arterial

摘要： Dear editor,Extracorporeal membrane oxygenation(ECMO)is a modality of extracorporeal life support that allows for temporary support in pulmonary and/or cardiac failure refractory to conventional therapy.[1]ECMO use has been exponentially increasing over the last decade and is now considered a mainstream lifesaving treatment modality in critical care medicine.Many studies report ECMO use in patients with acute respiratory distress syndrome refractory to conventional clinical support,in-hospital cardiac arrest,and cardiogenic refractory shock.[1-3]Herein,we report the use of veno-arterial ECMO(VA-ECMO)in the first successful combined lung-liver transplantation(CLLT)patient in China.

摘要： BACKGROUND It is unclear whether the dementia patients with Alzheimer’s disease(AD)and vascular dementia(VaD)and mixed dementia(MIX,including AD and VaD)would have more developed arterial stiffness as compared with local residents without dementia.The aim of this study was to assess arterial stiffness and cognitive function in different types of dementia pa-tients[AD,VaD,MIX and mild cognitive impairment(MCI)]and community residents without dementia.METHODS This was a single-center,cross-sectional observational study.We studied a cohort of 600 elderly outpatients with a complaint of memory loss,who were divided into four groups(AD,VaD,MIX and MCI).In addition,they were compared with 55 age-matched local residents without dementia(Controls).We assessed arterial stiffness by brachial-ankle pulse wave velocity(baPWV)and the global cognitive function by the Mini-Mental State Examination(MMSE).RESULTS The baPWV was higher in AD,VaD and MIX than in MCI and in Controls(P<0.05).The baPWV was higher in MCI than in Controls(P=0.021),while MMSE were compatible between them(P=0.119).The higher baPWV predicted the presence of AD,VaD,MIX and MCI with the odds ratio of 6.46,8.74,6.16 and 6.19,respectively.In contrast,there were no difference in baPWV among three different types of dementia(P=0.191).The linear relationship between baPWV and MMSE was observed in the elderly with MMSE≥23(R=0.452,P=0.033),while it was not in dementia patients(MMSE<23).CONCLUSIONS The findings suggest that MCI and dementia patients have stiffer arteries as compared with age-matched local residents,although global cognitive function may be comparable between MCI and the local residents.

摘要： Hepatocellular carcinoma(HCC)is one of the most common cancers and is the second leading cause of cancer-related deaths worldwide[1,2].The main therapies for HCC include surgical re-section,local ablation,or liver transplantation,which are only applied to early-stage HCC.However,most patients at the time of initial HCC diagnosis have already progressed to an advanced stage,and survival can only be prolonged finitely via palliative therapies,such as transarterial chemoembolization,systemic ther-apy with tyrosine kinase inhibitors,and selective internal radiation therapy[3,4].Moreover,as HCC has a high recurrence rate,the treatment efficacy is not satisfactory[5].Currently,the diagnosis and monitoring of HCC primarily depend on serum biomarker de-tection,pathological examination,and imaging analysis.Common serum markers display poor diagnostic performance,and imaging and pathological examinations have limitations in diagnostic accu-racy and sensitivity[6,7].Therefore,we urgently require better ap-proaches for the diagnosis and monitoring of HCC.

摘要： 重症监护病房(intensive care unit,ICU)中的急性低氧血症性呼吸衰竭患者需要接受吸氧治疗,但不同的动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))治疗目标对患者预后的影响尚不清楚。有学者认为,与较高的PaO_(2)目标值相比,使用较低的PaO_(2)目标值反而会降低患者的病死率。为此,有学者进行了一项多中心临床试验。在这项多中心试验中,研究人员随机分配了2928例成人患者,他们因急性低氧性呼吸衰竭在ICU接受吸氧治疗,目标PaO_(2)为60 mmHg(低氧分压组,1 mmHg=0.133 kPa)或90 mmHg(高氧分压组),随访90 d。

摘要： Objectives:The purpose of this study was to investigate the prognostic factors for transcatheter arterial chemoembolization(TACE)for hepatitis B-related hepatocellular carcinoma(HCC).Materials and methods:The variables that may affect overall survival(OS),such as age,gender,AFP,Child Pugh classification,body mass index,HBV-DNA,Hbe Ag,tumor number,tumor diameter,BCLC stage,embolization method,ablation therapy,and targeted therapy,were analyzed by single factor and many factor COX regression.In addition,predictive factors of OS were stratified and a Kaplan-Meier survival curve was drawn.Results:Among the 136 patients,the median follow-up time was 14.5 months(range:2–72 months).HCC patients with the tumor diameter<3 cm had the highest survival rate,followed by patients with a tumor diameter of 3–5 cm;the survival rate of patients with the tumor diameter(greater than 5 cm)was the lowest.Among the BCLC stages,stage A patients had the highest survival rate,followed by stage B and stage C patients,which had the lowest survival rate.The survival rate of Child Pugh grade A patients was higher than those with Child Pugh grade B.Compared with patients who did not undergo ablation treatment,the survival rate of patients with combined ablation treatment was relatively high.The survival rate of patients receiving drug-eluting beads transarterial chemoembolization(DEB-TACE)treatment was higher than those receiving conventional transarterial chemoembolization(c TACE)treatment.Additionally,repeated TACE treatment improved the OS rate of patients.These six factors were related to patient prognosis and the differences were statistically significant(P<0.05).Conclusions:Tumor diameter,BCLC stage,TACE repetition,and TACE combined with ablation were independent prognostic factors of OS.

摘要： Pulmonary hypertension(PH)is a progressive disease caused by pathological vascular remodeling of arterial vessels and elevated pulmonary artery pressure that result in pressure overload of the heart right ventricle eventually causing its failure.Pulmonary artery endothelial cells(PAECs)dysfunction and local inflammation play important roles in the development of PH.Recent studies suggested that neurotrophin growth factors,particularly brain-derived neurotrophic factor(BDNF)and its high-affinity receptor TrkB,were significantly increased in the PAECs under the hypoxia condition.The aim of this study was to explore the possible effects of BDNF on PAECs.

摘要： 良性前列腺增生(benign prostatic hyperplasia,BPH)是中老年男性的常见病、多发病,50岁以上男性发生BPH的比例随年龄增加逐年上升[1]。超选择性前列腺动脉栓塞术(prostatic arterial embolization,PAE)是近年来治疗BPH的新方法,具有微创、住院时间短、恢复快、疗效佳、并发症少等优势,其可行性、安全性和有效性得到了临床证实[2],但却对围手术期护理提出了新的挑战。

摘要： 肺动脉高压(pulmonary arterial hypertension,PAH)是一种病因复杂、高致死性、进行性的恶性心血管疾病。无论是特发性还是继发于各种疾病的PAH,患者均表现出相似的病理生理变化,包括肺血管异常收缩、肺血管炎症、肺血管结构重塑及原位血栓形成等,最终导致肺血管阻力增加,随后发生右心室肥厚、功能衰竭,甚至死亡。流行病学显示,在>65岁人群中,PAH的发病率达10%[1]。

摘要： Coronavirus disease 2019(COVID-19)is caused by the novel coronavirus severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).Systemic complications include cardiovascular,neurological,hepatic,renal and altered coagulation.Derangements in haemostasis with SARS-CoV-2 infection have been termed COVID-19 associated coagulopathy(CAC).CAC is postulated to be one of the significant causes for sudden deaths in this pandemic,with infection of endothelial cells and subsequent endotheliitis through angiotensin-converting enzyme-2 receptors playing a key role in the pathogenesis.In this pictorial review,we describe the imaging findings in a multitude of extrapulmonary arterial(aorta,cerebral,mesenteric,renal and peripheral arterial system)and venous thrombotic phenomena detected on contrast-enhanced computed tomography and magnetic resonance imaging of COVID-19 patients which could not be attributed to any other causes.Knowledge of incidence of these complications,lowering the threshold for diagnostic imaging in symptomatic patients and timely radiological detection can play a vital role in subsequent management of these critically ill patients.

摘要： Endovascular intervention,such as percu-taneous transluminal angioplasty(PTA),improves claudication and saves limbs of patients with severe lower extremity arterial dis-ease(LEAD).[1]A previous study showed that the mortality among octogenarians was as high as 29%regardless of the type of intervention and that re-vascularization was associated with high peripro-ceduralmortality.[2]A previous study had already shown that reconstructive surgery for elderly indi-viduals over 80 years old resulted in a significantly higher mortality rate than that for patients between 70 and 80 years old,whereas endovascular inter-vention and primarily conservative treatment had comparable prognoses.[3]Consistently,another study showed that the risks of both overall and am-putation-free survival were significantly lower with endovascular treatment than with bypass surgery in patients with critical limb ischemia.[4]A systematic review and meta-analysis of 27 studies(15 cohort and 12 randomized controlled trials)with 1642 pa-tients suggests that conservative treatment may be considered for nonreconstructable patients with critical limb ischemia;[5]however,because a high risk of bias and serious inconsistencies were found in the included studies,the meta-analysis provided low-quality evidence.In contrast,a small cohort study with 49 patients suggests that amputation im-proved quality of life and health status in fragile elderly individuals.