Research On The Pathogenesis And Clinical Treatment Of Thoracic Aortic Aneurysm

Objective:Carry one the researchs on molecular biology pathogenesis and clinical treatment to improve the prognosis of thoracic aortic aneurysm.Methods:The research methods of this paper is divided into two parts1?Aortic endothelial cells were isolated from Sprague Dawley rats,RAECs were incubated in TNF-a conditioned medium or Slit2 conditioned medium,The cell proliferation and migration were detected,and small interfering(SI)RNA transfection was performed.RAECs were incubated in endothelial basal medium,TNF-a conditioned medium(10 ng/ml)or Slit2 conditioned medium(100 ng/ml),RNA was then extracted for polymerase chain reaction and the level of VEGF in cell culture medium was measured by electrochemiluminescence.Data are presented as the mean 1 standard deviation.One-way analysis of variance was used to compare the differences among more than three groups.Bonferroni post-hoc test was subsequently used to analyze the differences between two groups.P<0.05 was considered to indicate a statistically significant difference.2.From 2015.10 to 2017.10,435patients was diagnosed as the aneurysm of the thoracic aorta and underwent endovascular treatment;Mean age was 58114 years,and 80%were men.The aorta CTA was reviewed in 1 and 6 monthes after the operation,The follow-up rate was 100%during a period of 27 months(range,6-30 months).Results:1.Compared with the control group,TNF-? stimulates endothelial cell proliferation and migration in vitro.TNF-? administration increased VEGF,Notch1 andNotch2 expression in RAECs.Treatment with Slit2,resulted in a dose-and time-dependent decrease in TNF-a induced cell proliferation and migration(P<0.05).VEGF siRNA transfection silenced VEGF expression,and reduced Notchl and Notch2 expression.2.The success rate of the operation was 100%.Hospital mortality was 0%.The incidence of vascular injury was 3%(n=1).The incidence of type I endoleak was 8%(n=3).The incidence of renal failure was 11%(n=4),6%(n=2)died within 30 days after operation.The mortality rate was 11%(n=4)during follow-up.All the patients freedom reoperation during follow-up time.Conclusion:Slit2 inhibited endothelial cell proliferation and migration,and the inhibitory effects.of Slit2 dependent on the VEGF-Notch signaling pathway.It provides a new evidence for the treatment of aortic aneurysm with anti angiogenic therapy.When anatomically feasible,endovascular therapy is a viable alternative to open surgery.