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Objective To evaluate the curative effect of endovascular treatment for Leriche syndrome.Methods The clinical data of 57 patients with Leriche syndrome,who were admitted to authors' hospital during the period from September 2010 to October 2014,were retrospectively analyzed.The curative effect of percutaneous transluminal angioplasty (PTA) was analyzed.Results Among the 57 patients (65 diseased limbs in total),simple PTA was employed in 2,catheter directed thrombolysis (CDT) with subsequent PTA and stenting in 5,and PTA plus stenting in 50.A total of 97 stents were implanted,the technical success rate was 100％.After the treatment,the ankle brachial index (ABI) increased from preoperative (0.42±0.22) to postoperative (0.83±0.15),the difference between the two data was statistically significant (P＜0.01).Thepatients were followed up for (9.8±2.8) months.The 6-month and 12-month primary patency rates were 95.4％ and 90.7％ respectively,the postoperative secondary patency rate was 96.4％.After the treatment,the symptoms of lower limb ischemia were improved in all patients.During perioperative period,iliac artery rupture due to balloon dilatation occurred in 2 patients,pseudoaneurysm at brachial aaery puncture point in one patient,hematoma at puncture point in 3 patients,cerebral infarction in 2 patients and myocardial infarction in one patient.One patient developed contrast-induced nephropathy and finally died of multiple organ dysfunction syndrome.The perioperative mortality was 1.75％.One patient developed in-stent obstruction in 3 months after two stage treatment,and artificial vascular bypass grafting had to be carried out.Conclusion For the treatment of Leriche syndrome,PTA is safe and reliable,it carries less complications and lower perioperative mortality with satisfactory short-term patency rate.(J Intervent Radiol,2017,26:221-224)
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Objective To investigate the role of Wnt signaling pathway hypofunction mediated by dephosphorylation ofβ-catenin in the impaired wound healing of type 1 diabetic rats. Methods The back skin defect wounds were produced in rats with type 1 diabetes. These rats were divided into control, diabetes, lithium chloride treatment, and epidermal growth factor ( EGF) treatment groups. The situation of back wound healing, the ratio ofβ-catenin positive cells,β-catenin, phosphorylatedβ-catenin, and vascular endothelial growth factor ( VEGF) levels were detected. Results Compared to diabetes group, the wound granulation tissue was more mature, wound healing time was shorter, and healing rate, as well as the ratio ofβ-catenin positive cells, dephosphorylatedβ-catenin, and VEGF levels, were higher in normal group, lithium chloride treatment group, and EGF treatment group ( P<0. 05 or P<0. 01). Conclusion The hypofunction of Wnt signaling pathway is involved in the process of wound healing in type 1 diabetic rats, of which the dephosphorylation ofβ-catenin is the key point. EGF may play a beneficial role in the wound healing of type 1 diabetic rat models via Wnt pathway.
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Objective To investigate the role of Wnt/β-catenin signaling pathway in impaired wound healing of diabetes mellitus.Methods The back skin defect was produced in rats with type1diabetes.All of these rats were divided into normal group, diabetes group, lithium chloride group, and epidermal growth factor (EGF) group.The back wound healing and β-catenin expression were observed.Results There were no signs of infection in the wound of rats after injury.Compared with diabetic group, the wound healing time was shorter,wound healing rate was higher, wound cavity volume was smaller, granulation tissue was more mature, and β-catenin positive cell rate was higher in normal group, lithium chloride group, and EGF group(P＜0.05 or P＜0.01).Conclusions Wnt/beta-catenin signaling pathway is involved in the process of wound healing in diabetic rats.
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Objective To explore the suitable range of PT-INR for Chinese people with acute deep venous thrombosis (DVT) treated by warfarin anticoagulation therapy. Methods Eighty seven DVT patients with indications to warfarin anticoagulation therapy were enrolled into the study and divide into two groups randomly. Patients from group A (n=47) took warfarin to adjust the PT-INR to range 1.7-2. 5,and patients from group B (n =40) took warfarin to adjust the PT-INR to range 2. 0-3. 0. The therapeutic effectiveness and the incidence of bleeding complications were compared between two groups. Results Forty-six patients (46/47,98%) had limb swelling symptoms relief in group A with one exception,which was diagnosed as pelvic tumor by ultrasonography,CT and tumor markers examination later. No patient underwent bleeding in group A Thirty eight patients (38/40,93%) had limb swelling symptoms relief in group group B with two exceptions,of which one case had Cockett syndrome and the other one had unknown aetiology. The total effective rate of group B was 95% . As to the complications of this group,3 patients had slight gum and nasal mucous membrane bleeding, 1 patient developed gastrointestinal bleeding. No patients had pulmonary embolism in both groups. Conclusion For Chinese people,anticoagulation therapy of acute deep venous thrombosis to adjust the range of PT-INR to 1.7-2. 5, shows good effectiveness and significantly reduced bleeding complications.
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Diabetic vascular disease is a major complication of diabetes, which is characterized by the formation of collateral vessels of serious damage to systemic disease. Substantial evidence have shown that timpaired endothelial progenitor cell function, non-enzymatic glycation end products accumulate, and Wnt signaling pathway dysfunction may be an important mechanism of impaired angiogenesis after the diabeticlimb ischemic. This paper is to make a study of its mechanism, and to provides a new strategy for diabetes therapeutic angiogenesis.
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BACKGROUND: Angiogenesis attracts much attention in tissue engineering field. Previous research has proved that a two-dimensional culture of vascular endothelial growth factor (VEGF) promotes angiogenesis.OBJECTIVE: To evaluate the effect of VEGF on three-dimensional angiogenesis.METHODS: Endothelial progenitor cells were separated from the SD rat bone marrow. At about 70%-80% fusion, rat tail collagen gel was added to establish three-dimensional models. Samples in the experimental group were incubated in complete culture solution containing M199 culture media, fetal bovine serum, VEGF, and double antibody. The samples in the control group were incubated with VEGF-free culture media. In vitro culture and amplification of bone marrow-derived endothelial progenitor cells were determined at 1, 4, 7, and-20 days after incubation. Morphology and quantitative analysis were performed at 3, 6, 9, and 12 days after three-dimensional model establishment.RESULTS AND CONCLUSION: Endothelial progenitor cells grew from three-dimensional matrix into collagen matrix in the experimental group. Budding and infiltration were observed in the collagen within 24 hours, and branching-like structure was then gradually formed. Cells in the control group grew slowly, with slowing budding, small tubiform structure, superficial infiltration into COllagen, sparse network structure, and non-intact. Numbers of newborn vessels in the expedmental group were significantly greater than control group (P<0.01). A detection on gel block showed positive expressions of endothelin-1 and endothelial nitric oxide synthase-3 on the 3~(rd), 6~(th), 9~(th), and 12~(th) days. The results demonstrated that VEGF mobilized and induced endothelial progenitor cells in order to promote angiogenesis. Rat tail collagen gel induced endothelial progenitor cells which behaved migration, proliferation, and pullulation of angiogenesis.
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Wound healing is a complicated biological process, which consists of inflammatory cells, re-pairing cells, extracellular matrix, cell factors, et al. These factors participate in the process of wound heal-ing in great harmony and coordination. The sufferers of diabetes mellitus are vulnerable to skin injury ,which often results in non-healing or healing delay, which became an urgent difficulty and warm spot unsolved in clinic. So far, especially for the last few years, great progress has been made in the mechanism of wound non-healing of Diabetes Mellitus, mainly including signal pathways, angiopoiesis, neuropeptides, advanced glycation end products, cell apoptosis and matrix metaltoproteinases.
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OBJECTIVE: Because of the widely origin, easily isolation and cultivation, the powerful multiplication ability and some other characteristics, endothelial progenitor cells have become the most important seeding cells in tissue-engineered vascular, but the condition to become a vascular in vitro, characteristics of endothelial progenitor cells and their progress in research and application in the tissue-engineered vascular deserve further study. DATA SOURCES: A computer-based online search of PUBMED database was undertaken to identify articles about endothelial progenitor cells being seeding cells in tissue-engineered vascular application published from January 1997 to July 2006 by using the keywords of "Endothelial progenitor cells,Tissue-engineered vascular,Tissue Engineering Blood Vessel" in English. STUDY SELECTION: The data were selected firstly, and quotation of each articles were read. Inclusive criteria: all articles related to the characteristics of endothelial progenitor cells and their progress in research and application in the tissue-engineered vascular were selected. Exclusive criteria: repetitive research or Meta articles were excluded. DATA EXTRACTION:Totally 136 articles were collected, of which 30 articles were associated with inclusive criteria. The 106 excluded articles were with old content or repetitive research. The 30 articles contained 8 articles on characteristics of endothelial progenitor cells, 14 articles about the advantages of endothelial progenitor cells as seeding cells in tissue-engineered vascular application, 8 articles on the application of endothelial progenitor cells construction in tissue-engineered vascular. DATA SYNTHESIS: ① Endothelial progenitor cells could be isolated from bone-marrow, peripheral blood, spleen and so on. They expressed CD133 and distinction from endothelial cells by CD133. Endothelial progenitor cells could transform to endothelial cells and smooth muscles, too. ② Endothelial progenitor cells could raise the density of capillary and the number of angiovascular. There were many research indicated that endothelial progenitor cells could improve ischemic, repair the injure of endocardium; Endothelial progenitor cells could improve reendothelialization, protect endomembrane, and hold the integrity of endomembrane; when incorporated with ischemic vascular, endothelial progenitor cells could improve patency rate and prevent restenosis. ③ With smooth muscle cells and some other materials, endothelial progenitor cells could widely applied in constructing tissue-engineered vascular and have a brilliant prospect in the tissue-engineering blood vessel. CONCLUSION: The research of endothelial progenitor cells will have a breakthrough in the expression of its vessel and the function in the organization remodeling. As one of the seeding cells, endothelial progenitor cells have widely origin and the powerful multiplication ability, and they have a brilliant prospect in the tissue-engineering blood vessel.
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Objective:To investigate the effects of nitric oxide(NO) and inducible nitric oxide synthase (iNOS) in the experimental abdominal aortic aneurysm (AAA) rat model.Methods:An intra-aortic elastase infusion model was used.Control rats received intra-aortic saline infusion.In the remaining groups,intra-aortic elastase infusion was used to induce aneurysm formation.These rats were treated with intraperitoneal injections of saline postoperatively(experimental group),aminoguanidine postoperatively(medicine group).Serum NO and aortic diameter were measured,Changes of histology,iNOS and MMP-9 were observed in the aortic wall.Results:Experimental group produced AAAs with significant production of iNOS,MMPs and serum NO compared with controls.In medicine group reduced aneurysm size and displayed suppression of MMPs expression,inflammatory infiltrates and serum NO production were detected.Conclusion:Expression of iNOS and MMP-9 are induced and serum NO levels are increased in experimental AAA,iNOS and NO production by iNOS play an important role with detrimental effects during experimental aneurysm development.
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To study the significance of the levels of plasma inflammatory cytokines (IL-6,IL-8,IL-10 and TNF-?) in patients with acute deep venous thrombosis (DVT) of lower extremity. Methods Forty untreated DVT cases were selected as the subjects in the DVT group, while thirty healthy subjects, whose ages and genders showed no significant difference with the DVT patients, were collected as the control group. The plasma levels of IL-6, IL-8 and TNF-? were detected by radioimmunoassay (RIA), and the plasma level of IL-10 was measured by enzyme-linked immunosorbent assay (ELISA). Correlation analysis was used to investigate the relationships between the levels of different inflammatory cytokines within DVT group. Results The levels of plasma cytokines in the DVT group were all significantly higher than those in control group (P
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Objective To investigate the recent studies about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm. Methods The current literatures about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm were reviewed. Results Chlamydia pneumoniae is one of the most important factors for the formation of abdominal aortic aneurysm since Chlamydia pneumoniae can cause abdominal aortic aneurysm through the metabolism of matrix metalloproteinases, the apoptosis of smooth muscle cells in the vessels and the chronic infection of the wall of the aneurysm. Conclusion There maybe a distinguishingly close relationship between Chlamydia pneumoniae and abdominal aortic aneurysm, and Chlamydia pneumoiae may take an important role in the development and progress of the abdominal aortic aneurysm.
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Objective To explore the protective effect of ligustrazine on the ischemia-reperfusion injury of rat liver. Methods Ninety-six healthy SD rats were divided randomly into three groups: sham operation group, ischemia-reperfusion group(I/R group) and ischemia plus ligustrazine reperfusion group(therapy group).The plasm ALT,AST and LDH were measured before operation,at thirty minutes,six hours and twenty-four hours after operation. One week survival and liver pathological change of every group were observed, and the hepatocyte apoptosis index was measured simultaneously.Results One week survival of therapy group was higher than that of I/R group ( P
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Objective To study the early functional change of sinusoid endothelial cell after liver transplantation in rat, and to investigate the endothelia protective effect of prostaglandin E_1(PGE_1). Methods Rat orthotopic liver transplantation model was performed in "two-cuff method", grouped as follows: group A served as normal rat blank control, group B as operative control with normal donor, group C as experimental control with shock donor, and group D as experimental group with shock donor and PGE_1 administration ( n =8 in each group). Transplanted groups (referring to recipients without specific definition) were sacrificed 6 h after operation for blood taken to detect serum liver enzymes (ALT, LDH), malondialdehyde (MDA), nitric oxide (NO) and plasm endothelin (ET). Liver tissue was resected at the same time for standard pathologic examination. Comparison of the difference the results was made between groups. Results Cold preservation time and anhepatic phase were similar in each group, (2?0.5) h and (15?3) min respectively. All survived 6 h after transplantation (8/8) in group B and D with a survival rate of 100%, only 5 survived 6 h after transplantation in group C (5/8) with a survival rate of 62.5%. Comparing with group C, blood ALT, LDH, MDA, ET decreased and NO increased significantly in group D ( P
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Objective To explore the application of extracorporeal veno venous bypass in orthotopic liver transplantation in pigs and to compare hemodynamic changes during operation of two different bypass ways. Methods Twenty five porcine orthotopic liver transplantations were performed and extracorporeal veno venous bypass was established during anhepatic phase through a catheter in portal vein (group A, n =16) or in splenic vein (group B, n =9).Hemodynamic changes were monitored continuously.Results Fourteen recipients survived two days after operation (14/16) in group A while all survived in group B (9/9).Transient hemodynamic disturbance (MAP and CVP decreased,and HR increased) was monitored at both the beginning and the end of anhepatic stage in group A,while these parameters kept stable in group B ( P
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<p><b>OBJECTIVE</b>Verotoxin-producing Escherichia coli (VTEC) strains of serotype O157 : H7 have been implicated in a wide spectrum of diseases, including blood diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS). To further explore the pathological role of verotoxin (VT) in HUS and other VTEC associated diseases, we investigated the effects of recombinant verotoxin 2 (rVT2) on the biological activity of neutrophils.</p><p><b>METHODS</b>The technique of flow cytometry, a fluorescent probe 2,7-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein acetoxymethyl ester (BCECF/AM), and the assay of reduced cytochrome c to detect superoxide production were used in this study.</p><p><b>RESULTS</b>gammaVT2 significantly inhibited spontaneous apoptosis in neutrophils. Neutrophils with prolonged survival due to gammaVT2 maintained various biological functions, such as the expression of adhesion molecules (shading CD62L and raising CD11b/CD18), adherence to human umbilical vein endothelial cells (HUVECs), and generation of superoxide (O(2)(-)).</p><p><b>CONCLUSION</b>Prolongation of the functional life-span of neutrophils by gammaVT2 may accelerate inflammatory responses at sites of inflammation. This may play a crucial role in neutrophil-mediated tissue injury in HUS and other VTEC-associated diseases.</p>
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Humans , Apoptosis , Cell Adhesion , Endothelium, Vascular , Cell Biology , Neutrophils , Physiology , Recombinant Proteins , Toxicity , Shiga Toxin 2 , Toxicity , Superoxides , MetabolismABSTRACT
Objective To explore the methods and the effect of the surgical treatment of patients with chronic ischemia of extremities.Methods In recent 6 years,the clinical data of 75 patients,including 7 upper(extremities) and 71 lower extremities with chronic ischemia,treated surgically were reviewed retrospectively.The surgical treatment included: traditional operation in 65 cases,interventional surgery in 4 cases and stem cell transplantation in 6 cases.Results Sixty-three patients(66 extremities) were followed up from 2 to 56 months after the surgical treatment,and the result showed that 9 extremities of 8 patients were amputated(within) 1 year(13.6%).In the other cases(83.3%),the ischemic symptoms were relieved or(disappeared),the ulcer healed or the amputating level had lowered(3.0%).The effective rate of the surgical treatment was 86.3%.Conclusions The appropriate surgical treatment of chronic ischemia limbs should be choiced based on the ischemic state of the limb,and a satisfactory result can be obtained in most patients.
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Objective To understand the experimentnl resluts and the advance in gene therapy for restenosis of the vessel. Method Literature review was made on gene therapy for restenosis directly at cytotoxic, cell cycle regulators, intracellular signal transducers, transcription factors, cytokines growth factors, nitric oxide and Fas ligand. Results cytotoxic gene therapy by thymidine kinase and cytosine deaminase, mutant retinoblastoma protein (Rb), cyclin-dependent kinases(cdk) inhibitors (such as p21 p27 and p53), antisense basic fibroblast growth factor (bFGF) blocking intracellular signal transduce by A-Raf and C-Raf, antisense Ag ??, promoting NO, ?-nterferon, vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF), ? chain synthesize suppressing nuclear factor-kB (NF-kB) overexpression of gax and Fas ligand can inhibit restenosis of the vessel. Conclusions The effect of gene therapy for restenosis of the vessed is obvious in experimental studies. Conbination of more gene and several links gene therapy is the research direction in the future.
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Objective To study the setting up a model of orthotopic liver transplantation (OLT) in pigs. Methods In pigs, OLT were performed based on the porcine anatomical and physiological features, and the extracorporeal veno venous bypass was established during the anhepatice stage. Results Fourteen pigs(87.5%) of 16 OLT survived after the operation, and the haemodynamics?serum biochemical parameters and core temperature were maintained in the normal value during OLT. Conclusions Extracorporeal venovenous bypass and perfect surgical techniques based on the anatomical and physiological features are the key to successful OLT in pigs.
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Objective To study the diagnosis and treatment of infected pseudoaneurysms(PA) resulting from drug injection. MethodsThe clinical data of 11 cases of i nfected PA resulting from drug injection were reviewed retrospectively.1 pat ient was treated by non-operation,10 cases were treated by artificial blood ve ssel transplantation after removal of PA and local debridement. Results One case dead. All the 10 cases treated by operation had satisfactory results and none had ischemic symptom of the limbs.Eight grafts were patent d emonstrated by color Dopler ultrasonography 3 months postoperatively. Conclusions The diagnosis of PA induced by drug injection can be m ade by the history of drug injection, pulsate mass of injection site. The eff ective treatment should include control of infection,local debridement,PA res ection and blood vessel implantation .