Vessel Damage Research Articles

A pictorial neuroradiological review of brain vascular abnormalities in patients with kidney disease.

A well-known link exists between cerebrovascular disease and chronic kidney disease. Cerebrovascular pathology in patients with kidney disease may be asymptomatic and occasionally discovered through neuroradiological examinations or it may present with neurological symptoms. Covert cerebrovascular lesions represent the earliest injuries associated with chronic kidney disease and primarily result from small vessel damage. These conditions often manifest incidentally, appearing as structural changes (such as lacunes, white matter lesions, enlarged perivascular spaces, cerebral microbleeds, and atrophy) as well as microstructural and hemodynamic alterations, detectable through routine and advanced functional MRIs. These alterations may be associated with a higher risk of stroke, cognitive decline, and dementia. Patients with end-stage renal disease or chronic kidney disease undergoing dialysis may be at increased risk of large-artery atherosclerosis, cardio-embolism, or small-vessel occlusion, and they may experience symptomatic acute ischemic strokes as rare complications. Currently, there are no established guidelines or standardized diagnostic protocols for preventing cerebrovascular disease in patients with kidney disease. Clinical and radiological studies are warranted to evaluate the usefulness of incorporating neuroimaging into the diagnostic work-up of these patients in order to improve prognosis and reduce diagnostic delays.

Managing ankle fracture-dislocation injury in the emergency department: a case study.

Ankle fracture-dislocation is a serious injury that requires prompt and appropriate management. The proximity of various neurovascular structures around the ankle joint means there is a risk of nerve or blood vessel damage. Initial management in the emergency department (ED), therefore, includes the realignment and repositioning of the dislocated joint to its normal anatomical position, referred to as reduction. This article details a case study of a 42-year-old woman who presented to an ED in Ireland with a suspected ankle fracture-dislocation following a fall while playing sport. Following triage and initial pain management, the patient's care was managed by an advanced nurse practitioner, in collaboration with medical colleagues, which involved history taking and physical assessment, reduction of the dislocation and splinting of the ankle under procedural sedation, monitoring during and after procedural sedation, and radiological imaging.

Multi scale systematisation of damage and failure modes of high-pressure hydrogen composite vessels in aviation, Part 1: Methodology

In the development of composite Compressed Gaseous Hydrogen (CGH2) storage vessels the multitude of design, material and manufacturing parameters introduce uncertainties. In addition with complex interacting failure modes such as delamination, matrix and fibre failure high safety margins are needed.The aim of this paper is to enable the decrease of safety margins by developing a fundamental methodology to systematise superimposed loads and their propagation across length scales and load domains to enable the reliability assessment and development of CGH2 vessels in aircraft with high reliability and maximum gravimetric storage density. Therefore, the objectives are to analyse existing development strategies, to derive requirements for a new development approach and to define its underlying logic and procedure. This results in a methodology to systematise potentially occurring load cases, corresponding stresses and resulting failure modes of CGH2 vessels in aircraft along the length scales from the aircraft super-system to the material level.

Assessment of simulated and observed cavitation-induced erosion damage in spallation neutron source target vessels

Cavitation-induced erosion damage in different Spallation Neutron Source (SNS) target designs are simulated using explicit finite element–based techniques and compared with observations of erosion in targets after operation. The efficacy of the previously developed method, called saturation time, was evaluated using erosion-damaged samples from new target designs. A new metric called maximum bubble size was implemented under the rationale that larger cavitation bubbles will collapse more intensely. The maximum cavitation bubble size over 1 ms of simulated time was calculated based on the Rayleigh–Plesset equation for each element integration point and presented as a contour map at the vessel surface for assessing with erosion observations. SNS targets are now operated with helium gas injection to reduce cavitation damage. A simulation method using a material model for the mixture of mercury and gas bubbles was recently developed and used to account for the effect of small gas bubbles on the structural response of the target vessel. This work compares the new method's results with observed cavitation damage. Maps of the calculated maximum bubble size for targets operated with and without gas injection were compared with photographs of erosion damage observed in SNS targets. The patterns in maximum bubble size maps correlated well with observations of erosion patterns in target vessels after service. Advantages and challenges of the maximum bubble size simulation technique are provided, and differences between results from the previous and the newly proposed metric are discussed.

Static and dynamic cell culture of small caliber bilayer vascular grafts electrospun from polycaprolactone

Developing a suitable vascular graft to replace damaged small-caliber vessels and promote tissue regeneration is a critical challenge. This study focuses on bilayer polycaprolactone (PCL) grafts, fabricated by electrospinning, with both randomly distributed and radially oriented fibers. The analysis covers surface morphology, fiber diameter, pore size, cellular behavior, and biodegradability. Human umbilical vein endothelial cells (HUVECs) show an impressive viability of 142.2% after 7 days, while umbilical artery smooth muscle cells (UASMCs) exhibit 112.6%. Fluorescent microscopy indicates a higher viability of HUVECs over UASMCs. On the other hand, less than 10% of HUVECs and less than 5% of UASMCs undergo cell death within 7 days. Biodegradation analysis over 12 months shows a significant weight loss of 65–70% for both types of fiber arrangements. A custom-designed bioreactor enables dynamic cell culture, revealing comparable activity to static cultures. In the dynamic cell culture environment, HUVECs maintain high viability and display robust proliferation at both the 4th and 7th days, supporting the results observed in static cell cultures. These findings underscore the significant potential of bilayer PCL grafts in advancing the field of blood vessels, offering promising avenues for the development of functional vascular replacements with enhanced regenerative capabilities.

Abstract 4124604: Finding the Right Course: Unknown Source of Hemorrhage Following Endocardial-Epicardial Ablation for Ventricular Tachycardia

Background: Epicardial radiofrequency ablation via percutaneous access is a common technique for ventricular tachycardia (VT) ablation. Rapid identification of and response to complications can reduce morbidity and mortality. Objective: We present a case of epicardial VT ablation complicated by a distal left internal mammary artery (LIMA) transection secondary to subxiphoid sheath insertion. Report: A 66-year-old man with hypertrophic cardiomyopathy was referred for endo-epicardial ablation of recurrent VT. Pericardial access was obtained using coronary vein exit and carbon dioxide insufflation technique. An 8.5F sheath was advanced over an indwelling pericardial wire, and ablation was performed. Following ablation, 400cc of blood was aspirated from the pericardial space after replacing the 8.5F sheath with a standard pericardial drain. Urgent angiography revealed intact coronary arteries, coronary sinus (CS) and LIMA. The 8.5F sheath was re-introduced and bleeding ceased. CT scan revealed no myocardial or great vessel damage. Mild pericardial drainage continued overnight. The next day, IR angiography demonstrated transection of the distal LIMA from the indwelling sheath. The patient underwent placement of a back-up pericardial drain, followed by coil embolization of the injured artery without complication (Fig). Conclusion: This case highlights the importance of maintaining a broad differential during apparent complications of epicardial access and the importance of staying close to midline for epicardial puncture given anatomic variability. The differential for acute blood loss and pericardial effusion following epicardial ablation includes 1) coronary artery damage, 2) CS damage, 3) extracardiac vascular injury, and 4) right ventricular injury. When extracardiac vascular injury is suspected, multidisciplinary collaboration is essential.

Electron microscopy method in assessing the quality of cell cryopreservation

During its existence, electron microscopy has become one of the reference methods for assessing the structural and functional state of cells, tissues and organs, and an extensive evidence base has been formed that allows its use in the creation and formation of a biobank. The selection of sources for the literature review was carried out using keywords based on publications over the past 20 years. The publications presented in the review were selected by searching the eLIBRARY.RU, PubMed and Scopus databases. Based on foreign and domestic experience in the work of biobanks, we can distinguish four areas that determine the effectiveness of the use of electron microscopy studies as a component of its work. Firstly, it is control of microbiological contamination of a biological sample. The effectiveness of electron microscopy in detecting contamination of a biological sample with bacteria, fungi and viruses is comparable to the effectiveness of classical microbiological techniques. Secondly, it is a diagnostic tool that allows you to identify or confirm the presence in a sample of a pathogenetic process that is of interest for biobanking: tumor growth, atherosclerotic vessel damage, etc. Thirdly, it is quality control for cryopreservation of samples. A wide range of morphological characteristics of the ultramicroscopic structure of cells and microanatomical formations makes it possible to characterize the quality of cryopreservation and quantify the degree of damage, which contributes to the unification and standardization of biobanking. Transmission electron microscopy is the most informative in this matter. Fourthly, this is the basis for digitalization of the results obtained and the formation of an interdisciplinary biobank repository, which allows the use of “big date” technologies for fundamental research. The compliance of the biobank profile with the economic, scientific and industrial characteristics of the infrastructure of the industry or region is of great importance. Electron microscopy data are successfully combined with the results of molecular studies, which allows the formation of interdisciplinary metadata databases suitable for interregional and interdisciplinary scientific integrations. The latter makes it possible to use electron microscopy data to solve a wide range of applied and interdisciplinary problems. The above allows us to consider scanning and transmission microscopy methods as one of the key methods in the development of biobanking in the region.

The effect of Xerostomia in diabetes mellitus patients on the incidence of dry socket after tooth extraction: A literature review

Background: Diabetes Mellitus (DM) is a metabolic disorder caused by the absence of insulin hormone production or lack of response to insulin. Diabetes mellitus can cause complications such as caries, periodontal disease, and xerostomia. Xerostomia is associated with low salivary flow which can cause several additional complications. Objective: To determine the effect of xerostomia, a complication in patients with diabetes mellitus, on the incidence of dry sockets after tooth extraction. Method: The method used in this study is a Literature Review, which searches three different journal databases, using the search terms "xerostomia" OR "diabetes mellitus" AND "tooth extraction" OR "dry socket." Results: It shows that there is an effect between the occurrence of xerostomia in patients with diabetes mellitus and the incidence of dry sockets after tooth extraction. Discussion: In patients with diabetes mellitus, saliva production can decrease due to nerve and blood vessel damage caused by glucose metabolism disorders in the body. This can reduce the quality and increase the viscosity of saliva, making the wound-healing process after tooth extraction more difficult. Xerostomia in patients with diabetes mellitus can worsen the dry socket condition because of the lack of moisture in the oral cavity, which can affect the blood clotting process after tooth extraction. If the blood clot dislodges, it can cause a dry socket in xerostomia patients. Conclusion: Dry socket in diabetic patients with xerostomia is thought to be due to low saliva production which interferes with wound healing after tooth extraction.

Modified laparoscopic sacrocolpopexy for advanced posterior vaginal wall prolapse: a 3-year prospective study.

To evaluate and validate the safety and efficacy of modified laparoscopic sacrocolpopexy for advanced posterior vaginal wall prolapse at up to 3 years of follow-up. As a prospective observational study, we collected 56 cases with advanced posterior vaginal wall prolapse and performed modified laparoscopic sacrocolpopexy (MLSC) with self-cut mesh. The main improvement is the cutting and fixing of the mesh. Patients were followed up at 6, 12, 24 and 36 months. The main indicators of follow-up were postoperative anatomic success rate and Pelvic organ prolapse quantitation (POP-Q) score, and secondary indicators were related to quality-of-life scales and postoperative complication rates. All patients completed the operation through minimally invasive surgery, and there were no vital organs and blood vessel damage during the operation. The mean age was (58.32 ± 7.63) years. There was no recurrence of stage I or lower during the follow-up maximum of 36 months (median 24 months), and the anatomic success rate was 100%. The quality-of-life scores improved significantly (p < 0.001) and the quality of sexual life was not affected (p = 0.5). There was 1 case of continuous vaginal mesh exposure at 12 months (2.86%) and 1 case of severe infection with poor healing of vaginal stump within 6 months (1.79%). No one had urinary incontinence (UI) requiring reoperation. In patients with advanced posterior vaginal wall prolapse, MLSC can provide good and durable pelvic floor anatomical recovery and functional outcomes with no specific complications.

Cerebral small vessel injury in mice with damage to ACE2-expressing cerebral vascular endothelial cells and post COVID-19 patients.

The angiotensin-converting enzyme 2 (ACE2), which is expressed in cerebral vascular endothelial cells (CVECs), has been currently identified as a functional receptor for SARS-CoV-2. We specifically induced injury to ACE2-expressing CVECs in mice and evaluated the effects of such targeted damage through magnetic resonance imaging (MRI) and cognitive behavioral tests. In parallel, we recruited a single-center cohort of COVID-19 survivors and further assessed their brain microvascular injury based on cognition and emotional scales, cranial MRI scans, and blood proteomic measurements. Here, we show an array of pathological and behavioral alterations characteristic of cerebral small vessel disease (CSVD) in mice that targeted damage to ACE2-expressing CVECs, and COVID-19 survivors. These CSVD-like manifestations persist for at least 7 months post-recovery from COVID-19. Our findings suggest that SARS-CoV-2 may induce cerebral small vessel damage with persistent sequelae, underscoring the imperative for heightened clinical vigilance in mitigating or treating SARS-CoV-2-mediated cerebral endothelial injury throughout infection and convalescence. Cerebral small vessel disease-associated changes were observed after targeted damage to angiotensin-converting enzyme 2-expressing cerebral vascular endothelial cells. SARS-CoV-2 may induce cerebral small vessel damage with persistent sequelae. Clinical vigilance is needed in preventing SARS-CoV-2-induced cerebral endothelial damage during infection and recovery.

Features of vascular anatomy in pancreaticoduodenal resection

In about 55–79% of patients, the vascular anatomy of the hepatic-pancreaticoduodenal area is characterized by a typical structure. In the rest of patients, the vascular and, primarily, arterial anatomy may vary due to both different variants of branches and additional arteries. Undoubtedly, this creates difficulties in surgical planning and performing pancreaticoduodenal resection. Vascular anatomic variations may contribute to increased intraoperative blood loss, postoperative complications, changes in the course and volume of surgery, and increased duration of hospital stay after surgery. Modern diagnostic methods, CT angiography in particular, facilitate the process of surgical planning and reduce the risk of unforeseen situations related to ligation or damage of arterial vessels, which are to be preserved during operations. In this work, we carry out a review of publications on the topography of arterial vessels in the area of pancreaticoduodenal resection. The issues related to anatomical variations in both trunk and pancreatic vessels are considered. Special attention is paid to the possible influence of variations in the vascular network structure on the course and volume of surgery, as well as the risk of intraoperative and postoperative complications.

Regulation of Cerebral Blood Flow Velocity by Transcutaneous Electrical Nerve Stimulation: A Preliminary Study

Objectives: An excessive and abrupt increase in cerebral blood flow may cause blood vessel damage, leading to stroke. Therefore, appropriate methods to immediately regulate blood flow velocity are important. Through an analysis of 31 healthy adults, we therefore investigated whether stimulating the common carotid artery (CCA) using transcutaneous electrical nerve stimulation (TENS) could modulate blood flow velocity in the CCA. Methods: Three stimulation intensities (below-threshold, threshold, and above-threshold) were applied in a random order. Blood velocity changes were examined by the measurement of peak systolic velocity (PSV) with Doppler ultrasound before, during, and after TENS stimulation. To evaluate arterial stiffness, pulse wave velocity (PWV) was calculated using CCA diameter, and blood pressure was measured before and after stimulation. Results: PSV changes in the below-threshold level were significant (p = 0.028). The PSV after below-threshold stimulation was significantly decreased by 2.23% compared to that before stimulation (p = 0.031). PWV showed no significant differences; however, a nonsignificant increase was observed immediately after stimulation only in the above-threshold condition. Above-threshold stimulation can increase vascular tone by activating the sympathetic nerve, possibly triggering vasoconstriction. Conclusions: A decrease in blood flow velocity may not be expected upon the above-threshold stimulation. In contrast, the below-threshold stimulation immediately reduces blood flow velocity, without significantly affecting hemodynamic function, such as arterial flexibility. Therefore, this short-term and low electrical stimulation technique can help to lower vascular resistance and prevent vascular damage from rapid blood flow velocity.

Evaluation of properties for Carbothane™ 3575A–based electrospun vascular grafts in vitro and in vivo

Bioengineered vascular grafts have emerged as a promising alternative to the treatment of damaged or occlusive vessels. It is thought that polyurethane-based scaffolds possess suitable hemocompatibility and biomechanics comparable to those of normal blood vessels. In this study, we investigated the properties of electrospun scaffolds comprising various blends of biostable polycarbonate-based polyurethane (Carbothane™ 3575A) and gelatin. Scaffolds were characterized by scanning electron microscopy, infra-red spectroscopy, small-angle X-ray scattering, stress-loading tests, and interactions with primary human cells and blood. Data from in vitro experiments demonstrated that a scaffold produced from a blend of 5% Carbothane™ 3575A and 10% gelatin has proven to be a suitable material for fabricating a small-diameter vascular graft. A comparative in vivo study of such vascular grafts and ePTFE grafts implanted in the abdominal aorta of Wistar rats was performed. The data of intravital study and histological examination indicated that Carbothane-based electrospun grafts outclass ePTFE grafts and represent a promising device for preclinical studies to satisfy vascular surgery needs.

Assessment of Hyperacute Cerebral Ischemia Using Laser Speckle Contrast Imaging.

Background: Accurate diagnosis of cerebral ischemia severity is crucial for clinical decision making. Laser speckle contrast imaging-based cerebral blood flow imaging can help assess the severity of cerebral ischemia by monitoring changes in blood flow. Method: In this study, we simulated hyperacute ischemia in rats, isolating arterial and venous flow-related signals from cortical vasculature. Pearson correlation was used to examine the correlation between damaged vessels. Granger causality analysis was used to investigate causality correlation in ischemic vessels. Results: Resting state analysis revealed a negative Pearson correlation between regional arteries and veins. Following cerebral ischemia induction, a positive artery-vein correlation emerged, which vanished after blood flow reperfusion. Granger causality analysis demonstrating enhanced causality coefficients for middle artery-vein pairs during occlusion, with a stronger left-right arterial effect than that of right-left, which persisted after reperfusion. Conclusions: These processing approaches amplify the understanding of cerebral ischemic images, promising potential future diagnostic advancements.

Deep learning-driven predictive tools for damage prediction and optimization in composite hydrogen storage tanks

This research presents a comprehensive framework for predicting the damage in lightweight composite high-pressure hydrogen storage tanks and optimizes their design to prevent failure. By integrating advanced analytical methods, numerical analysis, and deep learning techniques, we introduced a novel approach to enhance design optimization and damage prediction. The framework employs the 3D elasticity anisotropy theory to predict mechanical performance, incorporating failure criteria for accurate damage analysis. A parametric study was conducted to examine the effects of thickness, pressure, and diameter on the behavior of the tank. The analytical results were compared against finite element analysis using the WoundSim software, underscoring the significance of the modeling assumptions. Furthermore, we developed a new framework that combines deep neural networks with differential evolution optimization (DNN-DEO) to predict stress and damage in composite pressure vessels while identifying the optimal design parameters (pressure, radius, and thickness) to minimize failure risks and maintain high performance. A graphical user interface (GUI) was also designed to automate calculations and predictions, providing an intuitive tool for users. This integrated approach offers a powerful solution for optimizing the design and operation of lightweight composite hydrogen storage tanks, ensuring the reliability and efficiency of hydrogen storage systems.

A Dynamic Bayesian Network model for ship navigation risk in the Arctic Northeast Passage

The melting of a significant amount of sea ice has enabled the commercial and normal operation of ships in the Arctic. However, the harsh natural environment, unique geographical location and complex navigational conditions pose a serious challenge to the safety of ships during navigation. Ship besetting in ice and ship-ice collision are identified as the most critical risks, potentially resulting in vessel damage, property loss, environmental harm, and even casualties. This study proposes a dynamic Bayesian network (DBN) model to assess and predict the risk of ship besetting in ice and ship-ice collision in five sea areas along the Arctic Northeast Passage. The proposed method comprehensively considers environmental, ship and human factors and incorporates multi-year (2013–2022) marine meteorological reanalysis data and expert knowledge. The developed model has seven time steps and can be updated based on past, current and future conditions. The results indicate that it can effectively reflect the distribution of ship navigation risks in various sea areas and has the capability to be updated in real-time, serving as a tool for guiding ship operations and navigation decisions. At the same time, this study confirms August and September are the optimal navigation periods for the Northeast Passage, and the East Siberian Sea presenting the highest navigation risk. Ice thickness, ice concentration, navigation experience, professional skills, ship speed and ship class are identified as the primary risk factors in the region.

Modern approaches to the management of blunt liver trauma

Relevance. Liver trauma is one of the most common abdominal injuries. The purpose is to review the evidence and present the current level of diagnosis, tactics and treatment of blunt liver trauma.Materials and methods. The results of clinical studies in liver trauma have been analyzed. Literature was searched in PubMed electronic search engines (https://pubmed.ncbi.nlm.nih.gov), eLibrary (https://elibrary.ru) by keywords: "liver trauma", "management liver trauma", "diagnosis liver trauma". 134 publications were selected for analysis.Results. Historically, most patients with liver trauma were cured promptly using techniques such as liver suturing, liver resection, ligation of the hepatic artery, atrioval shunts. Conservative management was practically not used. Consequently, mortality was high and reached almost 90% in patients with severe trauma, including damage to the main hepatic vessels. The introduction of such techniques as perigepathic packaging and direct suturing of damaged vessels significantly improved the prognosis of patients. The widespread use of conservative therapy in patients with stable hemodynamics, the management of which is based on instrumental assessment, carefully selected diagnostic imaging of the nature of liver injury, instrumental dynamic observation using operative X-ray angiology and endoscopy, in a hybrid operating room, contributed to the improvement of treatment results.Conclusion. In recent decades, conservative therapy has been performed in 80–86% of cases in patients with stable hemodynamics. The use of minimally invasive interventions such as angiography and embolization, a combination of percutaneous drainage and endoscopic methods for injury to vascular and biliary structures can be considered as the main method of treating post-traumatic complications.

OXIGENOTERAPIA HIPERBÁRICA

Hyperbaric oxygen therapy (HBOT) has aroused increasing interest as an effective therapeutic intervention in diabetic patients, especially those suffering from chronic complications such as diabetic foot ulcers. This article examines the application of HBOT in this context, highlighting its potential benefits and the mechanisms underlying its therapeutic effects. HBOT involves administering pure oxygen at a pressure higher than atmospheric, resulting in increased levels of dissolved oxygen in the blood plasma. In diabetic patients, chronic hyperglycemia can lead to blood vessel damage, compromising tissue oxygenation and delaying wound healing. HBOT aims to correct this oxygenation deficiency by delivering oxygen at high concentrations and pressures that increase oxygen diffusion in compromised tissues. Clinical studies have shown that HBOT can accelerate the healing of diabetic foot ulcers, reduce the risk of amputation, and improve the quality of life of these patients. In addition, HBOT exerts anti-inflammatory effects and promotes the formation of new blood vessels, which may be crucial to restore compromised tissue perfusion in diabetic patients. Importantly, HBOT is not a monotherapy but rather an integral part of a multidisciplinary treatment plan and should be combined with appropriate glycemic control measures, wound care, antibiotic therapy, and other interventions as needed to optimize clinical outcomes. In summary, HBOT represents a promising approach in the management of chronic complications in diabetic patients, offering potential to improve wound healing, prevent amputations, and improve quality of life. However, more research is needed to fully elucidate the mechanisms of action of HBOT and identify subgroups of patients who will benefit most from this therapy.

Treatment of supracondylar fractures of the humerus in adults using a novel anatomical locking plate on the anterior distal humerus: a case report

BackgroundDue to its unique anatomical characteristics, supracondylar fractures of the humerus are often difficult to achieve firm fixation with internal fixation equipment, resulting in delayed functional exercise, often leaving cubitus varus deformity, elbow stiffness, contractures, and other complications. Here, we report an adult patient with a supracondylar fracture of the humerus who underwent internal fixation through an anterior median incision in the humerus with our self-developed anterior anatomical locking plate of the distal humerus.Case presentationA 29-year-old male patient of Chinese ethnicity with trauma-induced right supracondylar fracture of the humerus and multiple soft tissue contusions, without nerve damage, blood vessel damage, or other injuries, underwent an internal incision in our hospital using a new anatomical locking plate for the anterior distal humerus fixed treatment. During the 16-month follow-up period, the patient’s elbow range of motion was almost completely restored, functional scores were excellent, and there were no minor or major postoperative complications.ConclusionIn this study, we propose a surgical reconstruction strategy for adult patients with supracondylar humeral fractures. Through the anterior median incision of the humerus, open reduction and internal fixation were performed with an anatomic locking plate on the anterior side of the distal humerus to restore and fix the structure of the distal humerus, and satisfactory clinical results were achieved in our case.

Identification of the effects of alkalinity exposure on the gills of oriental river prawns, Macrobrachium nipponense

Macrobrachium nipponense is an important commercial freshwater species in China. However, the ability of alkali tolerance of M. nipponense is insufficient to culture in the major saline-alkali water source in China. Thus, it is urgently needed to perform the genetic improvement of alkali tolerance in this species. In the present study, we aimed to analyse the effects of alkali treatment on gills in this species after 96 h alkalinity exposure under the alkali concentrations of 0 mmol/L, 4 mmol/L, 8 mmol/L, and 12 mmol/L through performing the histological observations, measurement of antioxidant enzymes, metabolic profiling analysis, and transcriptome profiling analysis. The results of the present study revealed that alkali treatment stimulated the contents of malondialdehyde, glutathione, glutathione peroxidase in gills, indicating these antioxidant enzymes plays essential roles in the protection of body from the damage, caused by the alkali treatment. In addition, high concentration of alkali treatment (> 8 mmol/L) resulted in the damage of gill membrane and haemolymph vessel, affecting the normal respiratory function of gill. Metabolic profiling analysis revealed that Metabolic pathways, Biosynthesis of secondary metabolites, Biosynthesis of plant secondary metabolites, Microbial metabolism in diverse environments, Biosynthesis of amino acids were identified as the main enriched metabolic pathways of differentially expressed metabolites, which are consistent with the previous publications, treated by the various environmental factors. Transcriptome profiling analyses revealed that the alkali concentration of 12 mmol/L has more regulatory effects on the changes of gene expression than the other alkali concentrations. KEGG analysis revealed that Phagosome, Lysosome, Glycolysis/Gluconeogenesis, Purine Metabolism, Amino sugar and nucleotide sugar metabolism, and Endocytosis were identified as the main enriched metabolic pathways in the present study, predicting these metabolic pathways may be involved in the adaption of alkali treatment in M. nipponense. Phagosome, Lysosome, Purine Metabolism, and Endocytosis are immune-related metabolic pathways, while Glycolysis/Gluconeogenesis, and Amino sugar and nucleotide sugar metabolism are energy metabolism-related metabolic pathways. Quantitative PCR analyses of differentially expressed genes (DEGs) verified the accuracy of the RNA-Seq. Alkali treatment significantly stimulated the expressions of DEGs from the metabolic pathways of Phagosome and Lysosome, suggesting Phagosome and Lysosome play essential roles in the regulation of alkali tolerance in this species, as well as the genes from these metabolic pathways. The present study identified the effects of alkali treatment on gills, providing valuable evidences for the genetic improvement of alkali tolerance in M. nipponense.