【Abstract】Objective To investigate the irradiating effect of low intensive microwave (LIM) on pathological process of blood vessel restenosis(RS) and assess the probability of LIM irradiation to prevent was used RS.Methods Fortyfour male healthy New Zealand rabbits were randomly divided into 2 groups. Fogarty catheter traumatize to the tunica intima of iliac artery so as to establish RS models. Two thousand four hundred and fifty MHz microwave with different power of 2 ,5 and 10 mW/cm2 was used, locally to irradiate EIA in irradiating group (1 h/d). Specimens were obtained at different time of 3,7,14 and 28 d after operation. Morphological changes of tissues were observed with HE and EF staining and the area of tunica intima, tunica media and the rate of cavity stenosis were analyzed with image analysis system; apoptosis was detected with TUNEL; phenotype and microstructure of VSMC were observed with TEM. Results After microwave irradiating, inflammatory reaction in early period was suppressed, mural thrombus decreased, the proliferation and migration of VSMC depressed, the area of tunica intima and the rate of cavity stenosis obviously reduced comparing with the control group (P＜0.01). The rate of apoptosis cells showed that there were no obvious differences among each group on 3 d after operation (Pgt;0.05). At other different time, however, the rate of apoptosis cells in irradiating groups obviously increased than that of the control group (P＜0.01), particularly in the one with power of 5 mW/cm2 .The number of synthesis form VSMC in the control group occupied (93.50±3.45)% of the total number of VSMC on 14 d after operation. Most of VSMC appear contractile in irradiating group in which a lot of morphological changes of apoptosis in fibroblast and VSMC existed.Conclusion LIM irradiation could obviously prevented from pathologic procedure of RS. After LIM irradiating, inflammatory reaction in early period is suppressed, the proliferation and migration of VSMC depressed. LIM irradiation promotes cell apoptosis, effectively prohibites the occurring and development of RS. LIM irradiation has had relationship between quantity and effect, power span to effectively prohibit RS, particularly in the one with power of 5 mW/cm2.
ObjectiveTo observe the effects of endovascular radiation (ER) on the proliferation and apoptosis of medial smooth muscle cells (SMC) and to discuss the possible mechanisms of radiation in the prevention of vascular restenosis (RS) in rabbits after carotid endarterectomy (CEA).MethodsForty rabbits undergoing CEA were randomly divided into four groups (each group=10) and given a radiation dose of 0, 10, 20 and 40 Gy 32P respectively. Rabbits were killed on the 3rd, 7th, 14th, 28th and 56th day after operation. The specimens were collected and histopathologic examinations were done.ResultsProliferation apparently occurred in the intima and media of carotid the lumen became narrow in the control group on the 14 th, 28 th and 56 th day after operation. While in the radiation groups, proliferation was apparently suppressed and the lumen was much less narrowed (P＜0.05). The apoptosis rate of SMCs and PCNA positive cells increased on the 3rd day after operation and reached the peak on the 7th day. There was statistical difference between the ER groups and control group (P＜0.01). The effects were much more evident in 20 Gy and 40 Gy groups compared with 10 Gy group (P＜0.01).ConclusionER may prevent RS by suppressing SMC proliferation and migration as well as inducing SMC apoptosis. The effects are positively correlated with radiation doses. SMC proliferation and apoptosis occur in the early period after balloon injury, while hyperplasia of intima and medial happens later.
ObjectiveTo discuss the clinical value of internal radiation therapy with hepatic intraarterial iodine131 labeled material for the treatment of hepatocellular carcinoma (HCC). MethodsThis summarized paper was made on literature review. ResultsIodine131lipiodol and several reported iodine131labeled antibodies to HCC associated antigens were concentrated in the foci of HCC with a high tumortonormaltissue absorbed dose ratios. No severe side effects occurred. It was used in various kinds of HCC patients, and mostly showed a significant tumor response. Survival rate of HCC patients was raised in several clinical trials.Conclusion Internal radiotherapy with hepatic intraarterial iodine131 labeled material may be considered as an effective method to treat HCC.
Objective To analyze the stabil ity and cl inical outcomes of arthroscopic anterior cruciate l igament (ACL) reconstruction with γ irradiated patellar tendon allograft compared with autograft. Methods From January 2004 to October 2007, 69 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into two groups: group A (autograft, n=36) and group B (γ irradiated allograft, n=33). In group A, there were 30 males and 6 females with an average age of 30.1 years, including 30 cases of simple ACL rupture and 6 cases of ACL rupture with medial accessory l igament injury; ACL rupture was caused by sports in 28 cases, by traffic accident in 5 cases, and by others in 3 cases; and the time from injury to operation was 1.4 months on average. In group B, there were 26 males and 7 femaleswith an average age of 32.5 years, including 27 cases of simple ACL rupture and 6 cases of ACL rupture with medial accessory l igament injury; ACL rupture was caused by sports in 27 cases, by traffic accident in 4 cases, and by others in 2 cases; and the time from injury to operation was 1.5 months on average. There were no significant differences in general data between two groups (P gt; 0.05). The same arthroscopic technique was used in all ACL reconstructions done by the same surgeon. The cl inical outcome was evaluated and compared by general conditions, pivot shift test, Lachman test, KT-2000 arthrometer testing, Daniel’s one-leg hop test, International Knee Documental Committee (IKDC) scoring, Lysholm knee scoring scale, and Tegner activity score. Results All patients were followed up for 39.5 months (group A) and 37.6 months (group B). In group A, patella fracture occurred in 1 case and anterior knee pain in 2 cases postoperatively. No compl ication occurred in group B. The hospital ization times in groups A and B were (15.6 ± 2.4) days and (15.5 ± 1.5) days, respectively, showing no significant difference (P gt; 0.05). The operation time of group A was longer than that of group B and the fever time of group A was shorter than that of group B, showing significant differences (P lt; 0.05). At the final follow-up, there were significant differences (P lt; 0.05) in Lachman test and the pivot shift test between two groups, between pre- and post-operation; there were no significant differences (P gt; 0.05) in Daniel’s one-leg hop test, the IKDC, Lysholm, and Tegner activity scores between two groups, however, there was a decreased trend in the functional and activity levels in group B. And there was significant difference between pre- and post-operation (P lt; 0.05). At the final follow-up, the differences between normal side and affected side were (2.4 ± 0.6) mm in group A and (5.5 ± 3.6) mm in group B, showing significant difference (P lt; 0.05). There was significant difference in tibial advancement between pre- and post-operation (P lt; 0.05). Conclusion The functional and activity level of the knee after ACL reconstruction with autograft and γ irradiated patellar tendon allograft were similar, but anterior and rotational stabil ity of the involved knee decreases significantly in the group with γ irradiated patellar tendon allograft.
Objective To investigate the results of human amniotic membrane(HAM) which are loaded with marrow mesenchymal stem cells(MSCs) and epidermis cells in treating fullthickness skin defect combined with radiation injury. Methods Eight minipigs were used in this study. Three round fullthickness wounds（Ф3.67cm）, which combined with radiation injury, were created on the dorsum of each side close to the vertebral column in each animal. Among 48 wounds, 24 left side wounds were treated with HAM loaded with MSCs and epidermis cells as experimental group (group A), 16 right side wounds with simple HAM (HAM group, group B) and 8 right side wounds with oil gauze as control (group C). The granulation tissue, reepithelization and wound area were observed after 1,2 and 3 weeks. Immunohistochemistry was performed using vWF as a marker for blood vessels.Image analysis was employed to test new area of wound at different interval time and healing rate of wound.Results The healing time of group A was 6 to 7 days faster than that of group C and 5 to 6 days faster than that of group B. After 15-17 days of graft, there were significant differences in new area of wound and healing rate between group A and groups B,C(Plt;001). New epidermis fully covered whole wound surface in group A, and their granulation tissue, which contained a lot of vWF, fibroblasts, capillaries and collagen, grew well. Many inflammatory cells still were seen in groups B and C, and their contents of vWF, fibroblasts, capillaries and collagen in granulation tissue were smaller than that in group A.Conclusion The graft of HAM loaded with MSCs and epidermis cells played an effective role in promoting healing of wound combined radiation injury with high quality.
OBJECTIVE To explore the effect of intravascular low level He-Ne laser irradiation on skin flap survival after orthotopic transplantation in avulsion injury. METHODS Fifty eight cases suffered avulsion injury were treated by debridement and orthotopic transplantation of avulsed flap within 6 hours, 31 of them were received intravascular low level He-Ne laser irradiation and routine treatment, and 27 of them were received routine treatment as control group. RESULTS The survival area and quality of avulsed flap in the experimental group were superior to that of control group after 15 days of operation, and the hemorheological items were markedly changed at 5 days after operation. CONCLUSION The better flap survival after orthotopic transplantation in avulsion injury can be improved by intravascular low level He-Ne laser irradiation through changed superoxide dismutase activity and hemorheological items in optimal irradiation intensity.
OBJECTIVE Influence of irradiation and phenytoin sodium on modulatory activities of wound fluid on proliferation of fibroblasts and collagen synthesis was studied. METHODS The male Wistar rats were used in this study. The rats were divided into irradiated and non-irradiated groups, and in each of them it was subdivided into phenytoin group and control. A 7 cm long incisional wound was made on the back of each rat, in which a polyvinyl alcohol sponge (PVAS) with a size of 1.0 cm x 0.4 cm was implanted into the wound and the wound was sutured up. The PVAS was prepared by rinsing in running water over night and then was boiled for 30 minutes. Before implantation, the sponge was immersed in phenytoin sodium solution (10 mg/l ml) or normal saline (as control). From each wound the wound fluid and fibroblasts were collected. The methods of incorporation of 3H were adopted to assess the proliferation of fibroblasts and synthesis of collagen. RESULTS It was shown that proliferation of fibroblasts and collagen synthesis were stimulated by wound fluid remarkably on 5 to 8 days after wounding, and that 6 Gy to total-body irradiation wound decrease this effect. It was also noted that topical phenytoin sodium increased the modulatory activity of wound fluid irrespective of being irradiated or not. CONCLUSION It could be drawn that, after total-body irradiation, stimulation of hyperplasia of fibroblasts and collagen synthesis by wound fluid was markedly lowered indicating the total-body irradiation resulted in changes of local conditions of the wound which was unbenefitted to repair of tissue cells, while phenytoin sodium could enhance the stimulating action of wound fluid on proliferation of fibroblasts and synthesis of collagen which was beneficial to wound healing.
摘要:目的: 评估手术、栓塞及γ刀综合治疗脑动静脉畸形的疗效。 方法 :回顾性分析了我科自2002年3月至2009年7月期间综合治疗的43例脑AVM患者,分析评估这43例脑AVM的临床特点及治疗效果,随访患者并对其进行GOS评分。 结果 :本组病例采取栓塞＋手术治疗3例、栓塞＋γ刀治疗26例、手术＋γ刀治疗11例、栓塞+手术＋γ刀治疗3例。术后随访28例,随访时间4月至7年6月,GOS评分5分者25例,患者均能重新回到工作或学校;GOS评分4分者2例,患者生活能够自理;GOS评分1分者1例,患者死亡。 结论 :对大型、功能区、有深部静脉引流的脑AVM综合治疗有一定的优越性,它不仅使脑AVM治愈率明显提高,而且与治疗相关的各种并发症和病死率也明显降低。Abstract: Objective: To evaluate the efficacy of multimodality treatment of cerebral arteriovenous malformations(AVMs) with surgery, embolization and γknife radiation. Methods : A retrospective analysis of 43 cases of cerebral AVMs applied with multimodality treatment in our department From March 2002 to July 2009 has been made, meanwhile we have analyzed and assessed the clinical characteristics and treatment outcome of these 43 patients with cerebral AVMs. Results : Patients received multimodality treatment with embolization followed by surgery(n=3), embolization followed by γknife radiation(n=26), surgery followed by γknife radiation(n=11), or embolization, surgery, and γknife radiation(n=3). Postoperative followup of 28 cases, the followup time is 4 months to 7 years and 6 months. GOS score 5 in 25 cases, who can be able to return to work or school. GOS score 4 in 2 cases, who can be able to live independently. GOS score 1 in 1 case, who is dead. Conclusion : In the cerebral AVMs which are large, or located within or immediately adjacent to eloquent regions of the brain, or have deep venous drainage, multimodality treatment has some superiority. It can not only improve the cure rate of cerebral AVMs significantly, but also reduce the treatmentrelated complications and mortality.
Objective To evaluate the effectiveness and prognosis of patients in advanced hepatocellular carcinoma (HCC) with portal vein (PV) tumor thrombus received external-beam radiation therapy (EBRT). Methods The clinical data of 126 HCC patients with PV tumor thrombus who were referred for EBRT at our institution from January 2000 to November 2009 were analyzed retrospectively. EBRT was designed to focus on the tumor thrombus with or without primary intrahepatic tumors， to deliver a median total conventional dose of 50 Gy (range of 30-60 Gy). Predictors of survival were identified using univariate and multivariate analysis. Results Unfavorable pretreatment predictors were associated by multivariate analysis with lower albumin and higher α-fetoprotein levels, poorer Child-Pugh liver function classification, poorer intrahepatic tumor control， lymph node metastases， and the two-dimensional EBRT technique. The dose of EBRT showed no significant in both univariate and multivariate survival analysis. Conclusions In patients with HCC， EBRT is effectively prevents progression in cases of PV tumor thrombus， but palliative dose of EBRT is not related to survival.EBRT is not related to survival.
Objective To summarize the application and advancement of neoadjuvant therapy combined with transanal resection in stage T2-3 rectal cancer. Methods Domestic and abroad publications on the studies of neoadjuvant therapy combined with transanal resection in stage T2-3 rectal cancer in recent years were collected and reviewed. Results In selected patients with stage T2-3 rectal cancer, neoadjuvant therapy combined with transanal resection was efficacious in sphincter preservation and complications prevention. Compared with modality without chemoradiation, the recurrence rate had decreased from 17%-62% to 0-20%. Conclusion Selected patients with stage T2-3 rectal cancer can benefit from neoadjuvant chemoradiation combined with transanal resection.