Peripheral Blood Vessels Research Articles

S-18-6: SALT AND AGE-RELATED HYPERTENSION

Hypertension is the greatest risk factor for cardiovascular disease and stroke, and its incidence increases with age. Clinical studies have shown that salt intake is involved in the development of age-related hypertension and that salt sensitivity of blood pressure (BP) increases with age, but the mechanism was unknown. On the other hand, it was reported that circulating Klotho level, an anti-aging factor protein, decreased with age, and there was an inverse relationship between circulating Klotho and mean BP changes after saline infusion. We hypothesized that the decrease in circulating Klotho levels might be involved in the increase in salt sensitivity of BP with aging. We found that circulating Klotho significantly decreased in aged mice and Klotho heterozygous knockout (KO) mice than in young wild-type mice. They showed salt-sensitive hypertension unlike young wild-type mice, suggesting that a decrease in circulating Klotho was involved in the pathogenesis of salt-sensitive hypertension in aged mice. In both aged mice and Klotho heterozygous KO mice, it was revealed that vascular Wnt5a-RhoA pathway was activated and vasoconstriction was enhanced during high salt intake, resulting in hypertension. We also demonstrated that Klotho supplementation and Wnt and Rho kinase inhibitors significantly suppressed the BP elevation during high salt intake in these mice. Furthermore, we found that Wnt5a was essential for the activation of RhoA by Angiotensin II, an important agent in the formation of hypertension. Since increased vascular resistance of the renal arteries and decreased renal blood flow are involved in the pathogenesis of salt-sensitive hypertension. We analyzed the effects of Angiotensin II and RhoA stimulators to the renal arteries of high-salt fed aged mice and Klotho heterozygous KO mice. Marked vasoconstriction of the renal arteries and decrease in renal blood flow with BP elevation were observed, while responses were less in young mice. Augmented responses observed in aged mice and Klotho heterozygous KO mice were normalized by Klotho supplementation. These findings suggest that in aged mice with low circulating Klotho, salt intake causes activation of the vascular Wnt5a-RhoA pathway, resulting in increased contraction of the renal arteries as well as peripheral blood vessels, which reduces renal blood flow and eventually caused hypertension. We suggest that reducing salt consumption is highly important and lifestyle habits preserving adequate levels of Klotho are useful in the prevention of age-related hypertension. Wnt and Rho inhibitors may be new treatment options. Therapeutic development focusing on the unique background of aging may be applied to other age-related diseases.

Effect of Electrocardiogram Observation on Chemotherapy and Radiotherapy Combined with Trastuzumab in Breast Cancer Postoperative Patients

In order to improve the therapeutic effect of breast cancer patients, trastuzumab combined with chemotherapy followed by radiotherapy was applied to breast cancer patients in this study and to observe the effect of this treatment on the abnormal rate of electrocardiogram and serum indexes of breast cancer patients. 60 patients received targeted therapy and chemotherapy during perioperative period. All patients received local radiotherapy after surgery. At the same time, for patients with poor peripheral blood vessels, jugular vein or subclavian vein catheterization should be performed before chemotherapy to avoid vein inflammation. The abnormal rate of electrocardiogram and serum indexes and rate of adverse reactions of 60 patients were examined. The results show that the abnormal electrocardiogram rate at T1, T2 and T3 was gradually increasing. The serum indexes after chemotherapy and radiotherapy are lower than those before chemotherapy and radiotherapy respectively. After chemotherapy and radiotherapy, there were 3 cases of radiation pneumonitis, 2 cases of pain and 2 cases of abnormal liver function. Postoperative chemotherapy and radiotherapy combined with trastuzumab can decrease serum levels in breast cancer patients. Meanwhile, the abnormal rate of electrocardiogram and cardiotoxicity were higher. Therefore, before trastuzumab therapy, cardiac function safety tests should be conducted in breast cancer patients and cardiac function should be closely monitored.

The Safety Assessment of Irrigation Fluid Management for Shoulder Arthroscopy and Its Effect on Postoperative Efficacy.

Fluid extravasation is a potentially dangerous complication associated with shoulder arthroscopy. Most relevant studies have involved respiratory system, while the primary purpose was to reveal the effects of the fluid extravasation on cardiovascular system and postoperative function. The clinical data of 92 patients was retrospective analyzed, in which 84 cases with rotator cuff injury, three cases with shoulder instability, three cases with fractures of the greater tuberosity of the humerus, and two cases with frozen shoulder. All the patients were undergoing shoulder arthroscopy. The relationship between the basic information of the patients and cardiac index (CI) or pulse pressure variation (PPV) were evaluated by linear regression analysis. The change of CI or PPV at different states were evaluated by the one-way analysis of variance. The liquid retention (TR) and postoperative clinical outcomes was analyzed using linear regression. The preoperative CI was affected by anesthesia status and body position, while PPV was not affected. Multivariate mixed-effects model analysis of CI found that there was a statistically significant difference in groups of older than 55 years old and those with obesity (BMI > 24). After the operation, the retention of irrigation fluid significantly influenced the circumference of the deltoid (P < 0.001 (95%CI: [0.30, 1.00])), but not on the circumference of the deltoid, neck, and arm. The multivariate analysis of the American Shoulder and Elbow Surgery (ASES) scores at 3 and 6 months after surgery showed that the fluid retention volume was correlated with the ASES score at 3 months after surgery, especially when the retention volume was greater than 2 L (P=0.001 (95%). %CI: [-12.49, -3.22]). The retention of irrigation fluid after shoulder arthroscopic surgery causes swelling of local limbs, and has an effect on peripheral blood vessels, which is mainly reflected in its influence on PPV and the postoperative function. Therefore, surgeons need to improve their surgical technique, shorten the operation time and reduce fluid retention.

Warm Compress to Overcome Hyperthermia: A Case Study

Objective: To find out the description of giving warm compresses to treat hyperthermia in An.M with febrile seizures in the Parikesit room of RST Wijayakusuma. Method: This type of research was qualitative, with a case study design that was described descriptively. In this case study, the subject is An.M with hyperthermia nursing problems in cases of febrile seizures at Wijayakusuma Hospital, Purwokerto. Data collection in the following research was carried out by means of observation, measurement, in-depth interviews or anamnesis (assessment by direct interviews with patients or families), physical examination, and documentation for the same data source. Result: The results obtained after giving compresses for 3 days the patient's body temperature which was originally 38.50C dropped to 370C. Conclusion: It was concluded that hyperthermia can be overcome by giving warm compresses, warm compresses cause the body temperature outside to be warm so that the body will interpret that the outside temperature is quite hot, eventually the body will reduce the temperature control control in the brain so as not to increase the body temperature, with the outside temperature Warmth will make the peripheral blood vessels in the skin widen and experience vasodilation so that the skin pores will open and facilitate heat dissipation, so there will be changes in temperature. This can be seen from the results of the researcher's evaluation that giving warm compresses can have an impact on decreasing body temperature.

Multi-modal retinal scanning to measure retinal thickness and peripheral blood vessels in multiple sclerosis

Our purpose was to investigate changes to the retina in multiple sclerosis (MS) using established and novel modes of retinal image acquisition and analysis. 72 participants with MS and 80 healthy volunteers underwent retinal scanning with optical coherence tomography (OCT) and ultra-widefield (UWF) scanning laser ophthalmoscopy (SLO), over a two-year period. Changes in retinal nerve fibre layer (RNFL) thickness, macular volume and retinal blood vessel diameter were measured and parameters were then tested for associations with MS. Measurements from OCT showed that individuals with MS had a thinner RNFL and reduced macular volume when compared to healthy volunteers. On UWF images, participants with MS had reduced arterial widths in the inferior nasal quadrant of both eyes and reduced venous widths in the inferior nasal quadrant of right eyes. Longitudinal analysis showed that participants with MS had an accelerated annual rate of RNFL thinning in several regions of the retina. In conclusion, the assessment of OCT showed thinning of the RNFL and macula in concordance with previous reports on MS, while analysis of blood vessels in the retinal periphery from UWF-SLO images revealed novel changes.

Bioprotective Role of Platelet-Derived Microvesicles in Hypothermia: Insights from the Differential Characteristics of Peripheral and Splenic Platelets

While platelets play an important role in hemostasis and blood coagulation, they also contribute to tissue repair. Most platelets are present in peripheral blood, but some are stored in the spleen. Since tissue environments of peripheral blood vessels and the spleen are quite distinctive, the properties of the platelets present in each may also differ. However, no studies have addressed this difference.We have reported that accidental hypothermia activates splenic platelets, but not peripheral blood, whose biological significance is unknown. Accidental hypothermia is an involuntary drop in core body temperature to less than 35°C due to exposure to low environmental temperatures. Shivering, an involuntary small contraction of skeletal muscles throughout the body, is thought to be an automatic defense system against cold, in which skeletal muscles contract to increase heat production. Shivering occurs in muscles throughout the body, so when muscles are damaged by it, the tissue must be repaired by a mechanism that covers the entire body.Platelets, when activated, release microvesicles that encapsulate many bioactive substances. These microvesicles are called platelet-derived microvesicles (PDMV). It is generally believed that when cells take up extracellular vesicles, they are affected by the action of the encapsulated substances. Therefore, we hypothesized that PDMV released by platelet activation in the spleen at hypothermia may be involved in the regeneration of skeletal muscle throughout the body. C57Bl/6 mice were placed in an environment of -20°C and the rectal temperature was lowered to 15°C to model hypothermia. Platelets, PDMV, and skeletal muscle tissue were collected from these mice for analysis.Transcriptomic changes between splenic and peripheral platelets were greater in hypothermic mice than in normal mice. Pathway analysis of these Transcriptomic changes showed alterations related to Wnt signaling, cytoskeletal remodeling, and cell adhesion. Electron microscopy and real-time RT-PCR analysis revealed that platelets activated in the spleen by hypothermia internalize the transcripts involved in tissue repair, such as Wnt3a and Ctnnb1, into PDMV and release them into plasma. Plasma microvesicles from hypothermic mice promoted wound healing in the mouse myoblast cell line C2C12. Skeletal muscles of hypothermic mice were damaged but recovered within 24 hours after rewarming. However, splenectomy delayed recovery from skeletal muscle injury even after the mice were rewarmed.These results indicate that PDMV released from activated platelets in the spleen plays an important role in the repair of skeletal muscle damaged by shivering of hypothermia, suggesting a novel function of the spleen not previously known.

Visualization of Peripheral Blood Vessels on the Lingual Aspect of the Mandible Using a Balanced Steady-State Free-Precession Sequence with a Time-Spatial Labeling Inversion Pulse: Usefulness for Prevention of Severe Complications of Dental Implantation.

The aim of this study was to evaluate whether a balanced steady-state free-precession (SSFP) sequence with a time–spatial labeling inversion pulse (time–SLIP) without contrast medium could elucidate branches of the lingual and facial arteries on the lingual aspect of the mandible as a potential technique for preventing severe complications in dental implantation surgery. In this study, magnetic resonance angiography (MRA) using SSFP with a time–SLIP was evaluated in 40 subjects. The outline and course of branches of the lingual and facial arteries near the mandible were assessed clinically in the same subjects against contrast-enhanced computed tomography (CT) images as the gold standard. The submental, sublingual, and deep lingual arteries could be visualized via MRA in 16, 20, and 16 of the 40 subjects, respectively. The major axes of the respective arteries were approximately 24, 24, and 16 mm. The outline and course of all visualized arteries coincided with those on CT. MRA using SSFP with a time–SLIP appears to have potential as a non-contrast technique for visualizing branches of the lingual and facial arteries on the lingual aspect of the mandible. Information regarding the outline and course of these arteries as obtained using this MRA technique could assist in preventing severe complications in dental implantation surgery.

Application and Prospect of Stem Cells in the Treatment of Alopecia

This article introduces the common types of hair loss and the common types of hair loss treatments on the market, such as topical finasteride topical or oral, minoxidil, fractional laser, hair transplantation, etc. And then I introduced the common types of stem cells and described the application of stem cells in the treatment of hair loss. I focused on the extraction methods of ADSCs and the advantages of them. For example, ADSCs have antioxidant effects, promote HF and the formation of peripheral blood vessels, and play a role in regeneration and other effects. Finally, I describe the prospect of stem cells in the treatment of hair loss, especially the drawbacks.

Blood Endothelial-Cell Extracellular Vesicles as Potential Biomarkers for the Selection of Plasma in COVID-19 Convalescent Plasma Therapy

Despite the advancement of vaccination and therapies currently available, deaths due to the coronavirus disease 2019 (COVID-19) are still heavily documented. Severely infected individuals experience a generalized inflammatory storm, caused by massive secretion of pro-inflammatory cytokines that can lead to endothelial dysfunction, cardiovascular disease, multi-organ failure, and even death. COVID-19 convalescent plasma (CCP) therapy, selected primarily based on anti-SARS-CoV-2 antibody levels, has not been as convincing as expected in the fight against COVID-19. Given the consequences of a dysfunctional endothelium on the progression of the disease, we propose that the selection of plasma for CCP therapy should be based on more specific parameters that take into consideration the effect on vascular inflammation. Thus, in the present study, we have characterized a subset of CCP that have been used for CCP therapy and measured their anti- or pro-inflammatory effect on human coronary artery endothelial cells (HCAECs). Our data revealed that the longer the time lapse between the onset of symptoms and the plasma donation, the more mitochondrial dysfunction can be evidenced. The concentration of blood endothelial cell extracellular vesicles (BEC-EVs) was increased in the plasma of young individuals with mild symptoms. This type of selected convalescent plasma promoted the activation of the blood vascular endothelium, as reflected by the overexpression of ICAM1 and NFκB1 and the downregulation of VE-Cadherin. We propose this mechanism is a warning signal sent by the injured endothelium to trigger self-defense of peripheral blood vessels against excessive inflammation. Therefore, these results are in line with our previous data. They suggest that a more specific selection of COVID-19 convalescent plasma should be based on the time of donation following the onset of the clinical symptoms of the donor, the severity of the symptoms, and the age of the donor. These characteristics are relatively easy to identify in any hospital and would reflect the concentration of plasma BEC-EVs and be optimal in CCP therapy.

Isolation and identification of aerobic bacteria and their antibiogram profile in catheter related bloodstream infection among the hemodialysis patient in a tertiary care hospital

Background: Catheter-related bloodstream infection (CRBSI) is quite evident in hemodialysis (HD) patients. The pattern of the isolates from the catheter tip as well as blood culture and their sensitivity against antibiotics varies and set a huge challenge for the physician for its management. Aims and Objectives: The present study was undertaken to isolate and identify, causative organism in CRBSI from the HD patient and to determine the antibiotic susceptibility profile of each isolate and determines the current trend. Materials and Methods: A total (n=101) patients admitted for HD in the nephrology unit of a tertiary care hospital with preexisting comorbidities such as diabetes and hypertension (HT) were recruited according to inclusion/exclusion criteria after obtaining written consent. Blood samples from peripheral blood vessel of suspected CRBSI patients were collected as well as the catheter tip was cut and collected in sterile test tube and transported to microbiology laboratory for isolation, identification, and antibiotic susceptibility test. Results: The HD catheter tip culture was found positive in 54 (53.46%) samples out of the total 101 samples. The distribution of catheter tip culture positive patients and their association with diabetes mellitus was highest at age group &gt; 60 years with a p &lt; 0.0001. The association between catheter tip culture positive and HT was also found significant with P&lt;0.0001. After analysis of culture reports of HD catheter tip and peripheral blood, culture-positive reports were found in 15 (14.85%) patients as CRBSI. The distribution of CRBSI predominantly found in the age group of 41–50 years (33%) which was significant with P=0.004. The causative organisms for CRBSI were Gram negative under this study and multidrug resistant too. The only drug polymyxin B was 100% sensitive to Gram-negative organism whereas vancomycin and linezolid were 100% sensitive to Gram-positive organisms. Conclusion: Patients with kidney disease receiving HD with a central venous catheter experience high rates of bloodstream and catheter tip infection commonly in those suffering from diabetes, HT, and dyslipidemia. The causative organisms for CRBSI were mainly Gram negative with a concern over existence of multidrug resistance strain.

Kelas Gizi Secara Daring Meningkatkan Pengetahuan Gizi dan Kadar Hemoglobin Remaja di Masa Pandemi Covid-19

Nutritional problems during the Covid-19 pandemic are one of the problems that need attention among adolescents. Nutrition education which is carried out regularly in the form of nutrition classes is expected to influence nutritional knowledge, nutritional status, and hemoglobin levels in adolescents. The purpose of this study was to determine the effect of providing nutrition education in the form of nutrition classes on knowledge, nutritional status, and hemoglobin levels of adolescents during the Covid-19 pandemic. This study was an experimental study with a quasi-experimental one-group design with pre-test – post-test. The sample in this study were students of Al-Istiqomah Wanasari Islamic Boarding School in Bandung. The intervention was carried out for 3 months with 6 meetings online. Nutritional knowledge was measured using an online form, nutritional status was measured by BMI for Age indicators, and hemoglobin levels were measured through peripheral blood vessels. Analysis of the data was used dependent sample t-test for normally distributed data. Data that are not normally distributed are performed by the Wilcoxon test. The average nutritional knowledge, nutritional status, and hemoglobin levels of the samples before intervention were 14.75, 0.19, and 14.36 mg/dl, after the intervention increased to 18.06, 0.24, and 15.45mg/dl. Nutrition education in the form of online nutrition classes affected increasing nutritional knowledge (p-value=0.000) and hemoglobin levels (p-value=0.001) after an intervention. Online nutrition classes can be conducted during the Covid-19 pandemic to increase adolescent nutrition knowledge in achieving optimal health status.

Blood vessel assessment using computed tomography : Effects of ephedrine on uterine artery.

Background: Ephedrine increased blood pressure due to the contractile properties of resistance vessels. Excessive contraction of the uterine arteries might cause fetal distress. This study was to determine the diameter of the uterine artery of female New Zealand rabbits after the administration of different doses of ephedrine using CT.Methods: Thirty-two rabbits were randomly divided into a control group (Group C), low dosage group (Group L), medium dosage group (Group M) and high dosage group (Group H). Normal saline and doses corresponding to the human dose of 7.5, 15 and 30 mg of ephedrine were injected respectively. The marginal ear and uterine artery diameters were measured 5, 10, 15, 30, and 45 min after injection using CT, and the hemodynamic changes were recorded.Results: The increase in mean arterial pressure in group M (p = 0.009), and H (p = 0.013) was higher than that in group C. Compared with group C, substantial contraction of the marginal ear artery was observed at the three doses of ephedrine. There were no differences in the uterine artery diameter among groups L, M and C, However, in Group H, a significant contraction of the uterine artery compared with the other groups (p < 0.001) was observed.Discussion: CT can be used to evaluate the effects of drugs on organs and blood vessels. Ephedrine can not only constrict the peripheral blood vessels but also do not affect the uterine artery at a dose of 15 mg or less. However, the dose should not exceed 30 mg, which may cause severe uterine artery depression.

Impact of a Structured Report Template on the Quality of Multislice Spiral Computed Tomography Scan Reports for Small Bowel Diseases: A Preliminary Study

Background: The application of multislice spiral computed tomography (MSCT) scan has improved the diagnosis of small bowel diseases (SBDs). Objectives: This study aimed to develop a structured report (SR) template for SBDs based on MSCT scans and to compare its value with free-text reports (FTRs) by radiologists with different levels of seniority in radiology. Patients and Methods: A total of 120 SBD cases were confirmed based on the clinical manifestations, surgery, colonoscopy, and pathology. An SR template for small bowel imaging was developed, and six radiologists were divided into inexperienced and experienced groups. Sixty cases with small intestinal MSCT data were available for FTRs and another 60 cases for SRs after training. The report accuracy, satisfaction, and completion time were compared between the two reporting methods. Results: The writing time of SRs was significantly shorter than that of FTRs. By using FTRs, the experienced group showed higher levels of sensitivity for all diseases (i.e., intestinal wall, intestinal peripheral artery, blood vessel, bone, and other abdominal organ diseases) (P &lt; 0.05). The experienced group showed a low misdiagnosis rate for all diseases (P &lt; 0.05), except for bone disease (P = 0.161). By using SRs, the experienced group only showed a low misdiagnosis rate for the intestinal wall disease (P &lt; 0.05). High sensitivity for the intestinal wall disease (P &lt; 0.05) and intestinal peripheral artery disease (P = 0.024), along with improved sensitivity for bone lesions (P &lt; 0.05), was reported in this group. In the inexperienced group, SRs improved sensitivity for all diseases (P &lt; 0.05), except for intestinal wall disease (P &gt; 0.05). The satisfaction scores for both inexperienced and experienced groups improved by using SRs (4 vs. 2.6 for the inexperienced group and 4.1 vs. 3.2 for the experienced group; P &lt; 0.05 for both). Conclusion: The SRs were superior to FTRs in terms of writing efficiency, accuracy, and satisfaction. They could improve the accuracy of inexperienced radiologists in diagnosis and help detect SBDs.

Efficacy and Clinical Value of Negative-Pressure Wound Therapy with Instillation (NPWTi) of Compound Phellodendron Liquid in the Treatment of Diabetic Foot Ulcer: A Prospective Cohort Study.

Objective To evaluate the efficacy and application value of compound Phellodendron liquid (CPL) for negative-pressure wound therapy with instillation (NPWTi) in the treatment of diabetic foot ulcers by observing the improvement of diabetic foot ulcers. Methods Sixty patients with diabetic foot ulcers who met the inclusion criteria were admitted to the Department of Peripheral Blood Vessels (Wound Repair) of Chongqing Hospital of Traditional Chinese Medicine from August 2020 to August 2021. The random number table method divided it into the CPL NPWTi group and normal saline NPWTi group, with 30 cases in each group. The experimental group adopted FufangHuangbaiye for NPWTi, and the control group used normal saline for NPWTi. The treatment effect was evaluated by baseline index, wound healing observation index, inflammatory factor index, pain scores during dressing change, and the number of days in hospital. Results After 10 days of treatment, the symptom integration, procalcitonin (PCT), and C reactive protein (CRP) of the CPL NPWTi group were significantly reduced compared with the normal saline NPWTi group, while there was no obvious difference between wound area and erythrocyte sedimentation rate (ESR). The wound area, symptom integral, PCT, ESR, and CRP of the CPL NPWTi group were significantly reduced compared with the normal saline NPWTi group after treatment for 20 days and 30 days. The positive proportion of bacterial culture in the CPL NPWTi group was significantly reduced compared with the normal saline NPWTi group after treatment for 10 days, 20 days, and 30 days. After treatment, the pain scores during dressing change and the number of days in hospital in normal saline NPWTi group were significantly lower than those in the CPL NPWTi group. Conclusion Compound Phellodendron liquid NPWTi therapy can improve diabetic foot ulcers, providing a safe and effective method for treating diabetic foot ulcers.

Factors associated with elevated blood lactate levels in patients undergoing maintenance hemodialysis.

Factors associated with chronic elevation of the blood lactate levels in patients undergoing chronic maintenance hemodialysis (hereinafter, hemodialysis patients) have not yet been thoroughly investigated. The purpose of the present study was to clarify factors associated with elevated blood lactate levels in hemodialysis patients. We divided the hemodialysis patients into two groups according the blood lactate levels (the high blood lactate group [> 2mmol/L] and normal blood lactate group), and conducted a retrospective comparison of the following items between the two groups: (1) the creatinine generation rate (%CGR) and the geriatric nutrition risk index (GNRI) as indices of the nutritional status; (2) the left ventricular ejection fraction (LVEF) and E/A, an indicator of diastolic function; (3) the ankle-brachial index (ABI) and transcutaneous partial pressure of oxygen as indices of the adequacy of circulation in the peripheral blood vessels of the lower extremities; (4) the white blood cell count and serum level of C-reactive protein (CRP) before dialysis as markers of an inflammatory state. The mean age and serum CRP level were significantly higher in the high blood lactate group than in the normal blood lactate group. There were no significant differences in the markers of the nutritional status, cardiac function, or adequacy of circulation in the peripheral blood vessels of the lower extremities between the two groups. Advanced age and a state of chronic inflammation appear to be associated with elevated blood lactate levels in patients undergoing chronic maintenance hemodialysis.

Classification of diabetic foot ulcer using convolutional neural network (CNN) in diabetic patients

The image of chronic wounds on human skin tissue has the similar look in shape, color and size to each other even though they are caused by different diseases. Diabetic ulcer is a condition where peripheral arterial blood vessels are disrupted due to hyperglycemia in people with diabetes mellitus. This research was aimed to analyze the accuracy of the Convolutional Neural Network algorithm in classifying diabetic ulcer disease with a transfer learning approach based on the appearance of the image of the wound on the sole in people with diabetes mellitus. By applying the transfer learning approach, the results showed that the Resnet152V2 model achieved the best accuracy value of 0.993 (99%), precision of 1.00, recall of 0.986, F1-Score of 0.993 and Support of 72. Therefore, the ResNet152V2 model was highly considered for classifying diabetic ulcer in patients with diabetes melitus.

Evaluation of resistance to radial cyclic loads of poly(L-lactic acid) braided stents with different braiding angles

Poly(L-lactic acid) (PLLA) braided stents have superior biocompatibility and flexibility, substituting metal stents in peripheral blood vessels. However, the radial supporting capacity of PLLA braided stent should be improved to bear the dynamic load from the peripheral artery. This paper evaluated the radial support performance of PLLA braided stents with different braiding angles after the radial cyclic loads test. The results indicate that braiding angle of stents is an important parameter affecting its ability to resist radial cyclic loads. The stent with a smaller braiding angle has better initial radial support but insufficient durability, while the stent with a larger braiding angle could maintain adequate radial support and suitable ability to resist radial cyclic loads. The theoretical analysis, verified by observing the surface morphology of filament crossover points, found that filaments of the stents with smaller braiding angles have more significant axial displacement and axial rotation angle during radial compression, which made the friction phenomenon more intense and led to insufficient ability to resist radial cyclic loads. This study could provide a meaningful idea for preparing biodegradable braided stents with suitable ability to resist radial cyclic loads.

A Comparative Study of Xi's Tendon Gangrene (Nonischemic Type of Diabetic Foot) and Gangrene (Diabetic Foot Ischemic Type).

Background Diabetic foot gangrene refers to a lesion in which the tissue of the foot or lower extremities of diabetic patients is damaged, and the cause is the infection of peripheral blood vessels and neuropathy caused by diabetes. Objective To compare the related indexes of blood glucose, inflammation, blood viscosity, and peripheral neuropathy between the nonischemic diabetic foot and ischemic diabetic foot, the same and different characteristics of the two different types of diabetic foot in pathogenesis were discussed and studied. Methods A total of 122 patients with diabetic foot were selected from the Department of Vascular Medicine, Shanghai Hospital of Integrated Traditional Chinese and Western Medicine, including 61 cases of ischemic type and 61 cases of nonischemic type. The differences in blood glucose, inflammation, blood supply, and peripheral neuropathy between the nonischemic diabetic foot and ischemic diabetic foot were compared to explore their different characteristics. Results The blood glucose index, inflammatory index, and plasma fibrinogen in patients with nonischemic diabetic foot were significantly higher than those in patients with ischemic diabetic foot (P < 0.05). The patients with ischemic diabetic foot were higher in age and blood lipid index than those with the nonischemic diabetic foot (P < 0.05), while having no significant difference in platelet count, plasma viscosity, hematocrit, and end products of glycation (AGEs). Conclusion The nonischemic diabetic foot is mainly infective necrosis, and the ischemic type is ischemic necrosis. The former occurs in the middle-aged and elderly with good blood supply between 40 and 60 years old, while the latter occurs in the elderly with the severe vascular disease over 60 years old. The blood glucose level of nonischemic patients is significantly higher than that of ischemic patients, but it has little to do with the course of diabetes.

Clinical Nursing Paths Benefit Patient Outcomes Undergoing Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma.

Objective The purpose of the study is to investigate patient outcomes of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) under clinical nursing paths (CNP) and whether the application of CNP can be a protective factor against the recurrence of HCC. Methods The study comprised of 48 patients who received TACE for HCC under the CNP (assigned into the CNP group) and 41 who received TACE for HCC under the routine care (assigned into the control group). Their treatment safety, pain, and psychology were compared. The nursing satisfaction and quality of life were investigated when patients were discharged from the hospital. A 6-month follow-up was performed to analyze the related factors affecting disease recurrence. Results In the CNP group, the incidence rate of total adverse reactions, VAS scores, SAS and SDA scores were lower, but conversely, the satisfaction and SF-36 scores were higher than those in the control group (P < 0.05). Logistic regression analysis revealed that advanced TNM stage, larger tumor diameter, greater Child-Pugh classification, and the presence of peripheral blood vessel invasion were independent risk factors of HCC recurrence (P < 0.05). Conclusion The study demonstrated that CNP intervention can improve the safety and quality of life of patients undergoing TACE for HCC and reduce their negative emotions and pain feelings, which is worthy of clinical application.

LncRNA MALAT1 promotes HCC metastasis through the peripheral vascular infiltration via miRNA-613: a primary study using contrast ultrasound

BackgroundThis study aimed to explore the specific pathogenesis of lncRNA MALAT1 promoting the invasion and metastasis of hepatocellular carcinoma (HCC) through peripheral blood vessels by regulating the expression of miRNA-613 molecule.MethodsThe data of 60 HCC metastatic patients and 60 HCC non-metastatic patients detected by the contrast-enhanced ultrasound (CEUS) in the Second Affiliated Hospital of Qiqihar Medical College from January 2020 to June 2021 were collected, as well as postoperatively retained HCC tissues and paired paracancer tissues (5 cm laterally from the edge of the cancer area), to study the changes of microangiogenesis in HCC tissues with CEUS. The correlation between CEUS grading and lncRNA MALAT1 in patients with HCC was analyzed through Pearson correlation analysis, lncRNA MALAT1 and miRNA-613 in HCC tissues of patients with HCC were detected by qRT-PCR, followed by the bioinformatic analysis for the relationship between lncRNA MALAT1 and miRNA-613. The Log-growing human HCC cell strain, HepG2, was selected for experiments. Adenovirus transfection knocked down lncRNA MALAT1 in HCC cells, which was divided into two groups (inhibitor-NC group and lncR-inhibitor group), followed by knocking down miRNA-613 on the basis of knocking down lncRNA MALAT1, which was divided into three groups (inhibitor-NC group, lncR-inhibitor groups, and lncR/miR613-inhibitor group). The expression of miRNA-613 and lncRNA MALAT1 in each group was detected by qRT-PCR. The migration and invasiveness of cells in each group were detected by Transwell assay.ResultsCEUS of HCC and Pearson correlation analysis showed that CEUS grading and lncRNA MALAT1 were positively correlated in patients with HCC. In HCC tissues of patients with HCC, lncRNA MALAT1 expressed high and miRNA-613 expressed low. The results of bioinformatic analysis showed the targeting of lncRNA MALAT1 and miRNA-613. Knocking down lncRNA MALAT1 could increase miRNA-613 expression significantly, and reduce the migration of HCC cells. Inhibiting miRNA-613 based on knocking down lncRNA MALAT1 could increase the survival and migration of HCC cells.ConclusionslncRNA MALAT1 can promote HCC metastasis through the peripheral vascular infiltration by inhibiting the level of MiRNA-613, which can, therefore, be used as a potential target for the treatment of HCC.