esophagectomy via thoracoscopy and laparoscopy and cervical esophagogastrosty, Ivor-Lewis MIE via thoracoscopy and laparoscopy, and hiatal MIE. Ivor-Lewis MIE gradually becomes a standard surgical option for the cancer of distal esophagus or esophagogastric junction while the solution of intrathoracic anastomosis via thoracoscopy has achieved. Several methods of intrathoracic anastomosis are reported such as hand-sewn, circular stapler, side-to-side and triangular anastomosis. MIE could decrease operative blood loss, shorten hospital stay and ICU stay, reduce postoperative especially pulmonary complications, and harvest more lymph nodes compared to open esophagectomy. The long-term survival has been proved similar with that after open esophagectomy for esophageal cancer. MIE has developed rapidly in recent years with some aspects in future prospectively: individual MIE treatment and quality of life, fast track after surgery, and robot-assisted MIE, as well the endoscopic submucosal dissection for esophageal cancer is mentioned.

Objective To evaluate the clinical outcomes of K-line(-) ossification of posterior longitudinal ligament (OPLL) between single open-door posterior decompression with instrumented in situ fusion(PDF) and laminoplasty (LMP).Methods From February 2008 to February 2015,38 cases including 30 males and 8 females underwent posterior decompression due to K-line(-) OPLL in our institution.The age ranged from 48 to 76 years,mean 56.3±9.7 years.The OPLL canal occupation ratio ranged from 38.6％ to 72.5％,mean 58.1％± 13.6％.According to surgical procedures,26 cases were in PDF group and 12 cases were in LMP group.The data collected from both groups included complications,C2-C7 Cobb angle and neurologic symptoms evaluated based on the Japanese Orthopedic Association (JOA) score and JOA score recovery rate,and were analyzed with statistics in and between groups.Results All the patients were completed follow up with a mean of 3.6±2.1 years (range,2.5 to 7.0 months).At the final follow-up,the postoperative JOA score was 11.8± 1.9 points on average,improved from preoperative 7.7± 1.6 points (t=3.757,P＜0.05),the mean JOA score recovery rate was 44.2±6.7％in PDF group;and the postoperative JOA score was 9.1 ±2.1 points,improved from preoperative 7.9± 1.5 points (t=1.327,P＜0.05),the mean JOA score recovery rate was 29.5±5.0％ in LMP group.No significant difference was found in preoperative JOA score between the two groups (t=0.365,P＞0.05),however,there were significant differences in the postoperative JOA score (t=3.941,P＜0.05) and JOA score recovery rate (t=6.741,P＜0.05) at the final follow-up.In PDF group,the C2-C7 Cobb angle was 4.1±2.0°,similar with preoperative 3.8±1.6° (t=0.587,P＞0.05).On the contrary,the C2-C7 Cobb angle was-2.1°±1.8°,lower than preoperative 3.9°±1.2° (t=6.824,P＜0.05) in LMP group.Ten cases occurred C5 palsy (PDF:7;LMP:3),and 3 cases occurred wound infection (PDF:2;LMP:1).The complication rate was 34.6％ and 33.3％ (x2=0.003,P＞0.05),respectively.Conclusion Compared with LMP,PDF without correcting cervical alignment for patients with K-line(-) OPLL showed better neurological recovery and clinical efficacy.

Objective To assess the effect of statin therapy on serum inflammatory cytokines in patients with abdominal aortic aneurysm (AAA).Methods The clinical data of 126 AAA patients who were hospitalized in the Department of Vascular Surgery,Peking Union Medical College Hospital,from September 2014 to September 2017 were retrospectively analyzed.Patients were divided into treatment group and control group according to whether statins were used or not.The levels of serum lipids and serum inflammatory factors were compared between these two groups.Results There was no significant difference in gender,age,body height,body weight,smoking ratio,and AAA diameter between these two groups (all P ＞ 0.05).While the levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were not significantly different before treatment (all P ＞ 0.05),the treatment group had significantly lower TC (t =2.868,P =0.009),TG (t =3.472,P =0.006),and LDL-C (t =3.924,P =0.005) and significantly higher HDL-C level (t =3.322,P =0.007) after treatment.In addition,the concentrations of interleukin (IL)-1β,IL-6,high-sensitivity C-reactive protein (hs-CRP),and tumor necrosis factor-α (TNF-α) were not significantly different between these two groups before treatment (all P ＞0.05);after treatment,the serum levels of IL-1β and IL-6 in the treatment group were (224.32 ± 78.54) and (116.49 ± 19.64) ng/L,respectively,which were lower than those in the control group [(254.68 ±96.77)ng/L (t=1.765,P=0.058) and (126.71 ±23.59) ng/L (t=1.692,P=0.063)],although the differences were not statistically significant.The serum levels of hs-CRP and TNF-α in the treatment group were (6.46 ± 1.24) mg/L and (0.77 ± 0.21) μg/L,respectively,which were significantly lower than those in the control group [(10.93 ± 4.18) mg/L (t =2.007,P =0.012) and (1.28 ± 0.49) μg/L (t =2.144,P =0.016)].Conclusion Statin treatment reduces the levels of hs-CRP and TNF-α in AAA patients.

Objective:To evaluate the feasibility and therapeutic efficacy of transhepatic arterial embolization with superparamagnetic iron oxide (SPIO) and lipiodol (LIP) for the treatment of VX2 tumor in rabbits.Methods:Twenty-four rabbits with hepatic VX2 tumors by surgical implantation were randomly divided into 4 groups and treated with transhepatic arterial embolization of 4 different agents as follows (n=6 each):doxorubicin (DOX) group,DOX-LIP group,SPIO-DOX group,and SPIO-DOX-LIP group.Liver function (AST and ALT) was measured at 0,1,3,5 and 7 d after transhepatic arterial embolization.The serum DOX level was measured at 0,5,15,30,60,and 120 minutes after transhepatic arterial embolization.MRI was performed at 7 d after the treatment to assess the distribution of SPIO in the SPIO-DOX group and SPIO-DOX-LIP group,while CT was performed to assess the distribution of LIP in the DOX-LIP group and SPIO-DOX-LIP group.All the rabbits were sacrificed and their livers were removed at 7 d after treatment for the detection of tissue DOX level.The histopathologic examinations were performed including HE staining,Prussian blue staining and TUNEL assay,and then the tumor necrosis percentage and apoptosis index were calculated.Results:Compared to the DOX group,the levels of AST and ALT in other 3 groups were significantly elevated at 1 and 3 d after embolization (P＜0.05).The levels of ALT and AST in the DOX group,DOX-LIP group or SPIO-DOX-LIP group returned to the baseline at day 7,there were no significant differences (P＞0.05).The SPIO-DOX-LIP group exhibited the lowest serum DOX level at all time points up to 120 minutes after embolization (P＜0.05).However,the tissue DOX level in the SPIO-DOX-LIP group was the highest among all groups at day 7 (P＜0.05).The SPIO-DOX group and SPIO-DOX-LIP group showed significantly lower MRI signal intensity of tumors in T2 weighted imaging (T2WI) at day 7.Meanwhile DOX-LIP group and SPIO-DOX-LIP group showed that high-density lipiodol was deposited in the tumors in CT images.Histopathologic findings showed an almost complete central necrosis coagulation of tumors in the SPIO-DOX-LIP group,and the tumor necrosis percentage and tumor apoptosis index were significantly increased in the SPIO-DOX-LIP group compared to those in other 3 groups (P＜0.05).Conclusion:This novel drug-delivery system of SPIO nano-drug carrier together with LIP is safe and feasible when it is used for transhepatic arterial embolization for liver tumor.It provides an excellent MR and CT visualization and improves the therapeutic efficacy for the treatment of rabbit VX2 liver tumor.