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Background Abdominal aortic aneurysm (AAA) is a complex vascular disease involving expansion of the abdominal aorta. Extracellular matrix (ECM) degradation is crucial to AAA pathogenesis, however, the specific molecular mechanism remains unclear. This study aimed to investigate differentially expressed circular RNAs (DEcircRNAs) involved in ECM degradation of AAA. Methods Transcriptome sequencing was used to analyze the DEcircRNAs between the AAA tissues and normal tissues. The expression of circRNAs in tissues and cells was validated using quantitative reverse transcription PCR (RT-qPCR). Overexpression of circRNAs in vascular smooth muscle cells (VSMCs) treated with angiotensin II (Ang II) was employed to explore its effect on ECM degradation of AAA. Bioinformatic technology, luciferase reporter gene assay, RT-qPCR, and rescue experiment were employed to evaluate the regulatory mechanism of circRNA. Results We identified 65 DEcircRNAs in AAA tissues compared with normal abdominal aortic tissues, including 30 up-regulated and 35 down-regulated circRNAs, which were mainly involved in inflammation and ECM-related functions and pathways. Moreover, circRBM33 was significantly increased in AAA tissues and Ang II-induced VSMCs compared with control samples. Overexpression of circRBM33 increased the expression of ECM-related molecule matrix metalloproteinase-2 and reduced the tissue inhibitor of matrix metalloproteinases-1 expression. Mechanistically, miR-4268 targeted binding to circRBM33 and inhibited the luciferase activity of circRBM33. Overexpression of circRBM33 induced the expression of EPH receptor B2 (EPHB2), and this effect was countered by miR-4268 mimics. Conclusions Overall, our data suggest that circRBM33 might be involved in AAA progression by regulating ECM degradation via the miR-4268/EPHB2 axis.

Background The purpose of this study is to record our institution's experience in the management of extracranial carotid artery aneurysms (ECCAs) over the past 15 years. Methods A retrospective chart review was performed on consecutive patients with ECCAs from April 2003 to December 2017. Outpatient and inpatient clinic charts were reviewed. All the patients were treated by open surgery between 2003 and 2008. For other patients, the treatment methods included open surgery, endovascular surgery, and hybrid operations which were dependent on the aneurysm anatomy, as well as conservative management. In open series, a carotid shunt was applied and transcranial color Doppler was selectively used for intraoperative monitoring of cerebral blood flow. The resected aneurysm sacs were tested with hematoxylin and eosin stains. Each case was reexamined one month after the patients were discharged from the hospital. A questionnaire survey, a clinical examination, and duplex ultrasonography or computed tomography angiography imaging were carried out. The patients were then reexamined three and six months after surgery and then annually. Results Thirty ECCAs were treated in 30 patients—14 men and 16 women, with a mean age of 54 ± 13 years. Four types of carotid aneurysms were identified: type I, II, III, and V, with 17, 3, 1, and 9 patients, respectively. From 2003 to 2008, there were eight patients (type I: seven; type II: one), and all were treated by open surgery and one suffered transient cranial nerve palsy. From 2009 to 2017, two patients were treated with conservative management, ten were treated with open surgery, nine were treated with endovascular surgery, and one was treated with hybrid operation. Among the patients who were treated with open surgery, two suffered neck hematoma. All patients recovered well without complications in the endovascular surgery group. Twenty-seven patients presented for follow-up and without contralateral aneurysms or other complications. Conclusions The optimal treatment of ECCAs is dependent on the morphology of the carotid artery and properties of aneurysms. Open surgical repair is a suitable and safe procedure for type I ECCAs when the aneurysms are concomitant with kinking in the internal carotid artery. Endovascular treatment is an effective alternative to open surgery for false ECCA repair.

Objective To study the beneficial place for the treatment of ruptured abdominal aortic aneurysms (RAAAs) . Method A retrospective chart review of consecutive RAAA patients was performed. Patients were divided into two groups: direct group and transfer group . We retrospectively reviewed patients' hospital charts and recorded various clinical factors apparent on presentation. The primary consequence was mortality during hospitalization, and some other parameters such as duration of intensive care unit (ICU). All patients were followed up at 1 month, 3 months, 6 months and one year after discharge. Results During 4-year period, 56 RAAA patients were treated (24 in direct group, and 32 in transfer group). Significant differences were shown for systolic blood pressure, pulse oxygen saturation, hemoglobin, the time interval from diagnosis to operation et al. There was no difference concerning age and comorbidity among two groups. All the patients were treated by open surgical aneurysm repair. The mortality rate was 68.8% ((6 + 16)/32) in transfer group and 33.3% (8/24) in direct group ( P = 0.00067). Both the duration of ICU stay and entire hospitalization were a bit longer in the transfer group, but there was no significant difference. The mean follow-up time was 25.2 ± 12.9 months. The cumulative survival difference was significant ( P = 0.042) between the two groups. Conclusion It is beneficial that we treat RAAAs in the diagnosed hospital. The reasons are: 1) to avoid the development of unstable state of aneurysm after rupturing of stable state; 2) the time interval from initial symptoms to operation will be shortened.

Background The purpose of our study is to analyze the methods of treating infected femoral artery pseudoaneurysms (IFAPs), and also to identify the most appropriate method, especially for patients with a long history of drug abuse. Methods A retrospective chart review of 88 consecutive IFAPs secondary to drug abuse between 2003 and 2014 was performed. Outpatient clinic charts were reviewed, as well as inpatient and anesthesia records. All patients had undergone a computer tomography angiography or contrast computer tomography to confirm their diagnosis. Routine blood tests were performed. The treatment methods included common femoral artery ligation (CFA) along with local debridement and drainage, direct oversewing, and amputation. A clamping test of the distal external iliac artery (EIA) or the common femoral artery was performed after vessel isolation, during which the oxygen saturation of the blood at the end of the affected limb was examined with a continuous pulse oximeter. Skin samples from affected limbs were tested with hematoxylin and eosin (HE) stain. Results There were a total of 88 patients, of which 79 and 9 came from emergency and outpatient, respectively. Acute hemorrhage at the injection site, pulsatile mass, septic syndrome, and necrosis were present in 65, 14, 8, and 1 patients, respectively. All patients experienced groin pain. Thigh or leg swelling was present in 63 patients. The drug injection history was a mean 6.9 ± 4.1 years. Seventy-four patients presented with anemia and 75 patients presented with hypoproteinemia. Hepatitis B, hepatitis C, syphilis, and HIV were found in 42, 57, 12, and 2 patients, respectively. One patient gave up the treatment. One patient was treated by amputation along with CFA ligation and local debridement because the limb was necrotic on admission. Three patients with short drug injection abuse history and local slight infection were treated by direct oversewing. Eighty-three patients, of which 27 had a drug injection history shorter than 5 years and 56 patients longer than 5 years, were treated by CFA ligation and local debridement. All patients' oxygen saturation of the affected limbs was higher than 90% after distal EIA clamping test and ligation, except the amputation patient. None of these required amputation. One patient, whose injection history was only half a year, underwent an operation for acute ischemic performance. Forty patients had differing degrees of lymph extravasations and were treated by injecting 70% methylated amine diatrizoate. HE stain showed that there were an abundant of microcirculation vessels in IFAP patients. The mean follow-up period was mean (26 ± 14) months from 3 months to 61 months. In the group with a history shorter than 5 years, 10 patients had mild claudication in the first 3 months and then relieved from 6 months. However, in patients with a history longer than 5 years, no case presented claudication. Many of them admitted to drug abuse after surgery and rehabilitation. Conclusions The appropriate and tolerated treatment for most IFAP is arterial ligation, particularly in patients with an injected drug history longer than 5 years. Primary repair may be adopted for special IFAP patients with short drug injection history and limit infection to avoid severe ischemia complication. Medical staff should take strict precautions and protection measures.

Drilling processes, as some of the most widely used machining processes in the manufacturing industry, play an important role in manufacturing process energy-saving programs. However, research focus on energy modeling of drilling processes, especially for the modeling of material-drilling power, are really scarce. To bridge this gap, an improved material-drilling power model is proposed in this paper. The obtained material-drilling power model can improve the accuracy of the material-drilling power and lay a good foundation for energy modeling and optimization of drilling processes. Finally, experimental studies were carried out on an XHK-714F CNC machining center (Hangzhou HangJi Machine Tool Co., Ltd., Hangzhou, China) and a JTVM6540 CNC milling machine (Jinan Third Machine Tool Co., Ltd., Jinan, China). The results showed that predictive accuracies with the proposed model are generally higher than 96% for all the test cases.

The surging costs of health care in China is highly related to the high expenses in pharmaceutical costs. Since the Government of China launched the health care reform in 2009, the issue of growing pharmaceutical expenditure continues to grasp policy makers' attention. Since 2015, an ongoing series of drug-related policies have been revised or developed, resulting in profound impact on the overall pharmaceutical market in China, and the dynamic is still evolving. As China has become the second largest pharmaceutical market in the world, any volatility in the Chinese pharmaceutical market may have great implications to multinational pharmaceutical markets that have had their products launched in China or plan to extend their business to the Chinese market. Based on a comprehensive analysis of the most recent health care reform policies in China, the objectives of this study were to identify the major opportunities appealed to and the challenges confronted by multinational pharmaceutical enterprises in the current Chinese pharmaceutical market.

We study the initial boundary value problem of the general three-component Camassa-Holm shallow water system on an interval subject to inhomogeneous boundary conditions. First we prove a local in time existence theorem and present a weak-strong uniqueness result. Then, we establish a asymptotic stabilization of this system by a boundary feedback. Finally, we obtain a result of blow-up solution with certain initial data and boundary profiles.

Background Aneurysms of an aberrant splenic artery originating from the superior mesenteric artery (SMA) are extremely rare; however, they are clinically important because possible rupture could be catastrophic. The methods of treatment for this condition include surgical resection, minimally invasive techniques (include laparoscopic technique) and endovascular therapy. The purpose of this study is to evaluate the efficacy of coils embolization combined with covered stents to treat aberrant splenic artery aneurysm (SAA). Cases Presentation We report four consecutive cases of aberrant SAA that the aberrant splenic artery was embolized with coils and the superior mesenteric artery was excluded with a covered stent and an up-to-date review of all previous cases in the field. A follow-up computed tomography performed 6 to 12 months postoperatively showed persistent exclusion with marked shrinkage of the aneurysm sac. Conclusions The authors believe although early results are promising, further careful follow-up will be needed to determine the long-term clinical efficacy, safety and applicability of this approach.