Experimental study of rapid and effective magnetic artificial blood vessel transplantation for caval reconstruction in canines / 西安交通大学学报(医学版)

【Objective】 To evaluate the performance of the magnetic artificial blood vessel device for fast non-suture anastomosis of caval reconstruction with artificial blood vessel transplantation after resection in canines. 【Methods】 Sixteen adult mongrel dogs of either gender were randomly divided into two groups for vena cava reconstruction with artificial blood vessel transplantation after inferior vena cava (IVC) resection. Group MCA (n=8): magnetic artificial blood vessel device for IVC reconstruction; Group manual sewing (MS) (n=8): hand suturing for IVC reconstruction. Operation time and stoma errhysis were recorded during operation. Patency and stoma stenosis were confirmed via color Doppler ultrasound scanning and X-ray cholangiography at different time points as late as 4 weeks after surgery. 【Results】 The time required to perform the vascular anastomosis was significantly shorter for the magnetic artificial blood vessel device (6.25±2.25)min than for MS (27.32±5.12)min (P<0.001). There were four cases of stoma errhysis in MS group which had to be repaired (P=0.077). Vascular X-ray angiography and color Doppler ultrasound found normal blood flow and no stoma stenosis in MCA group, but three cases of stoma stenosis in MS groups (P=0.200). Compared with MS group, the magnetic ring device stoma was associated with smooth re-endothelialization and depressed infiltration of inflammatory cells at the anastomotic site. 【Conclusion】 The magnetic artificial blood vessel device offers a simple, fast, reliable, and efficacious technique for vena cava reconstruction with artificial blood vessel transplantation.

Rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis technique / 器官移植

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.

Clinical application of LDLT after reconstruction of IVC using artificial blood vessel in the treatment of HCC beyond Milan Criteria / 中华肿瘤杂志

Objective@#To assess application of reconstruction of retrohepatic inferior vena cava using artificial blood vessel in right lobe living donor liver transplantation (LDLT) in the treatment of hepatocellular carcinoma (HCC) beyond Milan Criteria.@*Methods@#The clinical data of 9 HCC patients who underwent right lobe liver transplantation after reconstruction of retrohepatic inferior vena cava using artificial blood vessel between June 2015 and Nov 2016 at Liver Transplantation Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The liver of the patients was removed with retrohepatic inferior vena cava, and then the right donor graft was implanted by conventional orthotopic liver transplantation.@*Results@#All 9 liver transplantations were performed successfully. The time of reconstruction of hepatic venous outflow of the donor graft was (22.6±3.0) min, anhepatic time was (45.0±7.1) min, and total operation time was (321.9±52.5) min. All patients recovered uneventfully, ICU and hospital stay day were (1.2±0.4) days and (18.4±3.0) days. 2 patients suffered from thrombosis of artificial blood vessel, one recovered after conservative treatment and another was treated by placement of vein stent. No abdominal/pulmonary infection and non-artificial blood vascular complications were found, and none died in perioperative period. Postoperative pathological results showed that all patients were hepatocellular carcinomas and vascular tumor thrombosis was found in 5 cases. All patients were follow up, 1 patient died of pulmonary and brain metastasis 10 months after operation. One patient survived with local recurrence of tumor in liver. The other patients had no tumor recurrence and metastasis.@*Conclusion@#Replacement of retrohepatic inferior vena cava using artificial blood vessel in right lobe living donor liver transplantation is safe and feasible in the treatment of HCC beyond Milan Criteria, and might improve the resection rate of diseased liver and the prognosis of HCC patients after living donor liver transplantation.

Production of Transfusable Red Blood Cells from Stem Cells / 대한수혈학회지

Blood transfusion is a well-established cell therapy. However, blood available for transfusion is a limited resource and is available only through donations by healthy volunteers. Moreover, the perpetual and widespread shortage of blood products, problems related to transfusion transmitted infections, and new emerging pathogens have elicited an increase in demand for artificial blood. Therefore, research for alternative RBC substitutes has begun in the 1960s. Hemoglobin-based oxygen carriers (HBOC) and perfluorocarbon-based oxygen carrier (PBOC) were two popular study subjects; however, research on these substitute candidates was halted due to unsatisfactory results and safety issues, including death, in the 1990s. Since then, worldwide efforts to produce RBC have shifted over to stem cell-derived RBC production using cord blood and G-CSF-mobilized peripheral blood stem cells, and some progress has been made. In terms of practical usefulness, however, large-scale production and cost effectiveness are still problematic. Recently, human embryonic stem cells (hESC) and human-induced pluripotent stem cells (hiPSC) have shown the potential to produce RBCs as unlimited cell sources. These two methods using hESCs and hiPSCs are also cost-effective since autologous and O, D negative blood RBCs will be used for alloimmunized patients with multiple alloantibodies or rare blood types (high incidence antigens) as well as universal blood production. We will review the current research on in vitro RBC production from hematopoietic stem cells and pluripotent stem cells and assess future directions in this field.

Perioperative nursing of patients with re-operation of complex type A aortic dissection / 现代临床护理

Objective To investigate the nursing experience of caring patients with second total aortic arch replacement with stent“trunk”.Method The nursing data of 28 patients undergoing total aortic arch replacement with stenttrunkwere analyzed to summarize the perioperative nursing experience.Results The operations were successful in all 28 patients.None of them died. Conclusion The nursing measures such as strengthened preoperative evaluation,strengthened body position and skin management, preparation of articles,strengthened blood recollection during operation to reduce blood loss and enhanced temperature monitoring are key to the success of total aortic arch replacement with stenttrunk.

Laparoscopic left renal vein extravascular stenting for treatment of left renal vein entrapment syndrome / 中华泌尿外科杂志

ObjectiveTo investigate the surgical management of left renal vein entrapment syndrome.MethodsEight cases with left renal vein entrapment syndrome (5 males and 3 female ; mean age 26 years) with history of gross hematuria for 3 to 46 months were reviewed.Doppler ultrasound reports suggested compression of the left renal vein at mesenteric angle in all cases.And the dilated segment of the left vein was three-fold than the stricture segment in diameter.CT scan showed the abnormal angle between aorta and superior mesentery artery in all cases.Bleeding from the left ureteral orifice was detected by cystoscopy in 6 cases.We treated 8 patients by extravascular stent immobilization with laparoscope.ResultsThe operation was successful in the 8 cases without surgical complications.The average operation time was 63 min.The average blood loss was 14 ml,and the average hospital stay after operation was 6 days.Follow-up of 3 -20 months,there was no hematuria relapse since been relieved in 7 cases,one case remained microscopic hematuria.Color Doppler ultrasound examination in all 8 cases showed the narrowest inner diameter of left renal vein was 7.4 mm (6.5 - 8.7 mm),the blood flow was smooth.The angle between abdominal aorta and superior mesenteric artery become normal.Conclusions Laparoscopic left renal vein extravascular stenting could be a new surgical method to treat left renal vein entrapment syndrome.The method of putting artificial blood vessel around renal vein is simple,safe and effective.

Artificial blood vessel sheath around renal vein for the treatment of left renal vein entrapment syndrome / 中华泌尿外科杂志

Objective To explore the clinical efficacy of artificial blood vessel sheath around re-nal vein for the treatment of left renal vein entrapment syndrome. Methods Eight cases with left re-nal vein entrapment syndrome (7 males and 1 female, mean age, 16 years) with history of gross hema-turia for 6 to 36 months were reviewed. Doppler ultrasound reports suggested compression of the left renal vein at mesenteric angle in all eases. CT scan showed the abnormal angle between aorta and su-perior mesenterie artery in 5 cases. Cystscopy showed hematuria from the left ureteral orifice in 5 ca-ses. All cases with left renal vein entrapment syndrome were treated ,with the method of putting artifi-cial blood vessel as a sheath around left renal vein. Results The operations were all successful. The average operation time was 150 min, the average blood loss was 50 ml, and the average hospital stay after operation was 9 d. No surgical complications occurred. The gross hcmaturia disappeared in 6 ca-ses and Doppler ultrasound showed that left renal vein outflow was normal in 7 when the patients dis-charged from the hospital. The gross hematuria disappeared during 2-24 months' follow-up in 7 pa-tients. Conclusions The surgical aim of renal vein entrapment syndrome is to reduce the compres-sion of renal vein. The method of putting artificial blood vessel around renal vein could be a simple, safe and effective method.

Importância dos carreadores de oxigênio livre de células: [revisão] / Oxygen carriers free of cells in transfusion medicine: [review]

Os procedimentos necessários para redução de efeitos adversos associados à transfusão de sangue, em especial aqueles decorrentes da transmissão de agentes infecciosos e da aloimunização leucócito-mediada têm impacto nos custos de produção de hemocomponentes. Paralelamente, as necessidades transfusionais têm aumentado globalmente, ficando evidente a necessidade de um substituto seguro e amplamente disponível para o sangue, chamado de sangue artificial ou de substituto do sangue. Visto que o seu desenvolvimento tem se concentrado na função de carrear oxigênio aos tecidos, daí utilizarmos, nesse texto, a denominação "Carreadores de oxigênio livre de células". Atualmente, dois tipos de carreadores de oxigênio livre de células têm sido testados: as soluções de hemoglobina modificadas (de origem humana ou bovina) e os perfluorocarbonos (PFCs). Entretanto, esses produtos não são isentos de efeitos adversos e um grande número de pesquisas clínicas está em andamento para testar sua eficácia e segurança. O maior conhecimento desses carreadores de oxigênio livre de células e seus mecanismos de ação permitiu que aplicações outras, até mesmo não clínicas, estivessem em teste com as novas gerações desses produtos, expandindo assim as fronteiras da medicina transfusional.

The procedures needed to reduce transfusion-associated adverse effects, especially those related to transfusion-transmitted diseases and leukocyte-mediated alloimmunization, have a great impact on the production cost of blood components. Additionally, blood transfusion has increased worldwide making the need for a safe substitute for blood evident. These products have been named artificial blood or blood substitutes. Based on the fact that their focus has been oxygen delivery to tissues, "free oxygen carrying cells" is more appropriate. Two major groups of free oxygen carring cells have been tested: modified hemoglobin solutions (bovine or human) and perfluorocarbons (PFCs). Even though not without adverse effects, extensive clinical trials are being conducted to test their safety and efficacy. The understanding of free oxygen carrying cell mechanisms has made testing of a new generation of these products for other applications possible thereby expanding transfusion medicine frontiers.

Advances in Applications of Bacterial Cellulose in Biomedical Materials / 中国生物工程杂志

Bacterial cellulose (BC) is a natural polymer that has bioactivity, biodegradability and biocompatibility. It displays unique physical, chemical and mechanical properties including high crystallinity, high water holding capacity, nanofibre-network structure, high tensile strength and elastic modulus. Due to its unusual material properties, BC has recently become a kind of attractive biomedical material in the international research.Describes BC's properties, study history and its applications as biomedical materials, especially gives emphasis to introduce the applications of BC on scaffold tissue engineering, artificial blood vessels, artificial skin and the treatment of skin wound, as well as the present study status.

Resection of retroperitoneal tumors with reconstruction of major blood vessels in 12 patients / 中国癌症杂志

Background and purpose:In all treatments of retroperitoneal tumors,surgical operation is still the only effective method which might cure the tumors.However,the patients were always in advanced stages when they were clinically diagnosed.The inferior cava of the patients always have been invaded by tumors,which is considered to be a relative surgical contraindication.This study was to explore the surgical method in treatment of retroperitoneal tumors with major blood vessels invasion,and in order to raise the resection rate and survival rate. Methods :Retrospective analysis of twelve cases which implicate major vessels and have parallel artificial vascular reconstruction during operations of retroperitoneal tumor from January 2003 to June 2007. Results :Twelve cases of retroperitoneal tumor and implicated major vessels were integrally resected,corresponding important vascular reconstructions were done,no short-term postoperative deaths. Conclusions :Retroperitoneal tumor involving abdominal important vessels is not a contraindication of radical surgical.Integrated resection of retroperitoneal tumor and implicated major vessels and corresponding important vascular reconstruction are safe,and can improve the resection rate and reduce the relapse rate,extend the survival time.

Chemical Modification of RBC Surface Antigen with Methoxy Polyethylene Glycol / 대한임상병리학회지

BACKGROUND: Today, blood group antigens are a strong barrier of safe transfusion. We evaluated the change of agglutinability of antibody to RBC surface antigen before and after activated methoxy polyethylene glycol (mPEG) modification. METHODS: We collected blood from healthy volunteers and the blood were treated by activated mPEG (MW 5,000, Sigma, USA). Agglutinability of RBC was measured using anti-sera (Green Cross, Korea) in ABO and Rh(D) groups, and compared the agglutinability changes before and after mPEG treatment. RESULTS: The agglutinability of Rh(D) surface antigen (n=20) was disappeared after mPEG treatment. However, ABO antigens showed variable agglutinability against antisera, some of which showed no change at all. CONCLUSIONS: In the case of Rh(D) antigen, it would be useful to apply mPEG treated RBCs for clinical use, if the safety problem were solved. But in the case of ABO antigen, the more evaluation of the condition of reaction and the concentration of mPEG should be needed.

Chemical modification of RBC surface antigen with glutaraldehyde crosslinking / 대한수혈학회지

BACKGROUND: The chemical modification of RBC surface antigen has many advantages for safe transfusion practice. We evaluated the change of antibody reactivity to RBC surface antigen before and after glutaraldehyde crosslinking. MATERIALS AND METHODS: The 10 mL of blood were collected from 20 volunteers and were treated by 2-3% glutaraldehyde at 4degrees C. After 30 minute incubation, Agglutinability of various RBC surface antigen (ABO, Rh-C, c, D, E, e) was measured by titration using anti-sera (Green Cross, Korea, Dade, USA), and compared the agglutinability changes before and after glutaraldehyde crosslinking. RESLUTS: The agglutinability of Rh surface antigens (D, C, c, E, e) was disappeared after glutaraldehyde crosslinking. However, ABO antigens (n=20) still showed strong agglutinability against antisera with some decreased. CONCLUSIONS: It would be useful to apply glutaraldehyde crossliked RBCs for rare blood group transfusion practice, if the safety problem were solved.

Susceptibility of Anopheles anthropophagus from different areas of China to Plasmodium vivax / 中国血吸虫病防治杂志

Objective To compare the susceptibility of Anopheles anthropophagus from Jiangsu, Guangdong and Liaoning provinces in China to Plasmodium vivax.Methods The blood samples of patients with P. vivax in endemic areas of China were collected to feed the mosquitoes of An. anthropophagus from different areas by using the artificial in vitro membrane feeding system in the lab, and then the mosquitoes were dissected during the 7-9th day and on the 14th day after the feeding and the oocysts and sporozoites in the stomach and salivy gland of mosquitoes were counted. Results The mosquitoes from Jiangsu, Guangdong and Liaoning were simultaneously fed with the blood of 35 cases of P. vivax. The oocyst positive rates of An. anthropophagus from Jiangsu, Guangdong and Liaoning during the 7-9th day after the feeding were 68.57%, 60.00% and 68.57%, as well as the sporozoite positive rates of them on the 14th day after the feeding were 22.86%, 14.29% and 22.86%, respectively. On the 7th day after the feeding, 228, 235, 228 mosquitoes of An. anthropophagus from Jiangsu, Guangdong and Liaoning were dissected, and the positive mosquito rates with oocyst infection were 28.07%, 25.11% and 26.75%, respectively. On the 14th day after the feeding, 150, 142, 135 mosquitoes of An. anthropophagus from the three areas were dissected, the positive rates with sporozoite infection were 10.67%, 8.45% and 11.85%, respectively. The num-bers of mosquitoes dissected with infective grade("+","++","+++","++++") of sporozoites of An. anthropophagus from Jiangsu, Guangdong and Liaoning were 4, 3, 2, 7; 2, 2, 3, 7 and 1, 6, 3, 8, respectively. Conclusions An. anthropophagus from Jiangsu, Guangdong and Liaoning is susceptible to the parasites of Plasmodium vivax and there is no significant difference among the susceptibilities of An. anthropophagus from the three areas to Plasmodium vivax.

Growth difference of Plasmodium vivax in Anopheles sinensis and An.anthropophagus during the periods of clinic attack and diapause of vivax malaria patients / 中国血吸虫病防治杂志

Objective To compare the growth of Plasmodium vivax in Anopheles sinensis(An.s) and Anopheles anthropophagus(An.a) during the periods of malaria clinic attack and diapause. Methods The blood samples of patients during the clinic attack and diapause of vivax malaria patients in the vivax epidemic area in China were collected, feeding the mosquitoes of An.s and An.a by using the artificial membrane feeding system in vivo in the lab, and the mosquitoes were dissected during the day 7-9th and 14th after the infection and the oocysts and sporozoites in the stomach and gland of the mosquitoes were counted, respectively. Results The oocyst positive rate in An.s fed by Plasmodium vivax during the fever stage was lower than that in non-fever stage, the sporozoite positive rate in An.a fed by Plasmodium vivax during the fever stage was lower than that in non-fever stage. The positive mosquito rate with oocyst and sporozoite infected by Plasmodium vivax in the fever stage to An.s and An.a were lower than those in non-fever stage. The infective sporozoite intensity of An.s fed by Plasmodium vivax in the fever stage was lower than that in non-fever stage, but the reverse result was found to An.a. Conclusion There is a significant difference between the periods of malaria clinic attack and diapause of the oocyst and sporozoite infection to An.s and An.a.