Objective To study the change in serum levels of soluble CD14, tumor necrosis factor-α, E-selectin, interleukin-10 and mean arterial pressure, as well as their relationship to infection during the pathophysiologic process in endotoxemia of rabbits. Methods Sixteen rabbits were randomly divided into two groups: group A, as a control group; group B, endotoxemia group. The model of rabbit with endotoxemia were used. Endotoxin at a dose of 1.5 mg/(kg·h) or 3 mg/(kg·h) was continuously infused through external jugular vein within 2 hours, 1 hour respectively. The change of levels of serum soluble CD14, tumor necrosis factor-α, interleukin-10 and E-selectin were observed at 0 (time before infusion of endotoxin), 30, 60, 120, 180, 240, 300 minutes, while mean arterial pressure was measured by polygraphy system. Results In the group B,there was an increase of content of soluble CD14,tumor necrosis factor-α,interleukin-10 and E-selectin following 30, 120 minutes respectively,and mean arterial pressure was lower than that of group A at same time points. Conclusion The results suggest that soluble CD14,tumor necrosis factor-α,interleukin-10 and E-selectin may play an important role during the change of infection and that these changes may be closely related with severe infection.
Objective To observe the effects of Galectin-3 on proliferation of vascular endothelial cells derived from peripheral blood endothelial progenitor cells. Methods The cultured peripheral blood endothelial progenitor cells in vitro were isolated and purified from human peripheral blood, and the cells were differentiated into vascular endothelial cells. Then the cells were cultivated with the galectin-3 of different concentrations, and to observe the proliferation of endothelial cells derived from peripheral blood endothelial progenitor cells. Results The abilities of proliferation of endothelial cells derived from peripheral blood endothelial progenitor cells of 0.1, 1.0, 2.5, 5.0, and 10.0 μg/ml groups were higher than that of 0 μg/ml group, there were not statistic significance of the differences between the 0.1，1.0, 2.5, and 0 μg/ml groups （P＞0.05）. But the abilities of proliferation of 5.0 and 10.0 μg/ml groups were obviously higher than that of 0, 0.1, 1.0, and 2.5 μg/ml groups （P＜0.05）, and the abilities of proliferation of 10.0 μg/ml group was also higher than that of 5.0 μg/ml group （P＜0.05）. Conclusion Galectin-3 can promote the proliferation of endothelial cells derived from peripheral blood endothelial progenitor cell.
Objective To investigate the biological mechanism about autologous peripheral blood stem cell transplantation （ABSCT） derived neovascularization to lead and perfect the effect of ischemic state tissue of secondary blood flow remodeling. Methods Forty-two patients with critical limbs ischemia and 42 limbs in all from Mar. 2005 to Dec. 2005 in Yunnan Provincial Center of Vascular Surgery were selected，who treated by endovascular repair and ABSCT at the first flow reconstruction and the secondary flow reconstruction，respectively. The preoperative and postoperative effect degrees of limbs regional blood flow from cutaneous covering，blood vessel，and blood were measured by multifunction monitoring device，dopplor ultrasound monitoring device，percutem oxygen partial pressure （TcPO2）monitoring device and digital subtraction angiography （DSA）. The follow-up time was in four year after ABSCT.Results After ABSCT， the pain，cold or cool，and rest pain of leg were relieved. The distance of intermittent claudication after ABSCT was longer than that before ABSCT 〔（1 600.3±310.1） m versus （520.3±160.6） m，F=5.84，P＜0.05〕. The foot pain and limbs insensible feeling easement rates were 100% after ABSCT. Compared with beforeABSCT，the objective effect indexes of limbs regional blood flow after ABSCT were significantly improved 〔skin temperature index：1.63±0.31 versus 1.22±0.23，F=4.69，P＜0.05； TcPO2： （37.61±9.52） mm Hg versus （30.63±4.54） mm Hg，F=5.72，P＜0.05；ankle-brachium index：0.93±0.23 versus 0.33±0.24，F=6.72，P＜0.05；photoplethysmography index：0.81±0.12 versus 0.23±0.05，F=5.68，P＜0.05；saturation of blood oxygen： （79.44±20.42）% versus （42.43±10.41）%，F=5.68，P＜0.05； DSA score：1.34±0.23 versus 0.21±0.03，F=4.89，P＜0.05〕. Conclusions The results bly suggest that the ABSCT can promote blood flow remodeling in limbs ischemia，and stem cells derived neovascularization can significantly offer effective and permanent blood flow perfusions to the ischemic statetissue，and this biological effect play an important role in the ischemic state tissue for secondary blood flow remodeling.
Stem cell transplantation is one of the main methods to treat thromboangiitis obliterans (TAO). In recent years, research on the treatment mechanism of stem cell transplantation has made some progress. The results of a number of stem cell clinical trials specifically for TAO have been published. Some new stem cell types have gradually been used in the clinic. There is no major dispute over security. In addition, research shows that the efficacy of stem cell transplantation is affected in many ways, and some factors have a certain predictive effect on the possibility of amputation after transplantation. This paper reviews the clinical research progress of stem cell transplantation for TAO, and aims to provide some basis for the better use of stem cell transplantation in the treatment of TAO.
Objective To analyze the relation between the mode of delivery and postpartum lower extremity deep venous thrombosis （DVT）， and discuss the therapy methods. Methods The clinical data of 48 patients with postpartum lower extremity DVT from 2006 to 2012 in this hospital were analyzed retrospectively. Results There were 15 897 patients with the delivery， of whom were 10 097 cases of cesarean section and 5 800 cases of spontaneous delivery， the incidence rate of lower extremity DVT in the patients with cesarean section was significantly higher than that in the patients with spontaneous delivery〔0.41% （41/10 097） versus 0.12% （7/5 800）， χ2=9.94，P＜0.005〕. The higher incidence rate of cesarean section， the higher incidence rate of lower extremity DVT， which was a positive correlation between them （rs=0.87，P＜0.05）. Forty-three cases were only treated by drug therapy， 2 cases were performed operation combined with drug therapy， and 5 cases were placed the inferior vena cava filter. Forty-eight cases were cured and discharged. Conclusions The incidence rate of lower extremity DVT of cesarean section is higher as compared with the spontaneous delivery. The thrombolysis and （or） anticoagulation therapy is an effective way in the treatment for DVT. Controlling indications of cesarean section and early postpartum out-of-bed can decrease the DVT.
Objective To discuss and evaluate the value of insertion of inferior vena cava filter in treating lower extremity deep venous thrombosis (DVT). Methods Inferior vena cava filters were placed in 46 patients with lower extremity DVT prior treatment, 20 in which were treated by therapy with anticoagulation and thrombolysis, and therapy with pressure gradient, and the other 26 patients by operation and thrombolysis therapy, and therapy with pressure gradient. Whether patients occurred pulmonary embolism was observed and the form and site of filters were monitored by periodic fluoroscopy. Results Inferior vena cava filters were placed successfully in all patients, 38 cases were implanted permanence inferior vena cava filter, 8 cases were implanted temporary inferior vena cava filter. Symptoms and signs of DVT disappeared or remitted in 44/46 patients after treatment. None of pulmonary embolism was occurred. Follow up 2-24 months (average 13 months) for 36 cases with permanence inferior vena cava filter, there was no complication of the filter and pulmonary embolism occurred. Conclusions The method of inserting inferior vena cava filter is simple and safe, which can prevent pulmonary embolism effectually to offer sufficient safeguard for the treatment of DVT.
ObjectiveTo explore the value of potaried technique with Trivex system in treatment for venous skin ulcer with deep venous thrombosis sequelae (DVTS) of lower limbs. MethodsTotal 166 patients with venous skin ulcer with DVTS of lower limbs were included in this study. The patients of operation group (94 patients involving 94 legs) were treated by using potaried technique with Trivex system. The patients of nonoperation group (72 patients involving 72 legs) were treated by using nonoperative method. The clinical indexes of skin infection rate, skin necrosis rate, shrinkage rate of wound area, skin depigmentation rate, ulcer healing rate and ulcer recurrence rate were used to assess the clinical curative effect between two groups on 5, 20, 120 and 360 d after operation or treatment, respectively. ResultsThere were no skin infection and skin necrosis in two groups on 5 d after operation or treatment. The rate of shrinkage of wound area and skin depigmentation of patients in operation group were significantly higher than those in nonoperation group on 20 d after operation or treatment 〔(95.8±2.138)% vs. (68.7±3.125)%，P=0.048; (87.6±1.263)% vs. (12.3±1.324)%， P=0.018〕. The rate of the ulcer healing of patients in operation group was significantly higher than that in nonoperation group on 120 d after operation or treatment (97.9%vs. 8.3%， P=0.014). The rate of the ulcer recurrence of patients in operation group was significantly lower than that in nonoperation group on 360 d after operation or treatment (5.3% vs. 97.2%， P=0.015). ConclusionThe potaried technique with Trivex system can be used as one of the surgical treatment methods for venous skin ulcer with DVTS of lower limbs.
目的 总结急性动脉栓塞致肌病肾病代谢综合征(myonephropathic-metabolic syndrome,MNMS)的诊治经验。方法 回顾性分析2005年1月至2006年3月由急性动脉栓塞导致的11例MNMS的临床资料。结果 5例存活(保肢4例）； 2例死于高钾血症引起的心搏骤停，4例死于以急性肾功能衰竭为首发的多器官功能不全综合征。结论 急性动脉栓塞一旦确诊，尽早手术。MNMS是急性动脉栓塞的常见、严重并发症，急性动脉栓塞时尽快重建血流、骨筋膜室综合征尽早行筋膜室切开术及坏疽肢体尽早截肢是预防和治疗MNMS的关键。
Objective To investigate the efficiency and safety of autologous peripheral blood stem cell transplantation （ABSCT） in treatment for thromboangiitis obliterans. Methods Fifty patients （62 affected limbs） with thromboangiitis obliterans were treated by ABSCT. A series of subjective indexes including improvement of pain and cold sensation and objective indexes including intermittent claudication distance， ankle brachial index （ABI）， skin temperature， and improvement of foot skin ulcer were evaluated. Results Due to necrosis in middle and lower part of leg， 4 of 50 patients （4 lower limbs） were taken extremity amputation on 3 weeks after ABSCT， 46 patients kept their legs successfully. On 1 month after ABSCT， the legs pain and cold sensation of 46 patients （58 affected limbs） vanished， and the score of feet pain and cold sensation after ABSCT were better than those before ABSCT （P＜0.05）. The intermittent claudication distance， skin temperature， and ABI of 46 patients with kepting their legs on 3 months after ABSCT significantly increased as compared with before ABSCT 〔intermittent claudication distance：（80.38±45.53） m versus （330.56±142.31） m；skin temperature：（26.50±0.46） ℃ versus （31.49±0.45） ℃；ABI：0.41±0.02 versus 0.71±0.05〕， the differences were statistically significant（P＜0.05）. Six months after ABSCT， different degree neonatal lateral vessels were found in 58 affected limbs of 46 patients by lower extremity arteriography. The complications were not found in all the patients by laboratory or CT detection， such as malignant tumors， retinal hyperplasia， aneurysm and so on. After ABSCT， 40 patients were followed up for 9 to 36 months （mean 22.5months）， the symptom had improved. Due to leg pain aggravated after 6 months， score of pain feelings was 4 in 6 patients and with toe ulcers， who had ABSCT again. Eighteen months after transplantation， the patients had only debilitation of lower extremity. The pain feeling was improved （score of pain feeling was 1）. The toe ulcer was healed and no angiosclerotic myasthenia happened. Conclusions ABSCT is a simple， safe， and effective method， especially in treatment for patients with severe lower limb ischemia who is no arterial reconstruction is feasible. It could improve the quality of life of patients and might be avoided amputation of lower extremity or foot.