Renal subcapsular haematoma: an unusual complication of renal artery stenting / 中华医学杂志(英文版)

After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.

Relationship between endothelial cell protein C receptor gene 6936A/G polymorphisms and deep venous thrombosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Deep venous thrombosis (DVT) can result in pulmonary embolism, a fatal complication that is due to the dislodgement and movement of a blood clot (thrombus) from a limb into the lungs. Genetic risk factors related to DVT development include mutations in coagulation proteins, especially the endothelial protein C receptor (EPCR), a component of the anticoagulation protein C (PC) pathway. The objective of the present study was to analyze the relationship between the 6936A/G polymorphism in the EPCR gene and the occurrence of DVT.</p><p><b>METHODS</b>This study involved 65 patients with DVT and 71 age- and gender-matched healthy controls. Peripheral blood samples were collected from all subjects. Plasma levels of soluble EPCR (sEPCR) were measured by enzyme-linked immunosorbent assay. Genomic DNA was extracted and EPCR gene product was amplified by a standard PCR reaction. Gene product bands were sequenced to identify EPCR gene polymorphisms.</p><p><b>RESULTS</b>In the control group, the level of sEPCR in subjects with 6936AG genotype was significantly higher than that in subjects with 6936AA genotype ((0.97 ± 0.32) pg/ml vs. (0.61 ± 0.24) pg/ml, P < 0.01). Similarly in the DVT group, the level of sEPCR in subjects with the 6936AG were greater than that in subjects with the 6936AA genotype ((0.87 ± 0.21) pg/ml vs. (0.50 ± 0.18) pg/ml, P < 0.01). The sEPCR level in DVT patients was significantly higher than that in healthy controls ((0.68 ± 0.32) pg/ml vs. (0.54 ± 0.22) pg/ml, P < 0.05). The 6936AG genotype frequency in DVT patients was significantly higher than that in healthy controls (P < 0.05). In contrast, the 6936AA genotype frequency in DVT patients was lower than that in healthy controls (P < 0.05). Subjects carrying 6936AG had an increased risk of thrombosis (OR = 2.75, 95%CI: 1.04 - 7.30, P < 0.05).</p><p><b>CONCLUSIONS</b>EPCR gene 6936A/G polymorphism is associated with increased plasma levels of sEPCR. Subjects carrying 6936AG likely have an increased risk of thrombosis.</p>

The effect of bone marrow mesenchymal stem cell transplantation on diabetic cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>Diabetic cardiomyopathy (DCM), an important cause of heart failure, is characterized by microvascular pathologies and interstitial fibrosis. Bone marrow mesenchymal stem cells (MSCs) are pluripotent, which can differentiate into cardiomyocytes and vascular endothelial cells. They also secrete angiogenic and antiapoptotic factors. However, little information is available about the effect of MSCs transplantation on diabetic heart.</p><p><b>METHODS</b>MSCs were isolated from bone marrow of isogenic adult rats and cultured ex vivo. Eight weeks post streptozotocin injection, saline or exogenous MSCs labelled with 4'6-Diamidino-2-Phenylindole (DAPI) were injected into the femoral vein of diabetic rats and examined 4 weeks later by echocardiography, histopathologic analysis, reverse transcription polymerase chain reaction analysis for matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of matrix metalloproteinase (TIMP)-1, zymography analysis for activities of MMP-2 and Western blot analysis for troponin T.</p><p><b>RESULTS</b>Left ventricular posterior wall thickness and myocardial arteriolar density as well as the TIMP-1 mRNA and MMP-2 activity were significantly decreased in DCM group (P < 0.01 versus control group respectively), these changes were significantly attenuated by MSCs transplantation (P < 0.05 versus DCM). MSCs transplantation also significantly reduced fibrosis and downregulated MMP-9 mRNA in diabetic myocardium.</p><p><b>CONCLUSION</b>Intravenous MSCs transplantation could attenuate LV remodeling in DCM rats.</p>

Autologous transplantation of peripheral blood stem cell in treatment of critical limb ischemia / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To apply autologous transplantation of peripheral blood stem cells in the treatment of critical limb ischemia.</p><p><b>METHODS</b>Fifteen patients with critical lower limb ischemia were recruited in this study. After bone marrow mobilization, peripheral blood stem cells were collected using CS-3000 Plus device, and transplanted directly into the ischemic limb. In total 17 times of transplantation were performed.</p><p><b>RESULTS</b>One year after implanted peripheral blood stem cells, the pain scale decreased from 5 to 0, the ankle-brachial pressure index (ABI) increased from 0.30 to 0.46, the pain-free walking distance and maximal walking distance increased from 0.15 to 0.72 km and 0.96 to 2.13 km separately, from a total of 6 of 15 limb ulcers of transplanted patients 5 were healed after cell transplantation.</p><p><b>CONCLUSION</b>Autologous peripheral blood stem cell transplantation is able to induce functional angiogenesis in ischemic limb, which can significantly reduce rest pain, increase walk distance, and promote ulcer healing.</p>

Therapeutic neovascularization with autologous bone marrow CD34+ cells transplantation in hindlimb ischemia / 中华外科杂志

<p><b>OBJECTIVE</b>To explore whether transplantation of autologous bone marrow stem cells might augment angiogenesis and collateral vessel formation in a canine model of hindlimb ischemia.</p><p><b>METHODS</b>CD34(+) stem cells were centrifugation through Ficoll and an immune magnetic cell sorting system from bone marrow (20 ml) of canine (n = 5) and induced into endothelial cells with VEGF in vitro, and expression of von Willebrand factor. Bilateral hindlimb ischemia was surgically induced in canines and Dil fluorescence labeled autologous stem cells were transplanted into the ischemic tissues.</p><p><b>RESULTS</b>Four weeks after transplantation, fluorescence microscopy revealed that transplanted cells were incorporated into the capillary network among preserved skeletal myocytes. The stem cells transplanted group had more angiographically detectable collateral vessels, a higher capillary density (12.0 +/- 2.8 vs. 5.0 +/- 1.6 per field; t = 4.17 P < 0.05) and a higher ABI (0.58 +/- 0.14 vs. 0.32 +/- 0.11; t = 2.95, P < 0.05).</p><p><b>CONCLUSIONS</b>Direct local transplantation of autologous bone marrow CD34(+) stem cells seems to be a useful strategy for therapeutic neovascularization in ischemic tissues in adults, consistent with "therapeutic vasculogenesis."</p>

Treatment of the infrequent complications after stent graft placement for aortic disease / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the infrequent complications and treatment after endoluminal stent graft implantation for aortic diseases.</p><p><b>METHODS</b>Review of the characters and complications for five cases of aortic diseases by stent graft implantation.</p><p><b>RESULTS</b>The complications of 4 cases have been relieved by operation or re-stent implantation, 1 case was died.</p><p><b>CONCLUSION</b>The complications are difficult to forecast for stent graft placement in aortic diseases, the surgeon should be well practiced in surgical and interventional technique, so as to treat the complications in time.</p>

Induction of differentiation of CD34+ cells in vitro and application in endothelialization of blood vessel prostheses / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To induce differentiation of CD(34)+ cells from varying sources into epithelial cells for potential application of blood vessel prostheses.</p><p><b>METHODS</b>CD(34)+ cells were isolated from canine peripheral blood and bone marrow or human umbilical cord blood by an immune magnetic cell sorting system. The isolated CD(34)+ cells were induced to differentiate into endothelial cells in a liquid culture with VEGF. Endothelial cells were evaluated by immunocytochemistry and transmission electron microscopy. CD(34)+ cells were seeded on PTFE prostheses, which were harvested and observed by electron microscopy.</p><p><b>RESULTS</b>The average isolated CD(34)+ cells from peripheral blood, bone marrow and umbilical cord blood were (26.30+/-2.42)%,(41.84 +/-3.65)%and (74.62+/-4.46)%, respectively. The number of CD(34)+ cells increased with the culture duration and reached to the highest level at the 14th d. Immunostaining showed positive signal for CD31 in endothelial cells and positive for factor VIII in cell culture. Transmission electron microscopy found Weibel-Palade bodies in the cytoplasm. Scanning electron microscopy demonstrated a single- layer of flat cells in the innermost layer of PTFE prostheses, and the cells were not of tropism.</p><p><b>CONCLUSION</b>CD(34)+ cells isolated from peripheral blood, bone marrow and umbilical cord blood can be induced into endothelial cells; bone marrow and umbilical cord blood can be used as the sources of seeding cells for endothelialization of prostheses.</p>

Experiment and study of endothelialization of prostheses with bone marrow CD34+ cells / 中华外科杂志

<p><b>OBJECTIVE</b>To exploration the endothelialization of prostheses with bone marrow CD(34)(+) cells.</p><p><b>METHODS</b>CD(34)(+) cells were isolated from bone marrow of carine by an immune magnetic cell sorting system and induced into endothelial cells with VEGF. Seeding the cells to PTFE prostheses which implanted the abdominal aorta artery (AAA) and inferior vena cava (IVC).</p><p><b>RESULTS</b>The isolated cells from bone marrow were CD(34)(+) by flow cytometer which could differentiate into endothelial cells in vascular endothelial growth factor (VEGF). The endothelial cells were identified by immunostaining and transmission electron microscope. The obliteration rate of the seeding grafts implanting AAA was 0%, the stenosis rate 12.5%; the obliteration rate implanting IVC 12.5%, the stenosis rate 25%.</p><p><b>CONCLUSION</b>CD(34)(+) cells were isolated from bone marrow by an immune magnetic cell sorting system and were able to be induced into endothelial cells with VEGF in vitro. PTFE prostheses seeding CD(34)(+) cells have the ideal endothelialization and patency.</p>

Role of bone marrow mobilization in the angiogenesis in ischemic hindlimbs of diabetic mice / 中华内分泌代谢杂志

Objective To investigate the angiogenesis effect induced by hone marrow mobilization on the ischemic hindlimbs of diabetic mice.Methods Diabetes mellitus was induced in mice by injection of streptozotocin.To observe the angiogenesis effect in ischemic limbs,unilateral femoral artery and all the side branches were excised and then was given granulocyte-colony stimulating factor (G-CSF) for bone marrow mobilization.Results The level of nitric oxide (NO) in plasma was significantly lowered 8 weeks after establishment of diabetes mellitus.After mobilization for 8 days,CD_(34)~+ cells in peripheral blood of mice were increased significantly [from (0.15?0.05)% to (2.30?0.41 )%],the vascular endothelial growth factor (VEGF) mRNA level of ischemic limb,which was examined with semi-quantitative RT-PCR,became higher in diabetic mice than that in non-diabetic mice.Two weeks following mobilization,the blood perfusion detected by LASER Doppler perfusion scan in the ischemic hindlimbs was significantly higher in the diabetic mice than in that the nondiabetic mice [(76.37?6.10) % vs (18.07?3.40) %,P＜0.05],vWF immunohistochemical staining showed that the density of capillaries was significantly greater in the mobilization group than that in the non- mobilization group [ (26.6?4.8 vs 11.5?2.6 )/per field,P＜0.05 ].Conclusion Diabetes mellitus reduced the modulatory role of the endothelium in mice,but therapeutic angiogenesis induced by bone marrow mobilization could be an effective treatment for ischemic limb disease in diabetic mice.