Objective To investigate the feasibil ity of preparing the porous extracellular matrix (ECM) by use of some chemicals and enzymes to decellularize the porcine carotid artery. Methods The porcine carotid artery was procured, and warm ischemia time was less than 30 minunts. The porcine carotid artery was decellularized with 1% sodium dodecyl sulfate (SDS) for 60 hours to prepare common ECM; then common ECM was treated with 0.25% trypsin (for 6 hours) and 0.3 U/ mL collagenase (for 24 hours) to prepare porous ECM. The common ECM and porous ECM were stained with HE,Masson’s trichrome, and Orcein to evaluate the histological features. Then the mechanical property, cytotoxicity, and pore size of ECMs were determined. After 4 weeks of subcutaneous implantation in dogs, the histological examination was used for the study. Results Histological observation confirmed that 2 kinds of ECMs were decellularized completely and more porous structure was observed in porous ECM. Scanning electron microscope showed the pores in porous ECM were greater and the length of shorter axis in porous ECM ranged from 5 to 30 μm, the length of longer axis from 40 to 100 μm. The porosity of porous ECM (99.25%) was greater than that of common ECM (91.50%). The burst pressure of porous ECM decreased when compared with common ECM, showing significant difference [(0.154 3 ± 0.012 7) MPa vs [0.305 2 ± 0.015 7) MPa, P lt; 0.05]. There was no significant difference in suture retention strength between 2 kinds of ECMs (P gt; 0.05). The cytotoxicity test showed no obvious cytotoxicity in 2 kinds of ECMs. In vivo implantation test showed that the deeper host cells infiltration and more neo-microvessels in porous ECM were observed than in common ECM. Conclusion SDS and some enzymes can be used to prepare porous ECM as the scaffold for tissue engineered blood vessels.
目的 探討腎病綜合征并發血栓形成的外科治療特點。方法 從筆者所在單位收治的腎病綜合征并發血栓形成的患者中選取4例血栓形成部位罕見、治療難度大的病例，對其臨床資料進行分析。結果 1例在下肢深靜脈血栓形成基礎上發生下腔靜脈血栓形成；1例腹主動脈急性血栓形成伴下肢動脈栓塞導致下肢壞疽行高位截肢；1例股動脈支架內反復血栓形成導致下肢壞疽行高位截肢；1例人工血管及下肢動脈支架內短時間內血栓形成，經干細胞移植后下肢缺血得到緩解。結論 在血栓形成的診治過程中提高對腎病綜合征的認識，針對腎病綜合征患者高凝狀態在圍手術期進行預防性抗凝治療，以及充分認識腎病綜合征并發血栓形成抗凝治療的特殊性，可能會降低腎病綜合征患者血栓形成的發生率，提高腎病綜合征并發血栓形成的外科治療水平。