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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 4 | Issue 2
Page Nos. 17-38

Online since Wednesday, November 27, 2019

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ORIGINAL ARTICLE  

Pro-inflammatory chemokine interleukin-17A may increase venous thrombus resolution by increasing venous thrombus neovascularization p. 17
Wang Ruihua, Wu Xiaoyu, Li Bo, Lu Xinwu
DOI:10.4103/ts.ts_8_19  
Objectives: The aim of this study was to assess the effect of the pro-inflammatory interleukin (IL)-17A in deep venous thrombosis (DVT) resolution. Materials and Methods: A total of 45 DVT patients, 30 primary deep venous insufficiencies (DVI) patients, and 18 healthy volunteers were divided into three groups: (a) Control group, (b) DVT group, and (c) DVI group. The venous blood samples of the lower extremity with DVT were collected to evaluate the expression of IL-17A in plasma. Samples of superficial venous thrombus and superficial vein without thrombosis were collected to evaluate the expression of IL-17A in tissue. Male C57/BL mice DVT model was established and was randomly divided into five groups: (1) Control group, no treatment or surgical intervention; (2) Sham group, no treatment and sham operation; (3) DVT group, each mouse intravenous (iv) injected with phosphate-buffered saline (PBS); (4) IL-17A group, each mouse was iv injected with IL-17A; and (5) IL-17A-neutralizing antibody (NA) group, each mouse was iv injected with IL17A NA. Inferior vena cava (IVC) with thrombi were collected to measure their length and weight and analysis CD31(+) endothelial cells in thrombus of internal cerebral vein. Results: Western blot suggested that the expression of IL-17A in superficial vein with thrombosis was higher than superficial vein without thrombosis from human samples (P < 0.05). Comparing the plasma IL-17A levels in human samples, it was found that the expression of IL-17A in DVT and DVI groups was higher than those control group (P < 0.05). In C57/BL mice DVT model, immunofluorescence showed that CD31(+) endothelial cells in thrombus in IL-17A intervention group were more than those in other groups (P < 0.05). The weight of IVC with thrombi in IL-17A intervention group were less than those in other groups (P < 0.05), however, without statistical difference compared with the DVT group and IL-17A-NA group. Conclusions: Venous thrombus neovascularization can be increased by pro-inflammatory chemokine IL-17A but do not appear to decrease thrombus size.
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REVIEW ARTICLE Top

Factors regulating the change of vascular smooth muscle cells in cardiovascular diseases: A mini review p. 22
Haocheng Li, Qingfeng Sun, Ye Yao, Chao Yuan, Gaoyan Liu, Bao Jing, Jingbo Li, Haiyang Wang
DOI:10.4103/ts.ts_4_19  
Vascular smooth muscle cells (VSMCs) are responsible for blood vessel relaxation contraction and hemodynamics. Cardiovascular diseases (CVDs) are a major cause of human death worldwide, and the pathophysiological changes to the VSMCs such as apoptosis, hypertrophy, and migration contribute to these diseases. Herein, we recapitulated the importance of molecular factors relevant to the regulation of VSMCs and how VSMCs are involved in these pathophysiological changes. This is significant to the development of therapeutic treatments for various CVDs. A literature search was conducted to identify studies assessing the regulating factors of VSMCs using the Medline and PubMed databases from inception to February 1, 2019. Search terms were applied either as single or in combination. In the present review, we will discuss some of the influential factors that may affect and regulate the changes of VSMCs in CVDs.
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CASE REPORTS Top

A four-generation pedigree of vascular-type Ehlers–Danlos syndrome with spontaneous aortic dissections and multiple aneurysms: A case report and literature review p. 27
Xu Zhang, Nuo Si, Yuan Li, Mei Liang, Yue Hong Zheng
DOI:10.4103/ts.ts_12_19  
Ehlers-Danlos syndrome (EDS) is a rare, heritable connective tissue disorder disease . Among the subtypes of EDS, vascular type EDS (VEDS), is the most catastrophic one which can lead to aortic aneurysm, aortic dissection and even aortic rupture. We report a four-generation pedigree of VEDS. We give the propositus and her sister a DNA Test and made a literature review about the treatment of VEDS. The diagnosis turned out to be VEDS, which is caused by mutations in COL3A1(c.2221G>A, p.G741S), The patient received conservative treatment and her family got the medical instructions. Although EDS is rarely seen, it is necessary to be aware of this disease to make the right diagnosis and chose the appropriate treatment strategy, Doctors' unfamiliarity with this disease may compromise care.
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An aneurysm-like entity inside a giant carotid body tumor reaching lateral skull base p. 32
Hui Zhang, Fangda Li, Yuehong Zheng
DOI:10.4103/ts.ts_10_19  
The successful resection of giant carotid body tumors (CBTs) with full protection of cranial nerve is challenging. Meanwhile, entities with fresh blood inside a CBT were commonly considered liquefactive necrosis preoperatively. However, we reported a case with an aneurysm-like entity inside the CBT instead. A patient with lump on the right neck complained of feeling dizzy. She was then reported with a giant CBT reaching lateral skull base. Preoperative imaging revealed a low-density entity inside the tumor, which was considered as liquefaction necrosis. However, during surgery, the low-density area was observed pulsing with fresh blood. Under the collaboration of vascular surgeons and otolaryngologists, the tumor was resected uneventfully. We reported a case of giant CBT over 10 cm and successful resection with no major facial nerve deficit. Moreover, an aneurysm-like entity inside the tumor was observed during the surgery, which was not reported before.
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Portal vein recanalization failed to improve chronic intestinal obstruction due to extrahepatic portal vein obstruction p. 35
Le Xiao, Lei Shang, Xuan Xu, Yiming Ouyang, Linhai Li, Yu Zhu, Kunmei Gong
DOI:10.4103/ts.ts_9_19  
Extrahepatic portal vein obstruction (EHPVO) refers to obstruction of the extrahepatic portal vein that is characterized by cavernous transformation, portal hypertension, and intestinal dysfunction. Radiological interventions on EHPVO are an extraordinary challenge, although being reported to be safe and effective in selected patients by pertinent experts. Chronic intestinal dysfunction is a rare complication of EHPVO; it is unknown whether portal vein re-canalization by radiological interventions can improve chronic intestinal dysfunction. We describe a 22-year-old male patient with chronic intestinal dysfunction due to EHPVO, which was not improved by portal vein re-canalization. The patient presented with acute abdominal pain and dyspepsia for 2 weeks without hematochezia in August 2016 and was diagnosed with EHPVO. Due to cavernous transformation, systemic anticoagulation therapy was administered, and although his abdominal pain was relieved, the patient still had dyspepsia and partial jejunum dysfunction. Intestinal segmentectomy was suggested but was refused, and the patient received catheter-directed thrombolysis in another hospital. Although the portal vein was partly recanalized, the intestinal obstruction was not alleviated. Four months after onset, an emergent enterectomy was performed due to severe hematochezia with pathological examination findings of necrosis, ulcer, and granulation formation. Unfortunately, the patient developed a serious systemic infection, severe thrombocytopenia and disseminated intravascular coagulation, which was assumed to be caused by intestinal bacterial translocation and serious malnutrition. The infection was subsequently controlled. In conclusion, in patients with chronic intestinal dysfunction due to EHPVO, portal vein re-canalization may not improve intestinal function. Timely enterectomy may prevent intestinal bacterial translocation and serious malnutrition.
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