【Abstract】 Objective To build nano-biomimetic tissue engineered blood vessel (NBTEBV) with nanotopology by using electrospinning (ELSP) technology. Methods Cony vascular endothel ial cell(VEC) on tubiform tooting in vitro was cultured. NBTEBV was built by use of multi-row nozzle with the suspension of cony vascular smooth muscle cell (VSMC) and mimic ECM (MECM) solution. NBTEBV was cultured with bioreactor in vitro . VEC and VSMC viabil ity and prol iferation were observed with MTT; and HE staining, scanning electron microscopy(SEM) observation and biomechanical test were carried out after 24 hours of static culture and 7 days of dynamic culture. Results After 7 days of culture, the length of NBTEBV was 57 mm, the external diameter was 4 mm and the thickness of wall was 0.4 mm. The NBTEBV’s color was white and the texture was even and flexible. MTT results indicated the viabil ity of cells cultured on NBTEBV for 7 days was normal(8.9 × 106 /mg, 3.5 ×105/mg for 24 hours). SEM and HE staining indicated that the topologic character of NBTEBV was similar to that of the naturalblood vessel. The NBTEBV showed a network scaffolds structure with 100 nm thick fiber and 600 nm aperture. The HE stainingresult showed that the NBTEBV was composed of VEC and VSMC by layer. Vascular mechanical results showed that the NBTEBVultimate hydrostatic pressure was 950 mmHg, the compl iance of the NBTEBV under physio-pressure (110/70 mmHg) was 3.0%; the ultimate tensile strength of 20 mm × 5 mm tissue sl ice was 18.5 MPa. Conclusion The technology of ELSP can use VSMC and MECM scaffold simultaneously to build tissue engineered blood vessel with nanotopology mimic native blood vessel.
Objective To develop an experimental model of abdominal aorta transplantation with nano-biomimetictissue engineered blood vessel (NBTEBV) and to investige the change of histomorphology in evolutionary process of degradation and remodel ing. Methods Twenty 6-month-old New Zealand rabbits were included, weighing 2-3 kg, male or female. The autologous seed cells of rabbits were harvested to build NBTEBV in vitro. After the branch of abdominal aorta under kidney was l igated, about 10 mm abdominal aorta was cut and replaced by NBTEBV; the anastomotic stoma was marked by Ti cl ips. NBTEBV’s evolutionary processes of degradation and rebuilding were observed. Twelve weeks after operation, DSA and color Doppler examinations were made. At 1, 4 and 12 weeks after operation, the gross and histological observations were made and 14C binding in PLGA was detected with X-ray photon spectroscopy. Results Of 20 rabbits, 17 showed that the NBTEBV was patency; 3 died from NBTEBV occlusion 36 or 72 hours after operation. The results of DAS and color Doppler showed the blood flow was patency, the blood flow rate was normal and there was no angiectasis. The lumen of transplanted blood vessel was covered with monolayer endothel ial cells. At 1 week, smooth muscle cells (SMCs) arranged regularly and much PLGA distributed in the EMCs. At 4 weeks, SMCs arranged in a layer, ECM was forming, mimic ECM degraded partly; PLGA decreased obviously. At 12 weeks, the SMCs arranged regularly, ECM formed, mimic ECM degraded, no PLGA was seen in the wall, the shape of graft was similar to the natural vessel. The decreasing crest value of 14C in specimen showed the degradation of PLGA. Conclusion NBTEBV has a good surgical maneuverabil ity and histocompatibil ity, its remodel ing evolutionary process fits in with tissue engineering specification. Building NBTEBV with ELSP is feasible.
Objective To investigate the distribution of the perforating branches artery of distally-based flap of sural nerve nutrient vessels and its clinical application. Methods The origins and distribution of perforating branchesartery of distally-based flap were observed on specimens of 30 adult cadavericlow limbs by perfusing red gelatin to dissect the artery.Among the 36 cases, there were 21 males, 15 females. Their ages ranged from 6 to 66, 35.2 in average. The defect area was 3.5 cm×2.5 cm to 17.0 cm×11.0 cm. The flap taken ranged from 4 cm×3 cm to 18 cm×12 cm. Results The perforating branches artery of distally-based flap had 2 to 5 branches and originated from the heel lateral artery, the terminal perforating branches of peroneal artery(diameters were 0.6±0.2 mm and 0.8±0.2 mm, 1.0±1.3 cm and 2.8±1.0 cm to the level of cusp lateral malleolus cusp).The intermuscular septum perforating branches of peroneal artery had 0 to 3 branches. Their rate of presence was 96.7%,66.7% and 20.0% respectively(the diameters were 0.9±0.3, 1.0±0.2 and 0.8±0.4 mm, andtheir distances to the level of cusp of lateral malleolus were 5.3±2.1, 6.8±2.8 and 7.0±4.0 cm). Those perforating branches included fascia branches, cutaneous branches, nerve and vein nutrient branches. Those nutrient vessels formed longitudinal vessel chain of sural nerve shaft, vessel chain of vein side and vessel network of deep superficial fascia. The distally-based superficial sural artery island flap was used in 18 cases, all flaps survived. Conclusion Distally-based sural nerve, small saphenous vein, and nutrient vessels of fascia skin have the same origin. Rotation point of flap is 3.0 cm to the cusp of lateral malleolus, when the distally-based flap is pedicled with the terminal branch of peroneal artery.Rotation point of flap is close to the cusp of lateral malleolus, when the distally-based flap is pedicled with the heel lateral artery.
ObjectiveTo study the mechanism of reducing the intratumoral microvessel density (MVD) by Ginsenoside Rg3 (Rg3) combined with cytotoxic agent in xenotransplanted human breast infiltrating duct carcinoma in nude mice. MethodsSixteen female nude mice were randomly divided into 4 groups to receive cyclophosphamid (16 mg/kg,qd) combined with Rg3 (10 mg/kg, qd),Rg3(10 mg/kg,qd) alone,cyclophosphamid (16 mg/kg,qd) alone and 0.5% sodium carboxymethyl cellulose (0.5 ml,qd) respectively for 55 days. Breast cancer mass were weighed and sampled for light microscopic observation. The intratumor MVD was examined by immunohistochemical staining. ResultsThe tumor weight of treated group was significantly lower than that of control group. The tumor weight of the Rg3 combined with CTX group was lower than that of Rg3 group. The MVD value of Rg3 group was significantly lower than that of CTX group and control group. The MVD was significantly reduced in the Rg3 combined with CTX group than that in the others.ConclusionRg3 combined with CTX can inhibit the growth of xenotransplanted human breast infiltrating duct carcinoma, and reduce the intratumoral MVD.
Ischemic lesions, lacunar infarcts and leukoaraiosis on head CT or MRI are commonly detected in patients with non-specific symptoms such as dizziness and headache or people undergoing healthy physical examinations. Although these imaging findings are mostly related to vascular disease, especially cerebral small vessel disease, it does not mean that long-term use of antiplatelet drugs and statins are required. On the basis of literature review and clinical experiences, the article points out that the treatment methods for such manifestations include determining whether these lesions are vascular lesions, searching for risk factors or causes such as aging, hypertension, diabetes mellitus, vascular stenosis, and psychological factors, and taking strategies for the corresponding prevention and management, provides a reference for the appropriate diagnosis and treatment of these imaging manifestations in clinical practice.
Severe heart and great vessel injuries were a fatal traumatic entity. How to improve the survival rate of these victims still was a challenge to date. This paper included： the pathogenesis and resuscitation of commotio eordis ; traumatic pericardial rupture associated with heart luxation and/or diaphragmatocele in pericardial cavity; indication selection of emergency room thoracotomy for severe heart injury and traumatic aortic disruption treated with endovascular stent graft. For the purpose of increasing our recognition of the severe trauma and making the early diagnosis and management as early as possible. The main relative references published in recently 5 years were reviewed.
ObjectiveTo investigate the relationship between retinal vessel diameters and cerebral infarction of carotid artery stenosis patients. MethodsEighty-seven patients (174 eyes) with carotid stenosis were included in this study. There were 49 males and 38 females, with an average age of (65.25±7.85) years. Thirty-four patients were suffered from cerebral infarction (cerebral infarction group), and the other 53 patients had no cerebral infarction (control group). There was no significant difference in age (t=1.916), male rate (χ2=0.142) and carotid stenosis extent (χ2=0.785) between the two groups (P=0.059, 0.706, 0.675). All patients underwent color fundus photography after mydriasis. Retinal vascular caliber measurements were performed using IVAN software. The main parameters were central retinal artery diameter (central retinal artery equivalent, CRAE), the diameter of the central retinal vein (central retinal vein equivalent, CRVE) and the retinal arteriole to venular ratio (AVR). The relationship between retinal vessel diameter and cerebral vascular disease were analyzed with logistic regression analysis. ResultsIn cerebral infarction group, CRVE, CRAE and AVR ratios were (132.90±20.67) μm, (243.47±43.92) μm and 0.56±0.10, while the control group was (145.26±21.59) μm, (224.99±32.35) μm and 0.68±0.13 respectively. There were significant differences between the two groups (t=-2.648, 2.257, -4.631; P < 0.05). After correction for risk factors, such as age, smoking history, CRAE reduction and CRVE increases were significantly correlated with cerebral infarction. ConclusionCRAE reduction and CRVE increases are risk factors of cerebral infarction in patients with carotid stenosis, and it is useful in the prediction.
Objective To study the influence of the pedicle length on the perforator flaps in hemodynamics. Methods Four mature swine (2 males, 2 females; weight, 23.0±2.0 kg) were applied to the experiment.Two transverse abdominal skin flaps, based on the superior epigastric pedicle orits rectus abdominal muscle perforators, were designed; each swine was used as its own control. At 2 hours and 1, 2, 3 weeks postoperatively, the skin paddle perfusion and the blood stream velocity in the superior epigastric artery were measured by the Laser Doppler Flowmeter and the Color Doppler Ultrasound, respectively. Flap survival percentages were calculated by the grid method at 1 week postoperatively. The swine were euthanatized, and they underwent angiography at 3 weeks postoperatively. Results At 2 hours and 1 week after operation, edema of the perforator flaps with the superior epigastric pedicle was more severe than that of the skin flaps with the rectus abdominal muscle perforator, and the skin perfusion had a statistical difference between the two kindsof flaps (Plt;0.05). The skin paddle viability and the skin perfusion had nostatistical difference after the first week postoperatively (Pgt;0.05). At 2hours and 1 week after operation, the blood stream velocity in the superior epigastric artery in the perforator flap with the superior abdominal artery pediclewas reduced, and there was a statistical difference between the two kinds of flaps (Plt;0.05); however, the velocity was almost the same after the first week postoperatively. Conclusion The excessively long pedicle of the perforator skin flap may have an unfavorable influence on the flap perfusion,especially during the first week after operation, because of the vascular compromise during the dissection of the long pedicle. The blood vessel anastomosis atthis level of the blood vessels may have no relationship with the perforator flap in hemodynamics. This study can also indicate that the ligation of the branches in the recipient vessels cannot make the perforator flaps overperfused.
Objective To explore the effect of transferring adjacent non-main vessel pedicle flap on repairing the heel skin defect. Methods From February 2000 to April 2004, 4 kinds of flaps with non-main vessel pedicle were used to repair 30 cases of heel skin defect. Of the 30 patients, 19 were male and 11 were female, whose ages ranged from 8 to 65. Among them, 19 cases were crush injury, 5 cases were press injury, 3 cases were electric saw injury, 2 cases were osteomyelitis, and 1 case was squamous cell carcinoma. Fourteen cases were with defect area ranged from 6.0 cm×5.5 cm to 16.5 cm×11.0 cm. All the 14 cases were repaired with distant pedicled sural vascular flap of nutrient vessels and saphenous vascular flap of nutrient vessels.The sizes of the dissected flap ranged from 6.0 cm×5.0 cm to 18.0 cm×12.0 cm. And the other 16 cases with defect area ranged from 2.5 cm×2.0 cm to 5.5 cm×4.5 cm were repaired with foot lateral flap and foot base medial flap.The sizes of the dissected flap ranged from 4.0 cm×3.0 cm to 8.0 cm×7.0 cm. Results All cases were followed up for 6 to 12 months. The flaps all survived with satisfactory appearance and no ulceration. Callus appeared in 2 cases.The sense of pain and touch was partly or completely restored. The two-point discrimination sense recovered to 1.0-3.2 cm. Conclusion As it is easilyaccessible, highly flexible and causes little damage to blood circulation, transferring adjacent non-main vessel pedicle flap is effective in repairing foot heel skin defect.
ObjectiveTo observe the stoichiometry of vascular endothelial growth factor receptor 2 (VEGFR2) on the retinal vascular endothelial cell membrane by single-molecule fluorescence imaging.MethodsRhesus monkey retinal vascular endothelial cells (RF/6A) were divided into blank control group (normal culture) and plasmid transfection group [transfected with VEGFR2-green fluorescent protein (GFP) recombinant plasmid]. The expression of GFP in the plasmid transfected group was observed by confocal microscope, and the expression of VEGFR2 in the cells was detected by real-time fluorescent quantitative polymerase chain reaction (qPCR) and Western blot. The fluorescence intensity distribution and bleaching steps of single VEGFR2-GFP molecule on the cell membrane were recorded by single-molecule imaging. The distribution of fluorescence intensity and the number of fluorescence bleaching steps of GFP were recorded.ResultsGFP green fluorescence was observed in the transfected cells 12 hours after transfection. qPCR results showed that the expression of VEGFR2 and GFP mRNA in the plasmid transfected group was significantly higher than that in the blank control group (t=11.240, 12.330; P＜0.001, 0.001). Western blot results showed that the expression of VEGFR2 protein in the plasmid transfected group was significantly higher than that in the blank control group (t=8.346, P＜0.01). The results of single-molecule imaging showed that the fluorescence intensity distribution of VEGFR2-GFP on the surface of RF/6A cell membrane without ligand stimulation was bimodal, in which monomer and dimer were 86.0% and 14.0% respectively. By counting the steps of GFP fluorescence bleaching, the proportions of receptor monomer, dimer, trimer, and tetramer were 81.4%, 12.9%, 5.5%, and 0.3% respectively.ConclusionIn the absence of ligands, VEGFR2 coexists in the form of monomers and dimers on the surface of RF/6A cell membrane, and monomers are dominant.