In diagnosing coronary artery disease, measurement of the cross-sectional area of the lumen, maximum and minimum diameter is very important. Mainly, it will be used to confirm the diagnosing, to predict the stenosis if any and to ensure the size of the stent to be used. However, the measurement only offers by the existing software and some of the software needs human interaction to complete the process. The purpose of this paper is to present the algorithm to measure the region of interest on intravascular ultrasound modality that is lumen and media adventitia area and diameter using an image processing technique. The methodology starts with the image acquisition process followed by image segmentation. After that, border for each region was detected and the algorithm was applied to calculate the corresponding region. The result shows that the measurement is accurate and could be used not only for intravascular ultrasound image but applicable to solid circle and irregular circle shape.

Objective To evaluate the clinical efficacy of robot-assisted laparoscopic ureteral reimplantation (RAUR) for primary obstructive megaureter (POM) in children. Methods Twenty-one patients who underwent RAUR for POM in Bayi Children’s Hospital between 2017 April and 2018 April were retrospectively analyzed. The study population consisted of 15 boys and 6 girls aged between 2 months and 11 years. Ten patients had left POMs, 9 had right POMs and two had bilateral POMs. All patients were preoperatively diagnosed with a POM based on urinary system ultrasonography, magnetic resonance urography, and diuretic renal dynamic imaging. Our main technique key steps include: Under general anesthesia, the patients were placed in a Trendelenburg position approximately 40 degrees from the horizon. An 8.5-mm camera port was placed at the level of the umbilicus. Followed by two 5-mm robotic Trocars placed under direct vision 6 cm to the camera port separately, a 5-mm assistant port was placed on the right upper abdominal quadrants which was located 3 cm from the camera and robotic port. The ureter was identified at the pelvic brim. The peritoneum covering the ureter was incised and the ureter was mobilized to the level of the vesico-ureteric junction. The bladder was filled with 60 ml saline and a 5 cm length and 1.5 cm wide submucosal detrusor tunnel was created. The ureter was transected at the bladder mucosa and the narrowed ureteral segment was discarded. The ureteroneocystostomy was performed using 6-0 absorbable suture. Dissecting the perivesical fascia appropriately and using down-top suturing approach, use of an apical stay stitch, and incorporation of the ureteral adventitia during detrusorraphy. Postoperative complications were analysed using the Clavien-Dindo classification. Success was defined as symptomatic relief, decreased hydronephrosis on ultrasound and no evidence of vesicoureteral reflux on voiding cystourethrography. Results All surgeries were successfully completed without conversion and no intra-operative complication was encountered. The mean operative time was 117.6±18.1(89-165)min, the mean estimated blood loss was 11.9±4.3(5-25)ml, the abdominal drainage tubes were removed after a mean of 4.9±1.1(3-8)days, and the mean postoperative hospital stay was 6.3±1.3(4-10) days. Postoperative complications (Clavien Ⅰ-Ⅱ) occurred in 9.5% (two patients had recurrent urinary tract infections postoperatively) children, no grade Ⅲ-Ⅳ complication was observed. The pre-operative symptoms in all patients disappeared. One patient had grade Ⅱ VUR on VCUG, who were followed conservatively. Ultrasound at postoperative follow-up showed that the hydronephrosis was disappeared in 20 ureters and significantly decreased in 3 ureters. The success rate was 95.7% at a mean follow-up of 16.3±4.0(10-23)months. Conclusion RAUR is a safe and feasible option for the treatment of POM in children with higher success rate and lower complication rate. Key words: Laparoscopes; Robot-assisted; Ureter reimplantation; Primary obstructive megaureter; Children

Objective To investigate the effects of single-hole and double-hole drilling and closed drainage on the expression of Hypoxia inducible factor-1α (HIF-1α), Claudin-5, transforming growth factor-β (TGF-β) and Smad2/3 in the epidermis of patients with chronic subdural hematoma. Methods 100 patients with chronic subdural hematoma were randomly divided into single hole and double hole drainage group according to random number table. Immunohistochemical streptavidin-peroxidase (SP) was used to detect the expression of TGF- β protein, and Western blot was used to detect the expression of HIF-1α, Claudin-5 and Smad2/3 in the epihematoma of the two groups before and after operation. Results Compared with pre-operation, the expression of HIF-1α, TGF-β and Smad2/3 protein in adventitia of hematoma in both groups decreased after operation, especially in the double-hole group (P<0.05). The expression of Claudin-5 protein in adventitia of hematoma was significantly increased in both groups, especially in the double-hole group, with statistically significant difference (P<0.05). Conclusions Single-hole and double-hole drilling and sealing drainage is an effective method to treat chronic subdural hematoma. It can reduce the expression of HIF-1α, TGF-β and Smad2/3 protein in the epidermis of hematoma, and significantly increase the expression of Claudin-5, and the effect of double-hole drilling and sealing drainage is more significant. Key words: Drainage; Hematoma, subdural, chronic; Hypoxia-inducible factor 1, alpha subunit; Claudin-5; Transforming growth factor beta; Smad proteins, receptor-regulated

Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction. Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction: 54 patients(62 plaques with CEUS) with cerebral infarction were included in group A, and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B. The plaques were divided into four grades according to the degree of plaque enhancement. According to the source of intraplaque contrast agents, plaque enhancement patterns were divided into adventitia enhancement, lumen enhancement and mixed enhancement. To analyze the degree and pattern of carotid plaque enhancement in the two groups. Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3(26/62) and grade 4(22/62), while that in non-cerebral infarction group was mainly grade 2(20/54) and grade 3(20/54). There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P=0.019) and grade 4 (P=0.041). The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B(37/50), with statistically significant difference (P=0.003). While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P=0.003). Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients, and the mixed enhancement pattern was more common. It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction. Key words: Angiography; Carotid artery diseases; Neovascularization, pathologic; Brain infarction

Knockdown of lncRNA PVT1 Inhibits Vascular Smooth Muscle Cell Apoptosis and Extracellular Matrix Disruption in a Murine Abdominal Aortic Aneurysm Model.

Objective To evaluate the value of color Doppler ultrasonography in diagnosing cystic adventitial disease of the popliteal artery. Methods The ultrasonographic images of 12 patients with cystic adventitial disease of the popliteal artery confirmed by surgery and pathology were retrospectivly analyzed. The ultrasonographic features were summarized. Results The ultrasonographic images showed the location, number, size and the compression of popliteal artery. Cystic adventitial disease of the popliteal artery showed cystic masses within popliteal artery wall. The tunica media and tunica externa were separated. Slender separations could be found in some cysts. Color Doppler ultrasonography showed no blood flow inside the cysts. When the popliteal artery was compressed, the velocity of blood flow increased significantly. The affected popliteal artery diameter was less than that of the contralateral side [(2.858±1.256)mm vs (5.500±0.095)mm, t=7.531, P<0.01], the peak flow velocity of the affected popliteal artery was higher than that of the contralateral side [(213.750±119.464)cm/s vs (57.417±4.209)cm/s, t=4.465, P<0.01], the peak flow velocity of the affected posterior tibial artery was lower than that of the contralateral side [(32.417±14.569)cm/s vs (47.250±4.115)cm/s, t=4.318, P<0.01]. Conclusions Color Doppler ultrasonography is the preferred imaging method for diagnosis of cystic adventitial disease of the popliteal artery. Key words: Ultrasonography, Doppler, color; Popliteal artery; Cysts

Objective Angiotensin1-7 (Ang1-7) and ITS inhibitor A779 were used to study the effect of Ang1-7 on intimal hyperplasia in autogenous vein graft. Methods The transplantation models of the external jugular vein to the abdominal aorta were established in 40 Specific Pathogen Free SD male rats. All models were randomly divided into control group, gel group, Ang1-7 group and A779 group (10 rats each). The adventitia of the transplanted veins was evenly sprayed with normal saline, Poloxamer 407, Poloxamer 407 mixed with Ang 1-7, Poloxamer 407 mixed with A779 respectively in each group forementioned. 5 rats form each group were sacrificed at 14th and 28th day respectively. The transplanted vein was intercepted and then stained with hematoxylin and eosin (HE). The thickness of the inner membrane (I) and medium membrane (M) of the vein grafts were measured by computer, and I/M ratio was calculated. The expression of proliferating cell nuclear antigen (PCNA), extracellular regulated protein kinase-1 (ERK-1) and angiotensin Ⅱ receptor 1 (AT1R) was determined by immunohistochemistry. Results (1)14th and 28th Day, the intimal hyperplasia of vein graft in Ang1-7 group [(59.26±7.51), (62.50±5.91) μm] was lighter than that in the other groups(P=0.001, respectively). (2)14th Day, the I/M ratio of vein graft in Ang1-7 group (0.67±0.05) was lower compare to that in other groups (P=0.001, 0.006, 0.001). 28th Day, the I/M ratio of vein graft in Ang1-7 group (0.71±0.14) was lower than that in the other groups(P=0.001, respectively). (3)There was statistically differences in the intimal thickness of vein graft between A779 group and control group at 14th, 28th day(P=0.007, 0.001). (4)14th Day, the expression of PCNA in the Ang1-7 group (21.80±7.05) was lower than that in other groups (P=0.011, 0.016, 0.001). 28th Day, the PCNA expression in the Ang1-7 group (12.80±5.31) was lower than that in the other groups (P=0.001, 0.002, 0.001). (5)14th Day, the express of ERK1 in vein graft Ang1-7 group (57.00±5.79) was lower than that in other groups (P=0.002, 0.003, 0.001). 28th Day, the express of ERK1 in vein graft Ang1-7 group(50.20±8.79) was lower than that in other groups (P=0.024, 0.017, 0.001). (6)14th Day, the express of AT1R in vein graft Ang1-7 group (27.20±6.87) was lower than that in other groups (P=0.001, 0.003, 0.001). 28th Day, the express of PCNA in vein graft Ang1-7 group(20.60±4.83) was lower than that in other groups (P=0.001, respectively). Conclusion The main cells resulting in intimal hyperplasia may be derived from the proliferation and migration of vascular smooth muscle cells in the medium membrane. Ang1-7 can significantly inhibit the expression of AT1R in the bridging vein, reduce its role in promoting endometrial proliferation, thereby reduce the proliferation and migration of VSMCs. Ang1-7 can also inhibit the expression of ERK in the bridging vein after vein transplantation; RAS and MAPK signal systems are involved in the intimal hyperplasia of vein graft. Key words: Angiotensin1-7; Vein graft; Intimal hyperplasia; Renin angiotensin system

Objective To explore the potential reasons of cerebral infarction caused by accidental incarceration of aneurysm-adjacent branches with temporary clips, and to give guidance to the appropriate application of temporary clips. Methods A retrospective analysis was conducted on the clinical data of 10 patients with accidental incarceration of branches of parent artery or aneurysm-adjacent perforator vessels who were admitted to Department of Neurosurgery of Fuzhou General Hospital from January 2004 to December 2016. Under microscopes, we observed the definite lesions of branches and perforator vessels during the procedures, features of temporary clips and the intraoperative procedure, and postoperative cerebral infarction with varying degrees in corresponding territories. Two cases of posterior communicating artery aneurysm and 2 cases of carotid bifurcation aneurysm were found on the extracranial superior mesenteric artery adventitia with varying degrees of atherosclerosis, misclipping occurred at the anterior pre-choroidal artery, recurrent artery of Heubner and lenticulostraiate artery. For 4 cases of anterior communicating artery aneurysms and 2 cases of middle cerebral artery aneurysm, mis-clipping was found at A1 or A2 and M1 segments adjacent to perforation. Results Among the 10 patients, CT review 2-4 days post surgery demonstrated cerebral infarction with varying degrees adjacent to the aneurysm branches, perforating branch of blood supply. Disturbance of consciousness occurred in 2 cases. Compared with preoperative state, short-term significant decrease in strength of limb muscles was observed in 5 cases, incomplete motor aphasia in 1 and asymptomatic cerebral infarction in 2. At follow-up ranging from 4 months to 3 years, 2 cases reported dementia and 2 cases had permanent hemiplegia, out of which 3 were disabling and needed long-term care. Conclusions Cerebral infarction caused by accidental incarceration of branches or perforator vessels with temporary clips could be related not only to the incarceration duration, age and vascular sclerosis, but also to the over-contraction of small blood vessels and the closing force of a temporary clip. Therefore, caution should be warranted regarding those factors in the use of temporary clips. Key words: Intracranial aneurysm; Vascular system injuries; Therapeutic occlusion; Brain infarction

Objective To compare the effects of renal denervation (RDN) from intima and adventitia for hypension. Methods Twenty-five neurogenic hypertensive beagles were randomly divided into intimal group (n=10) gvien percutaneous RDN from the inside of renal artery, and adventitial group (n=10) given RDN from the outside of renal artery. The sham-operated group was set up (n=5). Arterial pressure, renin activity (PRA) and angiotensin Ⅱ (Ang Ⅱ) were detected before and 2, 4, 8 weeks after operation. Results (1) At 8th week after the hypertension model was established, the arterial pressure increased from (107.56±4.37) mmHg (1 mmHg=0.133 kPa) to (125.16±7.86) mmHg (P=0.003) in the intimal group, and from (105.66±5.43) mmHg to (124.08±8.98) mmHg in the adventitial group (P=0.012). In the control group the arterial pressure increased from (106.34±6.45) mmHg to (125.89±9.54) mmHg (P=0.007). PRA and AngII increased simultaneously (P=0.005); (2) At 2nd, 4th, and 8th week after operation, the arterial pressure decreased from (125.16±7.86) mmHg to (117.45±7.98) mmHg (P=0.001), (114.35±7.89) mmHg (P=0.008), (110.32±7.54) mmHg (P=0.003), and from (124.08±8.98) mmHg to (111.23±8.34) mmHg (P=0.004), (108.34±8.65) mmHg (P=0.002), (103.06±8.56) mmHg (P=0.001) in the adventitial group. The arterial pressure decreased more significantly in the adventitial group [(103.06±8.56) mmHg] than that in the intimal group [(110.32±7.54) mmHg] (P=0.013). PRA and AngII decreased simultaneously (P=0.015). The blood pressure had no significant change in the control group; (3) The renoarteriography showed on obvious abnormalities, but the pathological examination showed that a nerve fascicle from all denervation vessels with marked densification of collagen fibers in the surrounding connective tissue and a perineurium thickened, and the perineurium was thicker in the arteries. Conclusion RDN from both intima and adventitia is safe and results in reduction of substantial and sustained blood pressure and renal sympathetic active substances in beagle dog model, and it was better from the adventitia. Key words: Renal denervation; Hypertension; Sympathetic nerve

Aim: This case-control study is aimed at identifying radial vascular wall abnormalities in patients with fibromuscular dysplasia (FMD). Methods: High-frequency ultrasound scans of the radial arteries and of FMD patients and healthy controls were obtained by Vevo MD (70 MHz probe, FUJIFILM, VisualSonics, Toronto, Canada). Radial wall showed in all individuals two echogenic interfaces: the 1 st ( lumen-media) and the 2 nd (media-adventitia). Intima-media (IMT), adventitia (AT), and global thickness (IMAT) were measured and wall cross-sectional area (WCSA) calculated. The disarray level of the two echogenic interfaces was assessed calculating the root mean square error (RMSE) between 20 gray-level profiles crossing the two interfaces and the profile obtained averaging them. For each echogenic interface, the RMSE was normalized for the maximum value of the corresponding mean profile (RMSE/mean). Results: 11 treated hypertensive female FMD patients and 8 healthy control women (C) were enrolled (age 52±5 vs 45±13 years, p=0.51; BMI 26±3 vs 23±3, p=0.12; mean BP 97±7 vs 85±10, p=0.01). Radial internal diameter was similar (1.938±0.432 vs 1.701±0.532 mm, p=0.21). IMT (0.166±0.037 vs 0.128±0.022 mm, p=0.03), AT (0.114±0.029 vs 0.083±0.019 mm, p=0.008) and IMAT (0.281±0.042 vs 0.211±0.027 mm, p=0.003) were higher in FMD. Wall/lumen ratio was similar and WCSA increased in FMD, calculated with either IMT or IMAT. The maximum values of 1 st (121±43 vs 157±22, p=0.09) and 2 nd interface 109 ±44 vs133±18, p=0.09) tended to be lower, whereas RMSE/mean was higher in FMD (1 st 1.31±0.24 vs 0.83±0.32, p=0.006; 2 nd 1.37±0.38 vs 0.94±0.32, p=0.03). The difference was attenuated for the 1 st but not for the 2 nd interface when considering age and mean BP as covariates (p=0.054 and p=0.016 respectively). Conclusions: Wall ultrastructure of radial arteries of hypertensive FMD patients showed eutrophic remodeling. Furthermore, a peculiar “blurred” pattern occurred, characterized of loss of echogenicity and inhomogeneity of the two echogenic layers, independent of age and mean BP.

Objective To investigate the distribution of sympathetic nerves around human renal arteries. Methods We collected 25 renal arteries from the patients who had a retroperitoneal laparoscopic nephrectomy and bilateral renal arteries from 7 human autopsy subjects. Each artery was equally divided into segments, which were made into paraffin sections. We examined the distribution of nerves around renal arteries and manually counted nerves by using optical microscope. Results A total of 3 065 nerves were identified from 258 sections. About 98% of all nerves existed within the renal arterial adventitia and the outside tissue. The mean number of nerves between the ventral, doirsal, superior, and inferior region of surgical specimens was 4.7±1.3, 1.4±0.7, 3.1±1.3, and 2.1±1.2, respectively. The mean number of nerves in the ventral region was greater compared with the doirsal region (P=0.000), the mean number of nerves in the superior region was also greater compared with the inferior region (P=0.005). The mean number of nerves in the middle segments was obviously greater compared with the distal segments (14.5±4.4 and 8.3±3.0, P=0.000). The mean number of nerves between the ventral, doirsal, superior, and inferior region of autopsy specimens was 5.4±1.4, 1.5±0.7, 3.1±0.8, and 2.8±1.0, respectively. The mean number of nerves in the ventral region was greater compared with the doirsal region(P=0.000), whereas the mean number of nerves was similar between the superior and inferior region (P=0.440). The mean number of nerves among the proximal, middle, and distal segments was 11.2±4.4, 17.6±4.4, and 8.5±2.2. It was obvious that the mean number of nerves in the middle segments was greater compared with the proximal and diatal segments (P=0.000). The distribution of sympathetic nerves around the left renal arteries was not considerably different compared with the right renal arteries (Psurgical=0.100, Pautopsy=0.916). Conclusion The mean number of nerves in the ventral region is greatest and least in the doirsal region. Along the renal artery, the distribution of nerves is relatively greater in the middle segments. Nerve anatomic distribution around the left renal arteries was not considerably different compared with the right renal arteries. Key words: Renal sympathetic denervation; Resistant hypertension; Renal artery; Sympathetic nerves; Anatomic distribution

Garmazi S. , Litvinenko M . A . Клинико - анатомические особенности иннервации почечных артерий у больных артериальной гипертензией = Clinical and anatomical features of innervation of the renal arteries in patients with arterial hypertension. Journal of Education, Health and Sport. 2016;6(2):293-300. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.46810 http://ojs.ukw.edu.pl/index.php/johs/article/view/3406 https://pbn.nauka.gov.pl/works/717684 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received : 05.01.2016. Revised 12.02.2016. Accepted : 27.02.2016. Клинико-анатомические особенности иннервации почечных артерий у больных артериальной гипертензией Clinical and anatomical features of innervation of the renal arteries in patients with arterial hypertension Гармази С., Литвиненко М. А. Garmazi S., Litvinenko M. A. Одесский национальный медицинский университет, г. Одесса, Украина Odessa National Medical University, Odessa, Ukraine Summary Clinical and anatomical features of innervation of the renal arteries in patients with arterial hypertension Garmazi S., Litvinenko M.A. Odessa National Medical University, Odessa, Ukraine The aim of this study was the clinical and anatomical features of innervation of the renal arteries. The retrospective analysis of health statistics on the prevalence of resistant hypertension based on the Odessa Regional Mortem Bureau during 2011-2012 was conducted. The analysis of the results of the autopsy and subsequent histological examination of 30 bodies of deceased patients with resistant hypertension II and III stages has been done. The morphometry of renal arteries and their segments was conducted. Fragments of the renal artery were not larger than 1,0x1,0x1,0 cm, fixed in 10% neutral formalin and alcohol after standard wiring block embedded in paraffin. Sections 5.0-8.0 microns (in an amount of at least two sections with each block) were stained by the observation procedures recommended modern guidelines: hematoxylin and eosin, by Van Gieson; by Nissle, by Golgi and by Masson. The evaluation of the histological response rate in the vessels was performed visually and compared to the control group. The greatest density of accumulation in the nerve ganglia determined adventitia proximal renal arteries, preferably on the frontal surface. Ganglions sizes ranging from 80 to 220 microns, larger than when the ganglia are located in the proximal renal artery. The main part of the sympathetic ganglia, located at a depth of 2-3 mm. Postbifurcation ganglia localization occurs in 32.2% of cases. The degree of fibrosis of the renal artery wall in hypertension does not preclude the implementation of radiofrequency catheter sympathectomy. Key words: arterial hypertension, renal arteries, innervation, pathomorphology.

Objective To study the feasibility of microsurgical technique to denervate sympathetic of femoral artery in rabbit, providing a reliable animal experimental model for further study of the mechanism of neuralization in bone tissue engineering. Methods From July, 2014 to July, 2015, 21 New Zealand white rabbits were divided into 4 groups randomly: the control group (n = 3), the 4 weeks group (n = 6), the 8 weeks group (n = 6) and the 12 weeks group (n = 6). Bilateral femoral arteries of the 21 rabbits were exposed. Adventitia of femoral arteries in 3 test groups were removed for about 2cm by microsurgical technique, whereas adventitia of the control group remained intact without any treatment. The arteries samples were collected at 4 weeks, 8 weeks and 12 weeks after treatment. The structure of vascular were indicated by hematoxylin-eosin (HE) staining, and the distribution and volume of the sympathetic fibers were evidenced by glyoxylic acid staining and the expression of tyrosine hydroxylase (TH), the marked protein of sympathetic. Results The adventitia of 3 test groups were invisible or lost most of it while the control group remained intact shown by HE staining. For glyoxylic acid staining, the fluorescence intensity value of the control group, 4 weeks group, 8 weeks and 12 weeks were 0.08124±0.00260, 0.02920±0.00206, 0.02661±0.00233, 0.03094±0.00211, respectively (n = 6). The distribution and fluorescence intensity of sympathetic nerve were both significantly reduced in test groups compared to the control group (P 0.05). Semiquantitative analysis of the expression of TH was 0.8626±0.03519, 0.3631±0.03019, 0.3964±0.02239, 0.3487±0.02356 respectively, which showed the same tendency as glyoxylic acid staining test. Conclusion Microsurgical technique is promising as an ideal method for the local denervation of sympathetic nerve from artery system as it can significantly reduce sympathetic fibers on adventitia without regeneration during the experimental period. Key words: Tissue engineering bone; Neuralization; Adventitia; Sympathetic nerve; Microsurgical technigue

To explore the pattern of lymphatic metastasis and risk factors of esophageal carcinoma that invades less than adventitia. Clinical data of 484 patients receiving esophagectomy from January 2011 to August 2014 were reviewed, whose carcinoma invaded less than adventitia. The lymph node metastasis pattern of the primary tumor and corresponding influence factor were analyzed. Total lymph node metastatic rate was 32.0% (155/484). Sixteen of 61 upper thoracic esophageal carcinoma patients (26.2%) had lymphatic metastasis. Fifty-five of 201 middle thoracic esophageal carcinoma patients (27.4%) had lymphatic metastasis. Eighty-four of 222 lower thoracic esophageal carcinoma patients(37.8%) had lymphatic metastasis. The deeper tumor invaded, the easier lymph node metastasis occurred, as well as the lower of the tumor differentiation and the larger of the tumor diameter. Multivariate analysis revealed lesion diameter (P=0.005), differentiation degree (P=0.007) and invasion depth (P=0.001) were independent risk factors of lymphatic metastasis in esophageal cancer that invaded less than adventitia. Depth of tumor invasion, diameter of tumor and tumor differentiation are risk factors of lymph node metastasis of esophageal carcinoma that invades less than adventitia.

Objective To investigate the effect of cystatin C (Cys C) on adventitia in rabbit abdominal aorta restenosis after angioplasty and its mechanism. Methods 48 New Zealand white rabbits were randomly divided into injury group (receiving balloon dilation of abdominal aorta), the treatment group (taking Cys C monoclonal antibody therapy) and the control group (receiving femoral artery puncture and catheter sheath without balloon dilation and intervention of Cys C monoclonal antibody injection), and each group had 16 rabbits.Peripheral vein blood was drawn to measure the serum level of cystatin C before and 8 h, 1 day, 1 week, 3 weeks, 6 weeks after the operation in all rabbits.After 6 weeks of operation, the abdominal aorta were taken and stained with HE.Vascular morphometry analysis and adventitial cell count were conducted.Smooth muscle actin (SM-actin) and proliferating cell nuclear antigen (PCNA) expressions in the adventitia were observed by immunohistochemical staining.The number of PCNA positive cell in the adventitia was counted and the PCNA proliferation index was calculated.The vascular remodeling index, vascular external elastic lamina area (EELA), internal elastic lamina area (IEIA) were used to evaluate the vascular remodeling and the residual stenosis and vascular cavity area was used to measure the vascular stenosis. Results Plasma Cys C level began to rise at 8h after operation and reached the peak at 1 week after operation, and continuously increased for 5 weeks in injury group, and reached to respectively at 3 weeks and 6 weeks after operation.The Cys C levels were significantly higher in injury group than in the treatment and control groups at different time points (all P<0.05). There were no significant differences in Cys C levels at different time points between the treatment group and the control group.The injury group showed that the number of PCNA positive cells was higher in injury group than in treatment and control groups, both P<0.05). Compared with the control group, the vascular luminal area, EELA and IELA were significantly increased (all P<0.05). After treated with the monoclonal antibody Cys C intervention, the treatment group showed that lumen area, vascular EELA, IELA was significantly decreased (P<0.05), and the vascular remodeling index and residual stenosis rate were decreased as compared with the injury group (0.871 vs.0.784, 33.1% vs.19.7%, both P<0.05). Correlation analysis showed that Cystatin C level was positively correlated with the vascular lumen area, neointimal area, internal elastic lamina area, external elastic lamina area and the number of PCNA positive cells (r=0.812, 0.797, 0.876, 0.932 and 0.822 respectively, all P<0.01). Conclusions Plasma Cys C level is increased in rabbit after abdominal aorta balloon injury and has a positive correlation with the severity of arterial stenosis.High Cys C level can induce adventitial fibroblast activation, proliferation, phenotype transformation and migration, and accelerate the processes of atherosclerosis and stenosis.Cys C level is the independent risk factor for abdominal aortic stenosis. Key words: Cyalones; Aorta, abdominal; Angioplasty

Heart valve disease is a major public health problem, with surgical valve replacement still representing the leading therapeutic option. In the last 20 years, implantation of cryopreserved human heart valves underwent so progressive increase that current availability of allogeneic valve substitutes is not sufficient to meet clinical demand. However, also valve allografts undergo long-term failure depending on host-versus-graft immune responses and degeneration of resident cells and extracellular matrix components with subsequent priming of mineralization processes. In a previous study, suitably decellularized porcine aortic valves implanted in the pulmonary position in Vietnamese pigs resulted to be permissive of in vivo spontaneous repopulation by recipient’s cells, showing tissue remodelling and satisfactory hemodynamic performance (1). Using the same animal model, decellularized valve allografts were compared with other ones which were additionally subjected to cryopreservation/thawing before implantation. Previous echocardiographic analysis showed near-normal hemodynamic behaviour for both allograft types. Here, microscopic examination revealed non-uniform outcomes for both treatments, because there was co-presence of native-like and altered regions. In the former, almost complete re-endothelialization and repopulation by cells with features of fibroblasts, myofibroblasts, and smooth muscle cells involved both cusps and aorta walls. Ultrastructural identification of typical canals of collagen fibrillogenesis and elastogenesis-related features revealed actual tissue remodelling to have been occurred. In aorta walls, incipient neo-vascularization and re-innervation of medial and adventitial tunicae were also detected. Conversely, altered regions showed fibrin deposits, inflammatory infiltrates, fragmented elastin fibers, and calcific loci in absence of cell repopulation, with these features mainly concerning cryopreserved allografts. In conclusion, cryopreservation was found to limit the favourable outcomes characterizing decellularized allografts, even if hemodynamic performance was not affected. However, both treatments were found to not compromise repopulation by host’s cells and tissue renewal. Thus, the obtained preclinical data suggest the feasibility to achieve cryobank-derived self-regenerating and hemodynamically functional allogeneic valve substitutes, after optimization of these two pre-implantation procedures or their mutual compatibility

Diabetic cardiomyopathy involves both cardiac and large vessels alterations in their biochemical and biomechanical properties. Part of these dysfunctions is due to ROS overproduction and advanced glycated end-products (AGEs) synthesis caused by high blood glucose concentrations (1). Epidemiological studies usually ignore sexgender outcomes of diabetes that has higher cardiovascular risk in women than in men (2). The aim of the present study was to assess the effects of diabetes on aorta, portal vein and myocardium morphology in females Wistar rats. Diabetes was induced by a single dose of streptozotocin 65 mg/kg, and, after 4 and half months, we evaluated the cardiovascular remodelling by light and transmission electron microscopy (TEM). Paraformaldehyde fixed samples of aorta and portal vein were stained with Masson Trichrome method (for collagen fibers), Weigert’s stain (for elastic fibers), Hematoxylin and Eosin (for nuclei), and underwent to morphometric analysis. TEM samples were prepared accordingly to common protocols. Morphometric analysis performed on diabetic aortas showed a reduction of tunica media thickness, but the internal diameter width or the lumen cross-area was unchanged compared to controls. The number of smooth muscle cells increased in tunica media of diabetic aortas. The main change observed in diabetic portal veins was a reduction of the area occupied by elastic fibers in tunica adventitia. TEM observations of papillary muscles did not reveal any changes in the sarcomere lengths across the two experimental groups. These results display slight differences on what was reported in male rats (3) and account for a different development of diabetes in female subjects.

To investigate the relationship between pulmonary arterial and small airway inflammation in smokers with normal lung function and smokers with chronic obstructive pulmonary disease (COPD). Patients requiring lung resection for peripheral lung cancer were divided into group A (nonsmokers with normal lung function, n = 10), group B (smokers with normal lung function, n = 13) and group C (smokers with stable COPD, n = 10). Normal pulmonary tissue was obtained more than 5 cm away from cancer lesion. The pathomorphological changes of the pulmonary muscularized arteries (MA) and small airways were observed by HE and Victoria blue-Van Gieson's stains.Lymphocytes infiltrated in the MA and small airways were observed by immunohistochemical methods. The characteristics and the correlations between pulmonary arterial inflammation and small airway inflammation were analyzed. The thickness of MA wall in the three groups was (119 ± 11), (139 ± 25) and (172 ± 28) µm respectively. The total small airway pathology score was (49 ± 10), (101 ± 34) and (163 ± 36) respectively. The score in group B and C was significantly higher than that in group A (P < 0.05), and the thickness of MA wall and total small airway pathology score in group C was significantly higher than that in group B (P < 0.05). The degree of CD(+)(3) T-lymphocytes and CD(+)(8) T-lymphocytes infiltration in the intima, media and adventitia of MA and epithelial layer, lamina propria and adventitia of small airway in group B and C was more significant than that in group A, especially CD(+)(8) T-lymphocytes infiltration in adventitia of MA and small airway (P < 0.05). Expression of CD(+)(4) T-lymphocytes on epithelial layer, lamina propria and adventitia of small airway in group C was higher than that in group A (P < 0.05), but the CD(+)(4)/CD(+)(8) ratio in the whole layer of airway wall declined (P < 0.01). Among three groups, the infiltration of B-lymphocytes in three layers compared each other had no statistical differences (P > 0.05). The infiltration of CD(+)(3)T-lymphocytes and CD(+)(8)T-lymphocytes in the whole layer of MA was positively correlated with the total small airway pathology score respectively (r = 0.431,0.633, P < 0.05), and the degree of CD(+)(3)T-lymphocytes and CD(+)(8)T-lymphocytes infiltration in MA showed positive correlation with that in small airway (r = 0.655,0.725, P < 0.01). The degree of CD(+)(8)T-lymphocytes infiltration in MA and small airway was positively correlated with thickness of MA (r = 0.589,0.556, P < 0.01). Both in smokers with normal lung function and smokers with stable COPD, CD(+)(8)T-lymphocytes infiltration in the whole layer of pulmonary arteries and small airways is the same kind of inflammation, mainly in the adventitia of pulmonary arteries and small airways. They are a part of pulmonary inflammation in COPD and promote the development of COPD.

Stem cells (SCs) are classified into embryonic and adult types; the latter is further divided into several subtypes including mesenchymal stem cells (MSCs), which are the most extensively studied adult SCs in the field of regenerative medicine. In urology the most frequently used MSCs are derived from the bone marrow, skeletal muscle, and adipose tissue. Due to its abundant tissue source and ease of isolation, adipose tissue-derived MSC (ADSC) is gaining wider acceptance as the most promising therapeutic cell type.Regardless of their tissue origin, MSCs have been shown to locate near or within blood vessels. In adipose tissue we demonstrated their localization in the capillaries and in the adventitia of larger blood vessels, and this has been independently confirmed by all subsequent studies. Thus, in a recent review article we proposed that MSCs are vascular stem cells, and this helps explain why MSCs exist in not only the bone marrow but also other adult tissues.Although MSCs have been shown to possess multi-lineage differentiation potential, the evidence is mostly in vitro. In a recent review article we discussed in detail why current in vivo evidence is unconvincing. Furthermore, in a recent book chapter we discussed that, instead of cellular differentiation, paracrine action is the principal mechanism through which MSCs exert therapeutic effects.MSC therapy for the kidney has been demonstrated in both acute and chronic renal failure animal models. The mechanism is generally trophic and anti-inflammatory while cell differentiation or engraftment is rarely detected. In 3 recent clinical trials MSC administration has been shown to improve kidney transplantation. For the ureter, both BMSC and ADSC have been tested for the construction of tissue grafts. For the bladder, MSCs have been investigated for the construction of tissue grafts and for the treatment of bladder dysfunction. In regard to the urethra, which is the most extensively investigated urological tissue in terms of SC therapy, we have recently summarized and discussed all published studies on SC therapy for stress urinary incontinence. In regard to the penis, which is the second most investigated urological organ in terms of SC therapy, we have also recently summarized and discussed all published studies on SC therapy for erectile dysfunction. Papers that are published more recently will be updated in this talk.

The aim of the study was to evaluate the polioencephalomalacia induced with amprolium in goats: pathologic changes of the central nervous system. Eight apparently healthy goats of 6 to 9 weeks of age were drenched with amprolium (200 mg/kg body weight) till the development of clinical signs. Three goats of the same age group were drenched with tap water only and these served as controls. Amprolium drenched goats were allowed to die after the onset of clinical signs and control goats were euthanised after the death of amprolium fed goats. At the time of development of typical clinical signs of cerebrocortical necrosis (CCN) the goats were killed and necropsied and a complete histopathologic examination was performed. At necropsy of the four goats, large necrotic lesion was found in the cerebral cortex, and tissue thiamine levels decreased significantly, especially in cerebrum and cerebellum. However, the brain as a whole in all experimental animals, exhibited moderate to severe congestion, oedema and numerous small yellowish foci of varying sizes scattered on the surface of the cerebral hemispheres.Microscopic changes in the brain were limited to gray matter structures of cerebral and cerebellar cortex, caudal colliculi of mid brain, thalamus, cerebellum and spinal cord. There was shrinkage of neurons, perivascular and pericellular edema, necrosis of neurons, satellitosis, glial nodule, gliosis, middle laminar necrosis and deep laminar edema. Blood vessel walls were thickened due to hypertrophy and hyperplasia of endothelial and adventitial cells. Swollen and prominent capillary epithelium, satellitosis, presence of ghost cells, gliosis and perivascular cuffing were also observed but only in some of the animals. In the cerebellar cortex, there was degeneration of Purkinje cells. The caudal colliculi of mid brain showed bilateral malacia. To the best of our knowledge, these researchers questioned the hypothesis that the amprolium could be the major factor causing polioencephalomalacia. This is the first documentation of Amprolium-Induced cerebrocortical necrosis on goat in Iran.