Search

Background: The aortoesophageal fistula (AEF) caused by thoracic endovascular aortic repair is a challenging condition. Traditional treatment approaches have been associated with high mortality and morbidity. This study introduces a modified single-stage surgical strategy that aims to optimize outcomes and to reduce the risk of recurrence for AEF. Methods: Our method involving mediastinal infection clearance, direct esophageal repair, aortic remnant cavity isolation with omental refilling, and aortic reconstruction with a Dacron graft (alongside the native aorta) was applied to all the patients. Results: None of the patients experienced intraoperative or in-hospital mortality. All 3 patients recovered well and exhibited successful repair and functionality at discharge. Our approach effectively controlled infection, repaired aortic and esophageal defects, and prevented future complications. Our experiences indicate a positive impact of this management strategy. Conclusions: Our single-stage surgical approach offers a promising solution for AEF after thoracic endovascular aortic repair, enhancing patients' quality of life. It achieves excellent outcomes in infection control and aortic and esophageal repair while avoiding the need for multiple staged surgical procedures.

Solar steam generation (SSG) is widely regarded as one of the most sustainable technologies for seawater desalination. However, salt fouling severely compromises the evaporation performance and lifetime of evaporators, limiting their practical applications. Herein, we propose a hierarchical salt-rejection (HSR) strategy to prevent salt precipitation during long-term evaporation while maintaining a rapid evaporation rate, even in high-salinity brine. The salt diffusion process is segmented into three steps—insulation, branching diffusion, and arterial transport—that significantly enhance the salt-resistance properties of the evaporator. Moreover, the HSR strategy overcomes the tradeoff between salt resistance and evaporation rate. Consequently, a high evaporation rate of 2.84 ​kg ​m−2 ​h−1, stable evaporation for 7 days cyclic tests in 20 ​wt% NaCl solution, and continuous operation for 170 ​h in natural seawater under 1 sun illumination were achieved. Compared with control evaporators, the HSR evaporator exhibited a >54% enhancement in total water evaporation mass during 24 ​h continuous evaporation in 20 ​wt% salt water. Furthermore, a water collection device equipped with the HSR evaporator realized a high water purification rate (1.1 ​kg ​m−2 ​h−1), highlighting its potential for agricultural applications.

Abstract Reconfiguration of architected structures has great significance for achieving new topologies and functions of engineering materials. Existing reconfigurable strategies have been reported, including approaches based on heat, mechanical instability, swelling, origami/kirigami designs, and electromagnetic actuation. However, these approaches mainly involve physical interactions between the host materials and the relevant stimuli. Herein, a novel, easy‐manipulated, and controllable reconfiguration strategy for polymer architectures is proposed by using a chemical reaction of host material within a hydrogel reactive microenvironment. 3D printed polycaprolactone (PCL) lattices transformed in an aqueous polyacrylamide (PAAm) hydrogel precursor solution, in which ultraviolet (UV) light triggered heterogeneous grafting polymerization between PCL and AAm. In situ microscopy shows that PCL beams go through volumetric expansion and cooperative buckling, resulting in transformation of PCL lattices into sinusoidal patterns. The transformation process can be tuned easily and patterned through the adjustment of the PCL beam diameter, unit cell width, and UV light on–off state. Controlling domain formation is achieved by using UV masks. This framework enables the design, fabrication, and programming of architected materials and inspires the development of novel 4D printing approaches.

A gas chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry (GC-APCI-MS/MS) method was established for the determination of the residues of eight amide herbicides (alachlor, acetochlor, propichlor, butachlor, dichlorochlor, pyrazolam, dimethochlor and metolachlor) in animal-derived foods. The sample pretreatment process involved acetonitrile extraction and enhanced matrix removal (EMR)-lipid cleanup, and ethyl acetate was used to dilute the purified acetonitrile extract instead of solvent conversion. The detection was performed with APCI in the positive ion mode using multi-reaction monitoring (MRM). The results showed that the average recoveries of the eight amide herbicides in spiked pork, pig liver, egg and milk matrices were 63.3%–108%, with relative standard deviation (RSD) 2.51%–13.8%. The limit of detection (LOD) was 0.029–1.3 µg/kg, the limit of quantitation (LOQ) was 0.095–4.2 µg/kg, and the matrix effect was −11%–12%. This method can effectively reduce the matrix effect, and is simple, efficient, accurate, sensitive, and suitable for the rapid quantitative determination of the eight amide herbicides in animal-derived foods.

Abstract Pressure engineering in semiconductors leads to a variety of novel physical phenomena and has recently received considerable attention. Here, we report on pressure-induced superconductivity in III–V gallium phosphide (GaP), a commercially important semiconductor that exhibits excellent optical performance. We show that the emergence of superconductivity is accompanied by the concurrence of piezochromic transition and metallization and can be correlated to a structural transition from the cubic to orthorhombic phase. In line with the structural origin of superconductivity, the critical temperature T c monotonically decreases with increasing pressure up to ~50 GPa. Moreover, the superconductivity could be preserved toward ambient pressure because of the irreversibility of the structural transition. Nevertheless, the superconducting transition displays evident broadening associated with the presence of amorphization in the depressurized sample. The synchronous evolution of the structural and electronic properties not only shows a vivid structure-property relationship but also could facilitate the exploration of novel functionalities by means of pressure treatment.

Abstract Background Hyperuricemia is associated with aortic dissection and cardiovascular diseases. The implication of high serum uric acid (UA) level after acute aortic dissection repair remains unknown. The aim of this study is to explore the role of peri-operative serum UA level in predicting 30-days mortality with acute type A aortic dissection (AAAD) patients, who underwent surgery. Methods This study retrospectively enrolled 209 consecutive patients with AAAD, who underwent surgery in Xiangya Hospital from 2017 to 2020. Post-operative laboratory examinations were measured within 24 h after surgery. Univariate analysis and logistic regression analysis were used for predictor finding. Results 209 consecutive AAAD patients were included, 14.3% (n = 30) were dead within 30 days after surgery. By univariate analysis, we found AAAD repair patients with 30-days mortality had a higher prevalence of cerebral malperfusion, lower pre-operative fibrinogen, longer cardiopulmonary bypass and aortic crossclamp time, and higher post-operative day 1 (POD1) creatinine and urea levels. Both pre-operative (433.80 ± 152.59 vs. 373.46 ± 108.31 mmol/L, p = 0.038) and POD1 (559.78 ± 162.23 vs. 391.29 ± 145.19 mmol/L, p

Abstract MicroRNAs (miRNAs) packaged into exosomes mediate cell communication and contribute to the pathogenesis of acute type A aortic dissection (ATAAD) with acute lung injury (ALI). The expression profile of plasma exosomal miRNAs in ATAAD patients with ALI hasn’t been identified. We performed a miRNA-sequencing to analyze the differentially expressed miRNAs (DE-miRNAs) of circulating exosomes in ATAAD patients with ALI compared to patients without ALI, founding 283 specific miRNAs in two groups. We respectively selected the top 10 downregulated and upregulated DE-miRNAs for further studies. The predicted transcription factors (TFs) of these DE-miRNAs were SMAD2, SRSF1, USF1, etc. The Gene Ontology (GO) and Kyoto Encyclopedia Genes and Genomes (KEGG) analysis predicted their target genes mainly involved acute inflammatory response, cell junction, cytoskeleton, NF-κB signaling pathway, etc. Construction and analysis of the PPI network revealed that RHOA and INSR were considered hub genes with the highest connectivity degrees. Moreover, we confirmed two exosomal miRNAs (hsa-miR-485-5p and hsa-miR-206) by real-time quantitative polymerase chain reaction (RT-qPCR) in a validation cohort. Our study identified a plasma exosomal miRNAs signature related to ATAAD with ALI. Certain DE-miRNAs may contribute to the progression of this disease, which help us better understand the pathogenesis of ATAAD with ALI.

ObjectiveThe study aimed to determine the relationship between body mass index (BMI) and the risk of acute aortic syndrome (AAS) with preoperative oxygenation impairment.MethodsA meta-analysis of published observational studies involving BMI and AAS with preoperative oxygenation impairment was conducted. A total of 230 patients with AAS were enrolled for retrospective analysis. All patients were divided into 2 groups (Non-oxygenation impairment group and Oxygenation impairment group). Logistic regression analysis was performed to assess the relation between BMI and the risk of preoperative oxygenation impairment after the onset of AAS. Dose-response relationship curve and subgroup analysis were conducted to test the reliability of BMI as an independent factor of it.ResultsFor the meta-analysis, the quantitative synthesis indicated that excessive BMI increased the risk of preoperative oxygenation impairment (OR: 1.30, 95% CI: 1.05-1.60, Pheterogeneity = 0.001). For the retrospective analysis, a significant association was observed after adjusting for a series of variables. BMI was significantly related to preoperative oxygenation impairment after the onset of AAS (OR: 1.34, 95% CI: 1.15-1.56, p

Abstract Background Inflammation underlies both the pathogenesis and prognosis in patients with acute aortic dissection (AAD). This study aimed to assess the association of ICU admission of white blood cell count (WBCc) with post-discharge mortality in these patients. Methods Clinical data were extracted from the MIMIC-III V1.4 database. After adjusted to covariables, Cox regression analysis and Kaplan–Meier survival curve were performed to determine the relationship between WBCc on admission and post-discharge mortality (30-day, 90-day, 1-year and 5-year) in AAD patients. Subgroup analysis and receiver operating characteristic (ROC) curve analysis were used to test the performance of WBCc in predicting mortality in AAD patients. Results A total of 325 eligible patients were divided into 2 groups: normal-WBCc group (≤ 11 k/uL) and high-WBCc group (> 11 K/uL). In univariate Cox regression analysis, high WBCc was significant risk predictor of 30-day, 90-day, 1-year and 5-year mortality [hazard ratio (HR), 95% CI, P 2.58 1.36–4.91 0.004; 3.16 1.76–5.70 0.000; 2.74 1.57–4.79 0.000; 2.10 1.23–3.54 0.006]. After adjusting for age and other risks, high WBCc remained a significant predictor of 30-day, 90-day and 1-year mortality in AAD patients (HR, 95% CI, P 1.994 1.058–3.76 0.033; 2.118 1.175–3.819 0.013; 2.37 1.343–4.181 0.003). The area under ROC curve of WBCc for predicting 30-day, 90-day, 1-year and 5-year mortality were 0.69, 0.70, 0.66 and 0.61, respectively. The results from subgroups analysis showed that there was no interaction in most strata and patients who were younger than 69 years of age or had history of respiratory disease with an elevated WBCc had an excess risk of 30-day mortality (HR, 95% CI, P 3.18 1.41–7.14 0.005; 3.84 1.05–14.13 0.043). Conclusions Higher than normal WBCc on admission may predict post-discharge mortality in patients with AAD.

Open thoracoabdominal aortic aneurysm (TAAA) repair is a complex and challenging operation with a high incidence of serious complications, and high perioperative mortality and morbidity. Left heart bypass (LHB) is a circulatory support system used to perfuse the distal aorta during TAAA operation, and the advantages of LHB include guaranteeing distal perfusion, reducing the use of heparin, and diminishing the risk of bleeding and postoperative neurological deficits. In China, the circuit for TAAA repair is deficient, and far from the perfusion requirements. We designed a modular multifunctional LHB circuit for TAAA repair. The modular circuit consisted of cannulation pipelines, functional consumables connection pipelines, and accessory pipelines. The accessory pipelines make up lines for selective visceral perfusion and kidney perfusion, suckers and rapid infusion. The circuit can be assembled according to surgical requirements. The ultrafilter and heat exchanger are integrated into the circuit to fulfill the basic demands of LHB. The LHB circuit also has pipelines for selective visceral perfusion to the celiac artery and superior mesenteric artery and renal perfusion pipelines. Meanwhile, the reserved pipelines facilitate the quick switch from LHB to conventional cardiopulmonary bypass (CPB). The reserved pipelines reduce the time of reassembling the CPB circuit. Moreover, the rapid infusion was integrated into the LHB circuit, which can rapid infusion when massive hemorrhage during the open procedures such as exposure and reconstruction of the aorta. The ultrafiltration can diminish the consequent hemodilution of hemorrhage and rapid infusion. A hemoperfusion cartridge also can be added to reduce the systemic inflammatory during operation. The circuit can meet the needs of LHB and quickly switch to conventional CPB. No oxygenator was required during LHB, which reduce the use of heparin and reduce the risk of bleeding. The heat exchanger contributes to temperature regulation; ultrafiltration, arterial filter, and rapid-infusion facilitated the blood volume management and are useful to maintain hemodynamic stability. This circuit made the assembly of the LHB circuit more easily, and more efficient, which may contribute to the TAAA repair operation performed in lower volume centers easily. 26 patients who received TAAA repair under the modular multifunctional LHB from January 2018-March 2022 were analyzed, and we achieved acceptable clinical outcomes. The in-hospital mortality and 30-day postoperative mortality were 15.4%, and the postoperative incidences of paraparesis (4%), stroke (4%), and AKI need hemodialysis (12%) were not particularly high, based on the limited patients sample size in short research period duration.

Objective: Oxygenation impairment is a common complication of acute aortic syndrome (AAS) patients after surgical repair. The aim of this study is to identify the relationship between body mass index (BMI) and the risk of postoperative oxygenation impairment in AAS patients.Methods: A total of 227 consecutive patients who were diagnosed as AAS and underwent surgical repair were recruited. They were divided into two groups based on the postoperative oxygenation impairment (non-oxygenation impairment group and oxygenation impairment group). Logistic regression was conducted to evaluate the association between BMI and the risk of oxygenation impairment after surgery. Dose-response curve and subgroup analysis were used to test the reliability of the results of regression analysis. A meta-analysis was then performed to further confirm these results using Pubmed, Embase, and Web of Science databases.Results: For the retrospective study, a significant association was observed after adjusting for a series of variables. BMI was significantly correlated with postoperative oxygenation impairment in patients with AAS (OR, 95% CI, P: 1.27, 1.17–1.46, 0.001). Compared with the normal weight group (18.5 kg/m2 ≤ BMI

Over the past 30 years, additive manufacturing (AM) has developed rapidly and has demonstrated great potential in biomedical applications. AM is a materials-oriented manufacturing technology, since the solidification mechanism, architecture resolution, post-treatment process, and functional application are based on the materials to be printed. However, 3D printable materials are still quite limited for the fabrication of bioimplants. In this work, 2D/3D AM materials for bioimplants are reviewed. Furthermore, inspired by Tai Chi, a simple yet novel soft/rigid hybrid 4D AM concept is advanced to develop complex and dynamic biological structures in the human body based on 4D printing hybrid ceramic precursor/ceramic materials that were previously developed by our group. With the development of multi-material printing technology, the development of bioimplants and soft/rigid hybrid biological structures with 2D/3D/4D AM materials can be anticipated.

Abstract Background Cardiac myxoma (CM) is the most common type of primary cardiac tumors. The prevalence of primary cardiac tumors is 0.0017–0.28% in various autopsy studies. The clinical symptoms of CM which includes embolism, intracardiac obstruction, general or constitutional manifestations and infected myxoma are largely depended on the size, growing speed, location and pedicle length of the tumor. The following case reported a missed diagnostic case of a right atrial myxoma firstly presented digestive, systemic symptoms and immunologic disorder, leading to emergent tricuspid valves obstruction situation. Case presentation We reported a critical case of a 51-year-old female with CM was firstly admitted to the gastroenterology clinical department because of poor appetite, marked fatigability and weight loss for 2 months. The physician diagnosed her as chronic gastritis and treated her with some symptomatic treatment such as ilaprazole and magnesium aluminum carbonate. After months without definitive diagnosis, this right atrial myxoma grew into right ventricle and obstructed the tricuspid valves, causing her dyspnea, sweating, dizziness, feeling of impending death when she was sleeping. Transthoracic echocardiogram revealed a 6.1 × 4.2 × 3.7 cm2 mass adjacent to tricuspid valves. The patient underwent surgical excision and pathology revealed a primary cardiac myxoma. Conclusion This case reported a critical result of missed diagnosis of right atrial myxoma and showed its systematic symptoms and immunologic disorder, highlighting the importance of systematic examinations on patients. Furthermore, it appeals early diagnosis of CM and consideration of drug targets to suppress CM development.

Abstract Background Lung cancer remains the top contributor to cancer-related mortality worldwide. Long non-coding RNAs (lncRNAs) have been reported to participate in normal development and tumorigenesis. LncRNA nuclear enriched abundant transcript 1 (NEAT1) is highly expressed in lung cancer and promotes lung cancer cell proliferation and migration. However, the upstream regulatory mechanism still needs investigation. Methods In the present study, we investigated the upstream regulators and mechanisms of NEAT1 expression disorders. We first examined NEAT1 expression in lung adenocarcinoma tissues and its correlation with clinic features in patient with lung adenocarcinoma; next, the detailed function of NEAT1 in lung cancer cell proliferation and migration was assessed. To investigate whether NF-κB acts as a transcription factor of NEAT1 to activate its expression, we validated the combination between NF-κB and NEAT1, and NF-κB regulation of NEAT1 upon LPS stimulation. Further, the effect of NF-κB upstream regulator, TLR4, on NEAT1 expression upon LPS stimulation was examined. Galectin-3 reportedly serves as a ligand of TLR4 and promotes TLR4, MyD88 and p-p65 expression; we investigated whether Galectin-3 could modulate lung adenocarcinoma cell proliferation and migration through TLR4/NF-κB/NEAT1. Finally, the expression and correlation of the above factors in lung adenocarcinoma tissues was validated. Results NEAT1 is highly expressed in lung adenocarcinoma tissues and promotes lung cancer cell proliferation and migration. NF-κB binds to NEAT1 promoter to activate NEAT1 expression after LPS-stimulated p65 nucleus translocation. LPS stimulation activates TLR4 signaling, followed by downstream NF-κB activation, and ultimately NEAT1 expression activation. Galectin-3 activates TLR4 signaling thus affecting lung cancer cell proliferation and migration through TLR4/NF-κB/NEAT1. Galectin-3 and TLR4 expression are abnormally up-regulated in lung adenocarcinoma tissues, and positively correlated with NEAT1 expression. Conclusion We confirmed that Galectin-3 as a ligand of TLR4 induced TLR4 signaling activation in lung adenocarcinoma cells, thereby activating downstream p65 nucleus translocation, promoting NEAT1 expression, and finally affecting lung adenocarcinoma cell proliferation and migration. Inhibiting Galectin-3-induced TLR4 signaling activation, thus to reduce p65-activated NEAT1 expression might be a promising strategy of suppressing lung adenocarcinoma cell proliferation and migration.

Abstract Transition-metal chalcogenides host various phases of matter, such as charge-density wave (CDW), superconductors, and topological insulators or semimetals. Superconductivity and its competition with CDW in low-dimensional compounds have attracted much interest and stimulated considerable research. Here we report pressure induced superconductivity in a strong spin-orbit (SO) coupled quasi-one-dimensional (1D) transition-metal chalcogenide NbTe4, which is a CDW material under ambient pressure. With increasing pressure, the CDW transition temperature is gradually suppressed, and superconducting transition, which is fingerprinted by a steep resistivity drop, emerges at pressures above 12.4 GPa. Under pressure p = 69 GPa, zero resistance is detected with a transition temperature T c = 2.2 K and an upper critical field μ 0 H c2 = 2 T. We also find large magnetoresistance (MR) up to 102% at low temperatures, which is a distinct feature differentiating NbTe4 from other conventional CDW materials.

High-pressure physics: transitions and superconductivity of compressed ReS2 ReS2 is a unique transition metal dichalcogenide (TMD) in terms of its distorted low-symmetry structure at ambient conditions. A subject that remains elusive so far is how its structure and electronic properties respond to pressure. Now a collaborative team led by Prof. Jian Sun from Nanjing University looks at the phase transitions in ReS2 under pressure utilizing ab initio crystal structure searching combining with high-pressure electrical resistance measurements. Upon small compression, the ambient phase transforms to a triclinic distorted 1T structure before changing to a tetragonal polymorph at higher pressure. The former transition is due to the layer sliding with a Peierls mechanism governing the energy stabilization and this semiconducting phase would be metallized with increasing pressure. The latter predicted structure is superconducting at a critical temperature of around 2 K at 100 GPa. This work suggests the role of pressure in tailoring the electronic structures of TMDs.

Frustration makes a tremendous amount of degenerate ground states which provides no energy scale of its own. Any perturbation has to be considered strong and fascinating phenomena may be emergent upon relieving of frustration. Here, we report the evolution of spin phonon coupling in the frustrated spinel system Zn1−xCdxCr2Se4 (0 ≤ x ≤ 1) from magnetization, specific heat and thermal conductivity. Our results give clear evidences that the spin-orientated structural transitions decay rapidly as x going from 0 to 0.4 while the correlations between spin and lattice degrees of freedom for 0.6 ≤ x ≤ 1 become weak and can be explained in terms of the traditional magnetostriction effect. In addition, for 0 ≤ x ≤ 0.4 thermal carriers reveal strong scattering from spin fluctuations in the vicinity of TN owing to strong frustration, in stark contrast with those for 0.6 ≤ x ≤ 1 where traditional phonon-like heat conduction behaviors are observed. Moreover, it is shown that a moderate applied magnetic field can drive readily the fluctuations-scattered thermal conductivity toward traditional phonon-like one as observed in CdCr2Se4, reaching about 30% for x = 0.4 at 25 K in 1 T. Such strong field-sensitive effects may introduce new promising functionalities for potential applications.

We have recently reported that the superconducting transition temperature of FeTe0.5Se0.5 flakes attached onto commercial Scotch tape can be enhanced by about 1-2 K due to a thermal-mismatch induced compressive strain. In this work, we further investigated the Scotch tape effect on structural variation of FeTe0.5Se0.5 and Fe1.05Te flakes by X-ray diffraction measurements. We show that for FeTe0.5Se0.5, the lattice constant c of taped flakes is elongated by about 0.5% at 15 K as compared with bulk crystal. Upon warming from 15 K, the lattice constant c of the taped flakes first levels off then displays negative thermal expansion followed by monotonic increase at temperatures above 100 K. For antiferromagnetic Fe1.05Te, the structural transition around 70 K is remarkably broadened by about 2 K. The present results demonstrate that the Scotch tape is a simple and effective tool to probe structure sensitive physical properties of layered materials.