ObjectiveTo study the cell apoptosis and the dynamic expression and significance of apoptosis-related genes in graft veins. MethodsA rat experimental model of autogenous graft vein was established by transplanting the right external jugular vein to infrarenal abdominal aorta in 100 Wistar rats. TUNEL and immunohistochemistry were used to detect the apoptosis, the expression of apoptosis-related genes bcl-2 and bax in vascular smooth muscle cells (VSMCs) of graft veins. ResultsWithin the 8 weeks after transplantation, the apoptotic VSMCs in the graft veins were much more than those in the control group with the apoptotic rate reaching the peak〔（28.5±16.6）%〕 on the 2nd week and dropping to （8.1±2.8）% during the 4th to 8th week. There was statistical difference compared to the control group 〔(0.5±0.2)%, P＜0.01〕. From 1 to 2 weeks, the positive rate of bcl-2 was (22.1±5.4)% which was higher than that of the control group and the 4-8 week group (P＜0.01); from 1 to 6 weeks, the expression of bax was higher than that of the control group 〔(5.5±2.3)%〕 and the postoperative 8th week group 〔(8.2±2.9)%, P＜0.01〕.Conclusionbcl-2 and bax protein may be involved in the regulation of apoptosis of VSMCs. Apoptosis of VSMCs may be an important factor in graft remodeling and graft vein stenosis.
Objective To discuss the early diagnosis and surgery of intestinal necrosis caused by superior mesenteric venous thrombosis （SMVT）. Methords The clinical data of 32 patients with intestinal necrosis caused by SMVT were reviewed retrospectively and analyzed, which included 6 cases of primary SMVT, 26 cases of secondary SMVT, 9 cases with pylethrombosis, 24 patients had been dignosed definitely as SMVT by imageology examination before surgery. All the patients accepted surgery therapy, within which 9 patients accepted Fogarty catheter, and anticoagulation and thrombolytic therapy were administrated postoperatively. Results All patients had recovered except for one with short bowel syndromle and one died. Conclusions SMVT is a rarely ischemic intestinal disease, which has complicated pathogenesis and difficulty in early diagnosis. Intestinal necrosis often occurs as a result of delayed treatment and the effective way is to cut off necrotic intestines in time. Intra-and postoperative anticoagulation and thrombolytic therapy could reduce recurrency effectively.
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.