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.
The misdiagnosis rate and mortality of mesenteric ischemia are high, but with the continuous updating of diagnosis and treatment techniques and treatment concepts in recent years, many patients can get timely and effective treatment. This article starts from the epidemiology, vascular anatomy, etiology, clinical manifestations and classification of mesenteric ischemia, and the progress of diagnosis and treatment under the multidisciplinary diagnosis and treatment mode, and details the research progress of mesenteric ischemia at home and abroad. This paper focuses on the significance of multidisciplinary diagnosis and treatment mode in the diagnosis and treatment of mesenteric ischemia, in order to strengthen the treatment consciousness of mesenteric ischemia and explore a more accurate and effective treatment system. The purpose of this study is to provide some reference for avoiding intestinal infarction and improving the survival rate of intestinal tract.
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 explore the effect and evaluation criterion of the transplantation of autologous peripheral blood stem cells(PBSC)for blood flow remodeling in the critical limb ischemia (CLI).MethodsThirty six patients with 39 limbs suffered from CLI at Yunnan Provincial Center of Vascular Surgery and Department of Vascular Surgery of The First Affiliated Hospital of China Medical University from March 2003 to January 2007 were included in this study.These patients were divided into two groups. One groupconsisted of 20 cases in all 22 limbs used the transplantation of autologous PBSC,and another group included 16 cases in all 17 limbs were not use this technique.Multifunction monitoring device,dopplor ultrasound monitoring device,per cutem oxygen partial pressure monitoring device and digital subtraction angiography were used to measure effect degree of limbs regional blood flow from cutaneous covering,blood vessel and blood on the preoperative and postoperative days and the follow-up time was six months.ResultsThe effect indexes of limbs regional blood flow of the case by transplantation of autologous PBSC was as follows:skin temperature index(STI)was(1.5±0.3) ℃， per cutem oxygen partial pressure monitoring device(TcPO2)was(36.6±9.3)mm Hg,ankle-brachium index(ABI)was0.7±0.1,photoplethysmograpy index(PPGI) was0.8±0.1,saturation of blood oxygen(SaO2)was(78.3±15.9)%,digital subtraction angiography score was1.5±0.3,the rate of limbs salvage was 82%,the distance of intermittent claudication was(150.3±41.1)meters,and the change of index was consistent with ameliorative tendency of symptom(0.415＜r＜0.592, P＜0.05).ConclusionThe transplantation of autologous PBSC can promote blood flowremodeling in limbs ischemia,and the effect indexes of limbs regional blood flow can objectively reflect the degree of blood flow remodeling.