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Background: D-dimer (DD) is a vital biomarker to rule out the diagnosis of aortic dissection (AD). However, the DD level in some patients with AD is not high in clinical practice, which often leads to missed diagnosis; therefore, understanding the characteristics of patients with AD and negative DD is of great clinical value., Methods: From May 2015 to October 2020, 286 patients with AD who visited the first medical contact (FMC) within 24 h of symptom onset and were hospitalized in the Xiamen Cardiovascular Hospital of Xiamen University were enrolled in this study. Clinical characteristics and outcomes of patients were assessed., Results: Among them, 13 cases (approximately 4.5%) had negative DD results. Compared to patients with positive DD results, patients with negative DD results had significantly higher platelet counts and lower aortic dissection detection risk scores (ADD-RS). The imagological analysis showed that patients with AD and negative DD had lower extension scores and milder damage to the mesenteric artery and three branches of the aortic arch. Furthermore, the results of the multivariable analysis showed that white blood cell count (WBC) [odds ratio (OR): 1.379, P  = 0.028], FMC (OR: 0.904, P  = 0.028), and extension score (OR: 1.623, P  = 0.046) were associated with negative DD result., Conclusions: Patients with AD and negative DD results had longer FMC and lower WBC. Imaging showed a smaller tear extension range and less damage to the mesenteric artery and three branches of the aortic arch. A negative DD result could not completely rule out AD even if the ADD-RS was zero., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Zhang, Wang, Su, Zhou, Wu, Sun, Ou, Yu, Chen and Wang.)

This study aimed to explore role of dendritic cells (DCs) fused with endothelial progenitor cells (EPCs) in inhibiting angiogenesis in acute myeloid leukemia (AML) mice. EPCs were isolated from human AML bone marrow mononuclear cells and fused with DCs, which were then injected back into AML mice. Changes in leukemia cells, micro-vessel density (MVD), early EPC molecular markers vascular endothelial growth factor receptor 2 (VEGFR2/KDR) and CD133 in bone marrow were measured. The results indicated that CD133 and KDR expression in EPCs was significantly higher than in epithelial cells (HUVECs). There were 46.14% ± 8.21% DCs doubly positive for VEGFR2 and CD11c, and it was 8.53% ± 1.27% in co-culture group. Fusion rate of DC/EPCs was 37.61% ± 6.94%, and 35.63% ± 6.09% in DC/ECs group. Growth rate of DC/EPCs was faster than that of EPCs ( P <0.05). At 14-20 days after fused cells injection, symptoms gradually decreased. There were a greater number of micro-vessels in bone marrow biopsy sections of AML mice than in normal controls ( P <0.05). There was slightly lower MVD in EC/DCs compared with EPC/DCs ( P >0.05). Positive expression of CD133 and VEGFR2 in bone marrow biopsies of AML mice was significantly higher than that in control mice ( P <0.05). Positive expression of CD133 and VEGFR2 in DC/EC fused cells was significantly lower than that before fusion ( P <0.05). In conclusion, DC-EPCs play a certain immunosuppressive effect on angiogenesis in AML mice. Our findings provide experimental data support for the construction of a cell vaccine with anti-angiogenic effect., Competing Interests: None.