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To evaluate the safety and efficacy of covered stents for treatment of visceral artery aneurysms (VAA).This multicenter retrospective study included patients with VAAs who were treated with covered stents between January 2015 and December 2020. A total of 65 patients (mean age, 58 years; range, 27-89 years) with 70 VAAs (60 true aneurysms [86%], 10 pseudoaneurysms [14%]) were included. Of the 65, 48 patients (74%) were asymptomatic. Patient demographics, endovascular treatments, and follow-up results were analyzed.All patients received covered stents. The mean diameter was 2.9 cm (range, 1.0-7.6 cm) for symptomatic aneurysms and 2.5 cm (range, 1.0-9.0 cm) for asymptomatic aneurysms. Of the asymptomatic aneurysms, 89% had a saccular shape. The mean distance between the ostium of the artery in which the aneurysm occurred and the aneurysm was 3.9 cm (median, 3.0 cm; range, 0.5-10 cm). Additional coil embolization was used in 7 aneurysms (10%). During the procedure, 68 (97%) aneurysms were completely excluded, while 2 (3%) had a Type Ib endoleak. After a mean follow-up of 20 months (range, 1-75 months), all patients were asymptomatic. Four endoleaks were recorded and left for close observation. Four stents (7%) had mild restenosis, while the rest of the stents were patent.Placement of covered stents in patients with VAAs excluded aneurysms and maintained artery patency.

Surface defect inspection is a key step to ensure the quality of the hot rolled steel surface. However, current advanced detection methods have high precision but low detection speed, which hinders the application of the detector in actual production. In this work, a real-time detection network (RDN) focusing on both speed and accuracy is proposed to solve the problem of steel surface defect detection. RDN takes ResNet-dcn, a modular encoding and decoding network with light weights, as the basic convolutional architecture whose backbone is pre-trained on ImageNet. To improve the detection accuracy, a skip layer connection module (SCM) and a pyramid feature fusion module (PFM) are involved into RDN. On the standard dataset NEU-DET, the proposed method can achieve the state-of-the-art recognition speed of 64 frames per second(FPS) and the mean average precision of 80.0% on a single GPU, which fully meets the requirements of the detection accuracy and speed in the actual production line.

In this paper, the optical trapping of multiple particles based on a rotationally-symmetric power-exponent-phase vortex beam (RSPEPVB) was introduced and demonstrated. Based on the theories of tight focusing and optical force, the optical force model of RSPEPVB was established to analyze the optical trapping force of tightly focused RSPEPVB. Then, an experimental setup of optical tweezer, by utilizing the RSPEPVB, was built to demonstrate that the optical tweezer of RSPEPVBs can achieve the optical trapping of multiple particles, and the number of captured particles is equal to the topological charge l of RSPEPVB, which shows that the RSPEPVBs can achieve multi-particles trapping with controllable number. Moreover, compared to vortex beam, the captured particles by RSPEPVB will not rotate around the circular light intensity distribution. The results will provide a new option for optical trapping of multiple particles in biomedicine, laser cooling and so on.

Background To evaluate the quality of in vitro fenestrations during in situ fenestration (ISF) and investigate the differences between needle and laser puncture in current stent-grafts. Methods An in vitro study evaluated the damage created by needle ISF on stent-graft fabrics versus laser ISF. Fenestrations were made in 5 different commercially available stent-grafts, including polyester stent-grafts (Relay, Valiant and Hercules) and expanded polytetrafluoroethylene (ePTFE) stent-grafts (TAG and Ankura). Each stent-graft received fenestration by needle and laser separately, followed by gradual dilation (4 mm, 6 mm, 8 mm, and 10 mm sequentially) of noncompliant balloons. Quantitative and qualitative evaluations including fenestration diameter, area, shape and margins were conducted using light microscopy and scanning electron microscope. Results The primary fenestrations created by needle were slit-like with visible cut-off fibers in polyester stent-grafts and were almost circular with clear margins in ePTFE stent-grafts; those created by laser were squared or elliptical with ragged edges and burned fibers in all the stent-grafts. Fabric debris and toxic particles due to burning of the material were generated during laser-assisted fenestration. The Primary holes in polyester stent-grafts (Relay, Valiant and Hercules) by needle showed smaller area (0.05 mm2 vs. 0.22 mm2, 0.52 mm2 vs. 0.70 mm2 and 0.28 mm2 vs. 0.46 mm2; P 0.05). Ankura stent-graft showed the largest holes with best quality than the others. Conclusions The primary fenestrations were different between needle and laser puncture, laser induced fabric debris and toxic particles release should be cautiously considered. The final fenestrations were similar after gradual balloon dilation.

Numerous studies have revealed that hyperglycemia is a pivotal driver of diabetic vascular complications. However, the mechanisms of hyperglycemia-induced endothelial dysfunction in diabetes remain incompletely understood. This study aims to expound on the underlying mechanism of the endothelial dysfunction induced by hyperglycemia from the perspective of long non-coding RNAs (lncRNA). In this study, a downregulation of SNHG15 was observed in the ischemic hind limb of diabetic mice and high glucose (HG)-treated HUVECs. Functionally, the overexpression of SNHG15 promoted cell proliferation, migration, and tube formation, and suppressed cell apoptosis in HG-treated HUVECs. Mechanistically, SNHG15 reduced thioredoxin-interacting protein (TXNIP) expression by enhancing ITCH-mediated ubiquitination of TXNIP. TXNIP overexpression abrogated the protective effect of lncRNA SNHG15 overexpression on HG-induced endothelial dysfunction. The following experiment further confirmed that SNHG15 overexpression promoted angiogenesis of the ischemic hind limb in diabetic mice. In conclusion, SNHG15 is a novel protector for hyperglycemia-induced endothelial dysfunction via decreasing TXNIP expression.

Vascular endothelial dysfunction is associated with the progress of many diseases. Circular RNAs (circRNAs) take part in the dysfunction of vascular endothelium. CircRNA hsa_circ_0008360 (circ_0008360) is dysregulated in high glucose-treated vascular endothelium, while the role and mechanism of circ_0008360 in high glucose-induced dysfunction remain unknown. Human umbilical vascular endothelium cells (HUVEC) were stimulated via high glucose. The abundances of circ_0008360, miR-186-5p and cyclin D2 (CCND2) were examined via quantitative real-time polymerase chain reaction or western blot. Vascular endothelial dysfunction was assessed via cell viability, apoptosis, migration and tube formation. The target relationship between miR-186-5p and circ_0008360 or CCND2 was analyzed via dual-luciferase reporter, RNA pull-down and RNA immunoprecipitation analyses. Circ_0008360 expression was enhanced in high-glucose-treated HUVEC. Circ_0008360 silence mitigated high glucose-induced suppression of viability, migration, tube formation, and increase in apoptosis in HUVEC. MiR-186-5p was sponged by circ_0008360, and miR-186-5p inhibition reversed the effect of circ_0008360 silence on high glucose-induced vascular endothelial dysfunction. MiR-186-5p alleviated high glucose-induced vascular endothelial dysfunction via targeting CCND2. CCND2 interference abolished the aggravated effect of circ_0008360 on high glucose-induced vascular endothelial dysfunction. Circ_0008360 knockdown attenuated high glucose-induced vascular endothelial dysfunction via regulating miR-186-5p and CCND2, indicating circ_0008360 might act as a target for the treatment of vascular endothelial dysfunction.Abbreviations: circRNAs, circular RNAs; HUVEC, human umbilical vascular endothelium cells; CCND2, cyclin D2; XPNPEP3, X-prolyl aminopeptidase 3; ceRNAs, competing endogenous RNAs; miRNAs, microRNAs; qRT-PCR, quantitative real-time polymerase chain reaction; RIP, RNA immunoprecipitation; HIF-1α, hypoxia inducible factor 1 alpha; TLR3, toll-like receptor 3; AKAP12, A-Kinase Anchoring Protein 12; ox-LDL, oxidized low-density lipoprotein; HG, high glucose; NG, normal glucose.

The metal additive manufacturing (AM) industry is actively developing instruments and strategies to enable higher productivity, optimal build quality, and controllable as-built microstructure. One of the beam controlling techniques, laser oscillation has shown potential in all these aspects in laser welding; however, few attempts have been made to understand the underling physics of the oscillating keyholes/melt pools which are the prerequisites for the these strategies to become a useful tool for laser-based AM processes. To address this gap, we utilized a synchrotron-based X-ray operando technique to image the dynamic keyhole oscillation in Ti-6Al-4V using a miniature laser powder bed fusion setup. We found good agreement between the experimental observations and simulations performed with a validated Lattice Boltzmann multi-physics model. The study revealed the continuous and periodic fluctuations in the characteristic keyhole parameters that are unique to the oscillating laser beam processing and responsible for the chevron pattern formation at solidification. Despite the intrinsic longer-range fluctuation, the oscillating technique displayed potential for reducing keyhole instability, mitigating porosity formation, and altering surface topology. The results provide important insights about the dynamics of the oscillating keyholes which are valuable guidelines for the future development and application of this technique.

An additively-manufactured molten salt (MS) to supercritical carbon dioxide (sCO2) compact primary heat exchanger (PHE) for solar thermal power generation is presented in this paper. The PHE is designed to handle temperatures up to 720 °C on the MS side and an internal pressure of 200 bar on the sCO2 side. Within the core of the PHE, MS flows through a three-dimensional periodic lattice network, while sCO2 flows within pin arrays. The PHE design includes integrated sCO2 headers located within the MS flow, allowing for a counter flow design of the PHE. The dimensions of the internal features of the core section are determined through finite element simulations and the headers are configured in a way that optimizes the flow distribution in each sCO2 plate and minimizes obstruction of the MS side. The overall design of the heat exchanger allows AM scalability both horizontally and vertically due to an integrated header architecture. Details of structural and thermofluidic design are presented. An experimentally-validated, correlation-based sectional PHE core model is developed to study the impact of flow and geometrical parameters on the PHE performance, with varied parameters including the mass flow rate of sCO2 and MS sides, the channels width, and the PHE overall height, width, and length. The model results show that a heat exchanger with a power density of 18.6 MW/m3 (including sCO2 header volume) and effectiveness of 0.88 can be designed achievable at a Cr ratio of 0.8.

Porosity is one of the most significant obstacles to widescale adoption of additive manufacturing since it acts as a stress concentrator that negatively impacts mechanical properties. Suboptimal process parameters and entrapped gas content in powder feedstock are two factors that can induce porosity in additively manufactured parts. This study utilizes laser diffraction, optical and scanning electron microscopy, and micro-x-ray computed tomography to study how four powders with varied entrapped gas concentrations and gas atomization environments create parts with different densities. Process maps of the four 17-4 PH stainless steel powders used in the EOS M 290 laser powder bed fusion machine, were developed. Furthermore, this paper also discusses how process parameters interact with the powder-entrapped gas porosity to influence the in-part porosity and the Charpy toughness of the as-built components.

Objective: To report demographics and clinical, laboratory, and imaging features of acute renal infarction (ARI) due to symptomatic isolated spontaneous renal artery dissection (SISRAD) and to analyze outcomes after the initial therapy for SISRAD. Methods: Thirteen patients with ARI due to SISRAD between January 2016 and March 2021 were enrolled in this retrospective study. We reviewed the demographics, clinical, laboratory, and imaging features (location of the infarct kidney, the branch artery involved by dissection, true lumen stenosis, false lumen thrombosis, and aneurysm), treatment modalities, and follow-up results; analyzed the difference between SISRAD and other causes of ARI; and propose an appropriate therapy strategy for SISRAD based on our data and literature. Result: Patients with ARI due to SISRAD were mostly young men (43 [24–53] years; 12/13 [92%]). No patients had atrial fibrillation or acute kidney injury at admission (0/13). All 13 patients received conservative treatment as the initial treatment. Sixty-two percent (8/13) of patients progressed, and 88% (7/8) of them had dissection aneurysm on the admission computed tomographic angiography (CTA) image. Seventy-five percent (6/8) of patients underwent endovascular intervention as follows, stent placement in 1 patient, renal artery embolization in 1, and stent placement with embolization in 4. Two patients with disease progression died: 1 during the conservative treatment period and 1 after the stent placement. Thirty-eight percent (5/13) of patients in remission continued to receive conservative treatment, none of whom had dissection aneurysm on the admission CTA. Conclusion: Symptomatic isolated spontaneous renal artery dissection is a rare and fatal disease. For young ARI patients with no previous history of tumors and cardiogenic diseases, CTA examination is recommended to exclude SISRAD. Dissection aneurysm seems to be a risk of progression for SISRAD in this series. Conservative treatment, a recognized initial treatment, has a good effect on patients without dissection aneurysm, and we recommend endovascular intervention as the initial treatment for the patient with dissection aneurysm at admission. Multicenter clinical studies are needed to explore a more-appropriate treatment for patients with SISRAD. Clinical Impact This article report the related factors, risks, demographics and laboratory data of Acute renal infarction (ARI) due to Symptomatic isolated spontaneous renal artery dissection (SISRAD) and explore a better initial therapy strategy for SISRAD. It will help improve the effectiveness of SISRAD treatment and reduce the mortality rate from this rare but lethal disease.

Fuzzy C-means clustering algorithm (FCM) is an effective approach for clustering. However, in most existing FCM type frameworks, only in-cluster compactness is taken into account, whereas the between-cluster separability is overlooked. In this paper, to enhance the clustering, by incorporating the feature weighting and data weighting method, we put forward a new weighted fuzzy C-means clustering approach considering between-cluster separability, in which for achieving good compactness and separability, making the in-cluster distances as small as possible and making the between-cluster distances as large as possible, the in-cluster distances and between-cluster distances are taken into account; To achieve the optimal clustering result, the iterative formulas of the feature weights, membership degrees, data weights and cluster centers are obtained by maximizing the in-cluster compactness and the between-cluster separability. Experiments on real-world datasets were carried out, the results showed that the new approach could obtain promising performance.

Powder-entrapped gas, which can occur naturally in gas-atomized powder, can induce porosity in parts fabricated with powder-based metal additive manufacturing processes. This study utilized synchrotron-based x-ray computed tomography and an in situ high-speed imaging technique, dynamic x-ray radiography (DXR), to investigate the formation of powder-induced porosity using 17-4 PH stainless steel powders with a controlled size distribution and intentionally varied entrapped gas contents. While powder with a low entrapped gas content showed no net part porosity increase, the results showed a strong correlation between the porosity in the powder and the porosity in the builds made from powder with a high entrapped gas content relative to typical gas-atomized powder. A threshold value was developed to classify porosity induced by powder-entrapped gas based on pore morphology measured using computed tomography. Transfer and coalescence of pores during laser melting was observed directly with DXR.

Although additive manufacturing (AM) is becoming increasingly popular for various applications, few studies have addressed design and potential problems in thin wall fabrication for the laser powder bed fusion (LPBF) process. In the LPBF process, rapid cooling induces thermal shrinkage, which in turn, results in high residual stress and complicates thin wall fabrication. The minimum wall thickness is limited by the parameters and machine settings while the dimensional accuracy is controlled by the powder size, scan strategy, and part geometry. The ability to fabricate thin-wall components is important for applications such as heat exchangers (HX). This study explores the performance of the LPBF process by fabricating thin walls with extreme geometries in different processing conditions and alloys using an EOS M290 LPBF machine. Results show that the material, part design, and scanning strategy contribute to the variation in thin wall dimensions. A maximum inclination angle of 60° and a minimum wall thickness of ~ 100 μm in Ti-6Al-4V, Inconel 718, and AlSi10Mg were achieved using optimized part design and processing conditions. The effects of part design and material on the thermal distortion and surface finish of thin walls were also investigated leading to a discussion on how the scan mode assigned by the EOS software affects design and fabrication. Additionally, synchrotron-based X-ray micro-tomography (μSXCT) was utilized to quantify the porosity in thin-wall structures and to correlate it with the integrity of the structures. Comprehensive design guidelines presented in this work can increase the success rate of fabricating thin-wall geometries.

Purpose: To compare characteristics of acute, subacute, and chronic type B aortic dissection and their influence on long-term results of thoracic endovascular aortic repair (TEVAR). Materials and Methods: In a single-center, retrospective cohort study, 314 patients (median age 52 years; 244 men) with acute (n=165), subacute (n=115), or chronic (n=34) type B aortic dissection underwent TEVAR between January 2009 and December 2013. Patient demographics, risk factors, and imaging characteristics were compared among the groups. Univariable and multivariable Cox regression analyses were performed to identify any factors influencing survival. Results: The acute and subacute patients exhibited more complications at presentation than chronic patients. However, the chronic patients exhibited more aneurysmal dilatation (p52 years, visceral malperfusion, and RTAD as independent factors influencing overall survival; aneurysmal dilatation, rupture/impending rupture, and RTAD were independent factors influencing aorta-specific survival. Conclusion: Acute and subacute patients had increased risks of rupture and complications at presentation, whereas chronic patients had increased risks for aneurysmal dilatation. From a long-term perspective, the subacute phase might be an optimal time for TEVAR in cases of type B aortic dissection that do not need emergent interventions. The risk factors influencing survival should be identified, carefully managed, and possibly prevented.

Predicting traffic speed accurately is a very challenging task of the intelligent traffic system (ITS), due to the complex and dynamic spatial-temporal dependencies from both temporal and spatial aspects. There not only exits short-term local neighboring fluctuation and long-term global trend in temporal aspect, but also local and global correlations in spatial aspect. Most existing work focus on the local spatial-temporal dependencies, ignoring the global dynamic spatial-temporal corrections, which is comparably critical for traffic speed prediction. To address this problem, we propose a novel D ynamic G lobal- L ocal S patial- T emporal N etwork(DGLSTNet) for traffic speed prediction, which consists of multiple spatial-temporal module considering the local and global information simultaneously from both temporal and spatial perspective. Each temporal module applies stacked dilated convolution block to exploit multi-scale local temporal information. Moreover, we empoly a global temporal attention block to capture global dependencies of temporal domain in an attention mechanism. In each spatial module, we not only learn the local but also focus on dynamic global spatial information learned by dymamic graph learning block. Combining the feature results from local and global perspective, the capability and expressiveness of traffic predicting model is improved. Experiment results on two real-world traffic datasets have demonstrated that our proposed model can effectively capture the comprehensive spatial-temporal dependencies and can achieve state-of-the-art prediction performance compared with the existing works.

One of the most encountered obstacles for utilizing nano-sized vehicles to implement the in vivo delivery of nucleic acid drugs (NADs) is the possible steric hindrance caused by their intrinsic size and charge. In this work, we added Ca2+ for the pH triggered self-assembly process of H-apoferritin (HFn), to neutralize negative charges and help siRNA condense during complexation and particle formation. As expected, the internalization efficiency of siRNA in HFn particle formation could be enhanced 1.65-fold, compared with that without incorporated Ca2+. Furthermore, the calcification that occurred within the cavity of HFn particles endows them with endosomal escape capability, which could explain their contribution to the demonstrated in vitro and in vivo gene silencing effect achieved by the internalized siRNA. Thus, this Ca2+ participating self-assembly process of a protein nanostructure would lead to advanced internalization efficiency for NAD therapy.

IntroductionFemoropopliteal artery in-stent restenosis (FP-ISR) represents one of the main obstacles for stent implantation in peripheral artery disease patients, especially Tosaka III FP-ISR, which is also referred to as in-stent occlusion. Diverse endovascular treatments of Tosaka III FP-ISR are available, and the results are unequivocal. However, real-world data are limited. This study aims to evaluate the efficacy, safety and health economics evaluation of various endovascular procedures in the treatment of Tosaka III FP-ISR.Method and analysisThis study is a prospective, multicentre, real-world, observational clinical study. Patients diagnosed with Tosaka III FP-ISR and treated with endovascular procedures in nine centres from 1 April 2021 to 31 December 2022 will be recruited. The relevant clinical information, Ankle-Brachial Index and CT angiography will be collected. All the participants will undergo follow-up at 1, 6, 12, 18 and 24 months after the operation. The primary outcome is freedom from clinically driven target lesion revascularisation at 24 months. Safety and health economics issues will also be reported.Ethics and disseminationThe FP-RESTORE clinical trial has been registered at ClinicalTrials.gov (http://clinicaltrials.gov/). This study was also approved by the Institutional Review Board and Human Research Ethics Committee of Zhongshan Hospital, Fudan University (approval number: B2021-427). Moreover, written informed consent will be obtained at the time of recruitment. The study outcomes will be disseminated by publication in a peer-reviewed journal to provide information for further clinical practice.Trial registration numberNCT04801004.

ObjectiveThis study aimed to investigate the characteristics and predictors of aortic remodeling over a long-term follow-up period after thoracic endovascular aortic repair (TEVAR) for acute, subacute, and chronic type B aortic dissections (TBADs).MethodsPatients who underwent TEVAR for TBAD from July 2011 to December 2013 were included, and relevant data were retrospectively analyzed.ResultsAfter TEVAR, the true lumen (TL) dimension increased and the false lumen (FL) dimension decreased or did not change over a 5-year follow-up period in all three temporal groups. Shrinkage proportion of the thoracic aorta was the highest in the subacute group (acute, 28.1%; subacute, 39.1%; and chronic, 17.4%; p = 0.048), while abdominal expansion showed no significant differences among the groups (acute, 29.6%; subacute, 40.5%; and chronic, 44.4%; p = 0.502). The chronic group had a rate of complete FL regression, which is lower than the subacute or acute group at all anatomic sections, with significant differences only in the stented section (chronic, 21.7%; acute, 92.2%; and subacute, 80.4%; p < 0.05) and in the distal thoracic aortic section (chronic, 13.0%; acute, 31.1%; and subacute, 50.0%; p < 0.05). Logistic regression analysis demonstrated that chronic dissection, TL compression, endoleak, the number of branches from FL, and the number of residual tears affected optimal FL remodeling.ConclusionThe present study provides data on aortic remodeling of TBAD after TEVAR during a long-term follow-up period. The features and risk factors of aortic remodeling in the acute, subacute, and chronic phases are different in different aortic segments. These findings may have implications in the timing of TEVAR.

Spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) occurs when a tear in the inner layer of the superior mesenteric artery (SMA) allows blood to flow between the layers of the SMA, forcing the layers apart, and creating two lumens. Abdominal pain is the most prevalent clinical manifestation. Other people may have no symptoms or experience nausea, vomiting, diarrhea, or blood in their stools. For people with SIDSMA who are not suspected of intestinal necrosis or intra-abdominal bleeding, medical treatment and endovascular therapy are the main treatment options. There is no consensus on the optimum first-line management strategy.To evaluate the benefits and harms of endovascular therapy versus medical treatment for spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).We used standard, extensive Cochrane search methods. The latest search date was 3 August 2021.We planned to include all randomized controlled trials (RCTs) which compared endovascular therapy and medical treatments for SIDSMA. We planned to exclude studies where participants were treated with open surgery.We used standard Cochrane methods. Our primary outcomes were endovascular intervention rate and recurrent abdominal pain. Our secondary outcomes were open surgery rate, remodeling rate of SMA, new aneurysm formation of SMA, SMA occlusion, new dissection of SMA, death, symptom relief rate and complications of endovascular therapy. We planned to use GRADE to assess certainty of evidence for each outcome.We did not identify any RCTs to include in any analysis.We were not able to include any RCTs that compared endovascular therapy versus medical treatment in people with SIDSMA. High-quality RCTs that evaluate the benefits and harms of these interventions are needed to help determine the optimal strategy for managing SIDSMA.

Generally, definite intestine targeting and immediate drug releasing are both important for the treatment of colon cancer via oral administration of anti-cancer drugs. We developed a highly specific oral colon-targeted pulsatile capsule, based on the effective enzyme-responsive ‘pulse plug’, which can be degraded under mannanase abundant in colon. Indomethacin (IN) solid dispersion immediate-release pellets were filled in an insoluble capsule body, a guar gum-lactose-hydroxypropyl methylcellulose (HPMC) composed tablet was embedded on the top of capsule as the ‘pulse plug’, and then covered by enteric soluble cap. In this study, the influence of the proportion of guar gum/lactose/HPMC, the viscosity of HPMC, and the tablet weight on the degradation behaviour of the plug tablet was investigated. The drug-releasing profiles of those pulsatile capsules in different simulated colon medium verified the ‘pulse plug’ could realise the colon-targeted pulsatile drug-releasing. Furthermore, the rabbit pharmacokinetic experiments showed that the in vivo time lag of drug loaded pulsatile capsules was significantly extended to 5.61 ± 0.08 h (p®). These results indicated that colon-targeted pulsatile capsules would be effective oral delivering system for colon cancers therapy.

Objectives Endovascular treatment (EVT) is an alternative method to treat spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). Although its short-term results are promising, few mid-term results have been reported. This study reports the five year follow up of EVT for SIDSMA. Methods A total of 128 consecutive patients with SIDSMA admitted to the study hospital between 2011 and 2016 were enrolled in this retrospective study. Their demographic information, clinical findings, EVT outcomes, and follow up results were analysed. Results Conservative treatment and pre-operative preparation were given immediately after admission, then digital subtraction angiography was performed. Stents were deployed in 112 out of 128 patients. The 16 patients who did not receive stents then continued conservative treatment. Peri-procedural complications occurred in three patients, including one death and two pseudoaneurysms at puncture sites. Mean follow up was 29.7 months (range 6–60 months) in patients with stents and 31.4 months (range 14–45 months) in patients without stents. During follow up, the overall complete remodelling rate in the stent group was 88.3%. Most took place within three months of stenting. The cumulative primary stent patency rate was 99.1%, and the cumulative event free survival rate was 99.0%, 95.8%, and 95.8% at one, three, and five years in patients with stents, compared with 62.5% at both one and three years in patents without stents (p Conclusions EVT for SIDSMA is clinically successful. The event free survival rate, primary patency, and complete remodelling are satisfactory during mid-term follow up. Endovascular treatment is an effective approach for SIDSMA.

Pea-like nanocabins (HA@APT§DOX) were designed for deep tumor inhibition. The AS1411 aptamer (APT) constituted "core shelf" which guaranteed DOX "beans" could be embedded, while the outer HA acted as "pea shell" coating. During the circulation (primary orbit), HA@APT§DOX could autonomously cruise until leak through tumor vasculature. Upon tumor superficial site, the "pea shell" could be degraded by highly expressed hyaluronic acid enzymes (HAase) and peel-off, resulting in orbit changing of released APT§DOX to reach the deep tumor tissue. Furthermore, APT§DOX could be specifically uptaken into A549 tumor cells (secondary orbit). Finally, DOX was released under the acidic environment of lysosome, and delivered into nuclear (targeting orbit) to achieve drug pushing for deep tumor inhibition. More importantly, the in vivo imaging and anti-tumor effects evaluations showed that these nanocabins could effectively enhance drugs accumulation in tumor sites and inhibit tumor growth, with reduced systemic toxicity in 4T1 tumor-bearing mice.

In our development of a lower cost, high toughness ultra-high strength steel we have examined the effect of nickel content on the strength and toughness of a base heat whose composition was similar to that of the hot work die steel H-11. The base heat was found to have exceptionally low toughness. Nickel additions improved the toughness significantly. Possible reasons for the low toughness of this base composition include: effect of secondary carbides precipitated with the grains; the decomposition of retained austenite to sheet like inter-lath cementite upon tempering; carbide precipitation on austenite grain boundaries during the air cool from the austenitizing temperature, and the formation of upper bainite during the air cool from the austenitizing temperature. The purpose of this work has been to examine these four hypotheses. The results suggest that the primary reason for the low toughness of the heat with no nickel was due to the formation of upper bainite during the air cool from the austenitizing temperature. It was found that nickel additions improve the hardenability and suppress the formation of bainite during the air cool. As a result, the toughnesses of heats modified with nickel additions were quite high.

Recently, interest in stimuli-responsive core–shell nanogels as drug delivery systems for tumor therapy has increased. Here, a temperature-activated drug locking and glutathione-triggered drug unlocking nanogel is designed, which is composed of hyaluronic acid (HA) conjugated with poly(N-isopropylacrylamide) (PNIPAAm) using a disulfide bond as the linker (HA–SS–PNIPAAm, H–SS–P). After injection into the systemic circulation, these synthetic copolymers endure temperature-motivated “lock” behaviors to form nanogels due to the thermosensitive lipophilic transformation of PNIPAAm, accompanied by doxorubicin (DOX) locking into the cavities of the nanogels. When they reach tumor cells, these nanogels exhibit glutathione (GSH)-triggered “opening” behavior to unlock the drugs for tumor therapy. The transmission electron microscopy (TEM) results demonstrate that the H–SS–P copolymer solutions are irregular at room temperature, while spherical structures (∼30 nm) can be observed below 37 °C, but dissociate in the presence of 40 mM GSH. Based on flow cytometry and fluorescence microscopy analyses, observations reveal that H–SS–P@DOX nanogels are intracellularly taken up into human lung cancer cells (A549) via HA-receptor mediated endocytosis. More importantly, these nanogels possess much higher tumor targeting capacity than free DOX and efficiently enhance the antitumor effect with reduced systemic toxicity in 4T1 tumor-bearing mice.

The fabrication of aptamers on DNA nanostructures through the DNA origami method has shown great potential for in vitro and in vivo tumor targeting delivery. Herein, tetrahedral multivalent DNA (Td) nanocages modified with different numbers of MUC1-aptamers (nApt-Td) were obtained via the self-assembly of nucleic acid backbones containing the aptamer DNA fragment without complicated chemical modification steps. Then, doxorubicin (DOX) was encapsulated in the modified nApt-Td nanocages via non-covalent interactions. Due to the specific identification of the aptamers, the intracellular uptake studies demonstrated that the multivalent modified aptamers on the vertex of Td significantly enhanced the intracellular uptake efficiency in MCF-7 tumor cells, but reduce that of normal cells. The number of aptamers had a significant influence on the intracellular uptake efficiency of Td nApt-Td. Furthermore, improved in vivo systemic safety and decreased systemic toxicity accompanied with effective tumor inhibition were also demonstrated compared with the anti-tumor efficiency of free DOX.

Objectives: Endovascular treatment (EVT) is an alternative method used to treat isolated dissection of the celiac artery (IDCA). However, only a few mid-term results have been reported. This study aimed to analyze and compare the outcomes of endovascular and non-operative therapies for IDCA. Methods: Data from a cohort of consecutive IDCA patients enrolled in the study hospital between April 2012 and September 2020 were retrospectively reviewed. Demographic information, imaging features, treatment modalities, and follow-up results of celiac artery remodeling and adverse events were collected and analyzed. Results: A total of 87 patients were enrolled in the study. Stents were deployed in 68 patients, and non-operative treatment (blood pressure control and pain management) was continued in the remaining 19 patients who did not receive stenting; among these 19 patients, EVT failed in 6. The mean follow-up period was 37.3 (range, 10–85 months) and 44.0 (range, 9–80 months) months in the EVT and non-operative groups, respectively. During follow-up, the overall complete remodeling (absence of residual dissection with no false lumen or no intramural thrombus) rate was significantly higher in the EVT group than in the non-operative group (87.3% vs 7.1%, pConclusions: EVT for IDCA may be considered an effective management option with a favorable clinical success rate, an encouraging complete remodeling rate, and a satisfactory adverse event-free survival rate. However, further evaluation with a long-term follow-up is required. Clinical Impact Endovascular intervention for isolated dissection of the celiac artery has attracted inadequate attention. In this retrospective study with comparative analysis of endovascular versus conservative therapy for isolated dissection of the celiac artery patients, a better complete remodeling rate and a higher adverse event-free survival rate were observed in the endovascular treatment (EVT) group during follow-up, indicating that EVT could be an effective management option for isolated dissection of the celiac artery.

So far, most reported delivery of CRISPR/Cas9 is achieved by internalized or encapsulated multiple ribonucleoprotein units into only one carrier unit, with relatively large size. Here, we report a novel, small-sized, individual package of CRISPR/Cas9, via using tetralysine modified H-chian apoferritin (TL-HFn) as packaging material. In this paper, each CRISPR/Cas9 complex is proved to be successfully installed into one TL-HFn (~26 nm), and delivered into the targeting cell via TfR1-mediated endocytosis. We found that after 6 h of treatment, the CRISPR/Cas9 complex can be tracked within the nuclear of Hela cells for the purpose of gene editing of enhanced green fluorescent protein (EGFP). Moreover, TL-HFn individually packed CRISPR/Cas9 displayed higher genome editing activity compared with that of free CRISPR/Cas9 treated group both in vitro (up to 28.96%) and in vivo. Such satisfied genome editing efficiency could be attributed to the endosomal escape and pH-induced disassembly abilities given by TL-HFn after uptake into cytoplasm, which had been verified in our previous research. In all, those results prompted that TL-HFn possessed more potential for intracellular delivery of CRISPR/Cas9, with potential biocompatibility, stability and delivery efficiency.

Objective: The majority of patients with COVID-19 showed mild symptoms. However, approximately 5% of them were critically ill and require intensive care unit admission for advanced life supports. Patients in the intensive care unit were high risk for venous thromboembolism and hemorrhage due to the immobility and anticoagulants used during advanced life supports. The aim of the study was to report the incidence and treatments of the two complications in such patients. Method: Patients with COVID-19 (Group 1) and patients with community-acquired pneumonia (Group 2) that required intensive care unit admission were enrolled in this retrospective study. Their demographics, laboratory results, ultrasound findings and complications such as venous thromboembolism and hemorrhage were collected and compared. Results: Thirty-four patients with COVID-19 and 51 patients with community-acquired pneumonia were included. The mean ages were 66 and 63 years in Groups 1 and 2, respectively. Venous thromboembolism was detected in 6 (18%) patients with COVID-19 and 18 (35%) patients with community-acquired pneumonia (P = 0.09). The major type was distal deep venous thrombosis. Twenty-one bleeding events occurred in 12 (35%) patients with COVID-19 and 5 bleeding events occurred in 5 (10%) patients with community-acquired pneumonia, respectively (P = 0.01). Gastrointestinal system was the most common source of bleeding. With the exception of one death due to intracranial bleeding, blood transfusion with or without surgical/endoscopic treatments was able to manage the bleeding in the remaining patients. Multivariable logistic regression showed increasing odds of hemorrhage with extracorporeal membrane oxygenation (odds ratio: 13.9, 95% confidence interval: 4.0–48.1) and COVID-19 (odds ratio: 4.7, 95% confidence interval: 1.2–17.9). Conclusion: Venous thromboembolism and hemorrhage were common in both groups. The predominant type of venous thromboembolism was distal deep venous thrombosis, which presented a low risk of progression. COVID-19 and extracorporeal membrane oxygenation were risk factors for hemorrhage. Blood transfusion with or without surgical/endoscopic treatments was able to manage it in most cases.

Background Circular RNAs have been demonstrated to play an important role in the development of vascular diseases. However, little is known about the role of circ-021774, also named circ-DAPK1, in vascular cell pyroptosis. Methods Circ-DAPK1 was selected from circular RNA sequencing data of HUVECs treated with high glucose medium and normal medium. RT-qPCR was used to determine the expression of circ-DAPK1 in vivo and in vitro. Dual luciferase reporter assay, fluorescence in situ hybridization (FISH) and RNA immunoprecipitation (RIP) were performed to prove the interaction of circ-DAPK1, miRNA-4454 and thioredoxin-interactingprotein (TXNIP). Adeno-associated virus (AAV) was injected intravenously to establish mouse models. PI staining, western-blot and transmission electron microscopy (TEM) analyses were performed to identify the role of circ-DAPK1 in promoting pyroptosis. Results We found that circ-DAPK1 was highly expressed in high glucose medium cultured HUVECs and db/db mice. In vitro and in vivo experiments demonstrated that circ-DAPK1 knockdown decreased the number of PI+ cells, the expression of ASC, NLRP3, GSDMD-N, cleaved caspase-1, IL-18 and IL-1β. In a mechanistic study, the circ-DAPK1/miRNA-4454/TXNIP signaling axis was demonstrated to promote vascular cell pyroptosis in diabetes. Conclusions Circ-DAPK1 functions as a promoter of vascular cell pyroptosis in diabetes via the circ-DAPK1/miRNA-4454/TXNIP signaling axis.

In this paper, we put forward a novel deep learning approach with Lp / L2 regularization based on sparse autoencoders network, trained by a nonnegativity constraint algorithm. Since L2 norm regularization penalizes the negative weights with smaller magnitudes much weaker than those with bigger magnitudes, lots of the weights could take small negative values. In order to address this issue, non-Lipschitz nonconvex LP norm (0

Objective Numerous evidence indicates that hyperglycemia is a pivotal driver of the vascular complications of diabetes. However, the mechanisms of hyperglycemia-induced endothelial dysfunction in diabetes remain incompletely understood. This study aims to expound on the underlying mechanism of the endothelial dysfunction induced by hyperglycemia from the perspective of long non-coding RNAs (lncRNA). Materials and methods Cell proliferation, migration, apoptosis, and tube formation were measured by cell counting kit-8 assay, transwell assay, flow cytometry, and tube formation assay, respectively. RNA pull-down and RNA-binding protein immunoprecipitation were used to detect the interaction between lncRNA SNHG15 and thioredoxin-interacting protein (TXNIP). Co-immunoprecipitation was used to detect the ubiquitination level of TXNIP and the interaction between TXNIP and E3 ubiquitin ligase ITCH. Results A downregulation of SNHG15 was observed in the ischemic hind limb of diabetic mice and high glucose (HG)-treated HUVECs. Functionally, the overexpression of SNHG15 promoted cell proliferation, migration, and tube formation, and suppressed cell apoptosis in HG-treated HUVECs. Mechanically, SNHG15 reduced TXNIP expression by enhancing ITCH-mediated ubiquitination of TXNIP. TXNIP overexpression abrogated the protective effect of LncRNA SNHG15 overexpression on HG-induced endothelial dysfunction. The following experiment further confirmed that SNHG15 overexpression promoted angiogenesis of the ischemic hind limb in diabetic mice. Conclusion SNHG15 is a novel protector for hyperglycemia-induced endothelial dysfunction via decreasing TXNIP expression.

Background Coil embolization (CE) alone and stent-assisted coil embolization (SCE) are two major endovascular techniques to treat renal artery aneurysms (RAAs). This study aimed at providing safety and efficacy data of CE and SCE for RAAs. Methods Between August 2015 and June 2019, 40 RAA patients treated with CE or SCE were included in the retrospective study. Patients’ demographics, clinical manifestations, aneurysm characteristics, treatment strategies, and follow-up results were collected and analyzed. Results There were 26 and 14 patients in the CE and SCE group, respectively. The mean aneurysm diameter was 2.5 ± 1.5 cm and 2.2 ± 0.8 cm (CE versus SCE, P = 0.52). The neck width of the aneurysm was 0.63 ± 0.37 cm and 1.07 ± 0.42 cm (CE versus SCE, P = 0.021). Technical success was achieved in 97.5% patients. No death or aneurysm rupture occurred. During the perioperative period, 12% and 7.1% patients suffered partial renal infarction (CE versus SCE, P = 0.45). The mean duration of follow-up was 8.8 ± 9.4 months and 16.1 ± 16.3 months (CE versus SCE, P = 0.158) by imaging and 20.8 ± 11.3 and 22.7 ± 16.5 months by visit/telephone (CE versus SCE, P = 0.703). During the follow-up, 17.4% patients in the CE group and 30.8% patients in the SCE group suffered partial renal infarction, while their overall renal function remained normal. In addition, there was no aneurysm recurrence, sac enlargement, or death in both groups. Conclusions Both CE and SCE were safe and effective to treat RAAs. In addition, SCE may prevent coil migration in the wide neck aneurysm in selected patients.

OBJECTIVE: To access the efficacy of stents for spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). METHOD: The study is a prospective single-arm study which has been registered on Clinical Trials (NCT03916965). Clinical data and follow-up information of the SIDSMA patients who received stent implantation in the First Affiliated Hospital of Zhejiang University during April 1, 2019 and September 30, 2019 were collected. The patients were recommended to be followed up at 1, 3, 6 and 12 months. RESULTS: A total of 34 patients were enrolled. Their mean age was (54±8) years. Abdominal pain was the most common symptom. Patients received (2.1±0.6) stents on the average. Post-operation hospital stay was (2.7±1.6) days, and the patients were followed up for (2.3±1.9) months (CT angiography) and (5.5±1.7) months (clinical visit/phone call). There was no recurrence of abdominal pain. The CT angiography showed complete remodeling and incomplete remodeling took place in 23 and 9 patients (69.7% and 27.3%), respectively. Two patients (6.1%) had mild in-stent stenosis. No stent rupture or migration was reported. CONCLUSION: This study demonstrated a satisfactory short-term result of stents implantation for SIDSMA, which indicated the endovascular treatment could be the first-line therapy for SIDSMA.

Purpose: To report the findings of an in vitro experiment to evaluate the quality of needle fenestrations dilated by different size balloons in various stent-grafts and to investigate the differences between gradual and rapid dilation. Materials and Methods: Fenestrations were made using an 18-G needle in 5 different polyester or expanded polytetrafluoroethylene (ePTFE) stent-grafts: Relay, Valiant, Hercules, TAG, and Ankura. Each stent-graft received 2 groups of fenestrations: one was followed by gradual sequential dilation (4-, 6-, 8-, and 10-mm balloons) and the other by rapid dilation (4- and 10-mm balloons). The pressure was increased to 10 atmospheres or until the balloon was fully inflated with no waist. Quantitative and qualitative evaluations, including fenestration diameter, area, shape, and margins were conducted using light microscopy and scanning electron microscopy. Results: Relay had the strongest resistance to dilation and Ankura the slightest. The maximum length and area of holes expanded as the balloon diameter increased. The fenestrations in polyester devices were mostly elliptical or slit-like, with limited tears but extensive fibers visible in the margin, while ePTFE stent-grafts showed larger fenestration areas with clearer margins. Ankura showed the best quality of fenestrations, which were always circular or square without fabric tears, while the holes in the TAG were square or elliptical but sometimes had a slit after large balloon dilation (≥6 mm). The Relay, Valiant, Hercules, and Ankura devices showed no difference in maximum diameter, fenestration area, or scores of shape and margin (p>0.05). Rapid dilation in the TAG increased the rate of uncontrolled fabric tear, resulting in a larger final diameter (12.90 vs 10.82 mm, p=0.047), smaller area (30.46 vs 41.09 mm2, p=0.028), worse shape (0.75 vs 1.20, p=0.268), and worse margin (0.40 vs 1.00, p=0.174). Though the decreased fenestration shape and margin scores did not reach statistical significance, the trend for decline was more obvious than with the other devices. Conclusion: Materials and structures of the stent-grafts determine the quality of fenestrations dilated by different size balloons. The use of sequential vs rapid balloon dilation is also crucial for fashioning high-quality fenestrations and should be selected judiciously.

Background: Pathogenesis of cardiovascular diseases begins with endothelial dysfunction. Our previous study has shown that advanced glycation end products (AGE) could inhibit the expression of homeobox A9 (Hoxa9), thereby inducing endothelial dysfunction. Leucine-rich repeat flightless-interacting protein 1 (LRRFIP1) has been found to participate in a variety of pathological processes, but reports of its role in endothelial dysfunction are rare. Objectives: This study aims to investigate whether LRRFIP1 is involved in AGE-induced endothelial dysfunction through Hoxa9-mediated transcriptional activation. Methods: Chromatin immunoprecipitation was used to detect the transcriptional regulation of Hoxa9 on LRRFIP1 promoters. Human umbilical vein endothelial cells were treated with AGE or pyrrolidinedithiocarbamate (nuclear factor kappa-B [NF-κB] inhibitor). Moreover, changes in apoptosis, proliferation, migration, release of nitric oxide, and angiogenesis were detected. Results: Hoxa9 promotes LRRFIP1 expression by binding to the ­LRRFIP1 promoter. Meanwhile, overexpression of LRRFIP1 inhibited phosphorylation of P65 and elevated expression of Hoxa9. Overexpression of LRRFIP1 or/and Hoxa9 reversed the effects of AGE on HUVEC. AGE-induced inhibition on the expression of LRRFIP1 and Hoxa9 could be reversed by the NF-κB inhibitor. Conclusion: LRRFIP1 is involved in AGE-induced endothelial dysfunction via being regulated by the NF-κB/Hoxa9 axis.