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Objective To compare the effects of telmisartan and (or) amlodipine on the reversal left ventricular re-modeling in two-kidney one clip hypertensive rats. Methods A total of 50 healthy male SD rats were randomly divided into 5 groups (n=10):two-kidney one clip renal hypertensive (2KIC) model group, sham group, telmisartan (10 mg/kg) group, am-lodipine (2.5 mg/kg) group and telmisartan (10 mg/kg)+amlodipine(2.5 mg/kg) group. The model of two-kidney one clip re-nal hypertensive rats was established. The tail arterial blood pressure was detected once a week. After 20 weeks, rats were sacrificed and specimens were collected. The left ventricular mass index (LVMI) was assessed. The myocardial ultrastructur-al changes were observed by electron microscope. Values of plasma renin activity (PRA), angiotensionⅡ(AngⅡ) and atrial natriuretic peptide (ANP) were measured by enzyme linked immunosorbent assay (ELISA).Results Compared with sham group, the levels of systolic blood pressure (SBP), LVMI, PRA, AngⅡand ANP were significantly higher in 2KIC group (P＜0.01). Compared with 2KIC group, values of SBP, LVMI, PRA and ANP were significantly lower in telmisartan group and am-lodipine group (P＜0.01), but the value of AngⅡwas significantly higher (P＜0.01). The levels of SBP, LVMI, AngⅡand ANP were significantly lower in combined medication group than those of single drug medication group (P＜0.01). There was no significant difference in the plasma PRA level between those groups (P>0.05). Results of myocardial electron microsco-py showed that the left ventricular remodeling was significantly improved in combined treatment group. Conclusion Telmisartan and amlodipine can effectively improve the left ventricular remodeling induced by hypertension. There was more effective therapy using both medications together.
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Objective To evaluate clinical application of the gastrocnemius blood vessles as recevier ones to anastomose with free flaps. Methods From June 2005 to July 2011,twenty adult lower limbs were infused with red glue to observe the origin,streching,branches and communication with other blood vessles of the gastrocnemius blood vessles and to measure their outer diameters and pedicle length. Operations were also simulated on these specimens to make the above chacracters of the vessles clear further.CT images of 16 fresh adult lower limbs were got to observe the effects of obstruction of one side of the gastrocnemius blood vessels to the blood supply of the gastrocnemius muscles. Fifty-two free flaps were transplanted to legs with large defects of skin and soft tissues where the gastrocnemius blood vessles were anastomosed with the flaps to supply artery blood and receive vein blood. Results The main blood vessles of the gastrocnemius muscles were medial and lateral gastrocnemius blood vessles. They both origined from the popliteal arteries and communicated with other blood vessles. The pedicles of the medial gastrocnemius blood vessles were 8.0 -13.8 cm in length which averaged 11.1 cm and their outer diameters were (1.8 ± 0.3) mm when they entered the muscles. The pedicles of the medial gastrocnemius blood vessles were 5.4 - 12.3 cm in length which averaged 8.8 cm.The outer diameters of the two accompanying veins were (1.8 ± 0.3)mm when they entered the muscles.When one gastrocnemius blood vessle were obstructed,the gastrocnemius muscles could got enough blood supply by co mmunicating branches between the obstructed vessle and other blood vessles.All the 52 free flaps survived. Through one to two-years follow-up, the defects cured with no infection and the knees' motions were normal. Conclusions With a long pedicle and wide diameter,the medial or lateral gastrocnemius blood vessle can be a reliable alternative used in free flap transplautation for repairing large defects of skin and soft tissues of seriously injured legs with no other choice of blood vessles, which causes unobvious effects to the blood supply of the legs and can simplify the free flap transplantation.
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Objective To investigate the effect to the blood supply of the gastrocnemius if ligating the medial or lateral artery, and provide theory base for the sural artery flap repairing the soft tissue defects of legs injuries.Methods The anatomical study involved 16 fresh adult cadaver lower legs ligating the medial or lateral gastrocnemius vessel, the arteries of which were perfused with the Meglumine Diatrizoatis Mucilage,and then carried out the cross-sectional analysis of the CTA, the bifurcation, location length, diameter and perforator of the sural artery were recorded by dissection.To observe the anastomosis with gastrocnemius vessel in artery pipeline foundry made by 1 specimen.Results The consistent with the result of the angiography was the gastrocnemius can completely get enough blood supply from some anastomotic arteriole when ligating one side of the sural vessel.Under normal circumstances, the blood supply of gastrocnemius muscle mainly supplied by sural artery.In the case of the sural vessel was cut off, the blood supply of gastrocnemius come from the anastomotic arteriole between medial and lateral artery and the soleus.The anastomotic arteriole from soleus has larger diameter, but less quantity, and was invariably deteced in the lower third of the gastrocnemius muscle constantly.A lot of anastomotic arteriole were found between the muscle heads, and it was also invariably deteced in the lower third of the gastrocnemius muscle, communicating with the surai neurovascular axis, the average external diameter was less than 0.5 mm.Conclusion The blood supply of the gastrocnemius are enough when ligating the medial or lateral artery.
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Objective:To explore the pharmacodynamic differences of india madder root before and after charcoal in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis and hemostasis function.Methods: The india madder root and india madder root charcoal decoction pieces were processed by the same one operation,then the water decoction of them were given to the mouse by intragastric administration in different dosages.The method of auricle tumefaction was adopted to compare the antiinflammatory function,body wrings was adopted to compare the ease pain function,to compare the hemostasis function of india madder root before and after charcoal by snipping off the mouse’s tail and capillary method.Blood stasis model was made by injecting Dexamethasone Sodium Phosphate,then to compare the promoting blood circulation for removing blood stasis function of india madder root before and after charcoal of india madder root before and after charcoal.Results: India madder root decoction pieces is more effective than india madder root charcoal decoction pieces in antiinflammatory,ease pain,promoting blood circulation for removing blood stasis,but less effective in hemostasis.Conclusion: The function of antiinflammatory,ease pain,promoting blood circulation for removing blood stasis of india madder root were less effective after charcoal,but the fuction of hemostasis was more effective.
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Objective To investigate the causer of, and the way to deal with the measurement of protecting from vascular compromise in free flap transplantation. Methods To retrospectively study the clinical data collected from the 89th Hospital of PLA including 305 cases of vascular compromise in free flap transplantation held on June, 1983 to December, 2006. Accoding to the different tissue flaps and different sites to be repaired, 11 factors of vascular compromise of free flap transplantation were to be investigated including operation design, the recipe of free flap, the variation of vascellum, the skill of recipe, the operation opportunity, the match of vascellum, the debride of vascellum, the vascellum angiotasis, the vascular anastomosis, the management of vascular articulo and the infection. Results Among the 305 cases of free flap transplantation, arterial compromise existed in 270 cases, 10 cases developed arterial compromise during operation, 6 cases were due to the injury of nutrient vessel, the flap survived after the revascularization. 4 cases obtained part necrosis of 10 cases, and the rotation flap and skingrafting covered the raw surface. The rest 213 cases survived and 47 cased failed. Another 35 cases of vein compromise were obtained. Among them, 5 cases survived, part necrosis of 10 cases, and 20 cases failed. Conclusion Vascular compromise is the factor of necrosis in free flap transplantation. It is of cardinal importance to timely and correctly treat the vascular compromise in free flap transplantation whether happened intra-or postoperatively. This is the key to access high successful rate. Preventive measures are even more beneficial than proper management after its occurrence. The venous return disorder was the main factor of free flap transplantation failure.