In order to solve the defect of blood vessel in tissue transplantation and complicated palmar amputation, bridge by "Y" type vein had been used from Jan. 1990 to Jul. 1996. Twenty-three cases were treated. In this series, there were 16 males and 7 females, with ages ranged from 10 to 42 years old. Six cases were the defect of lower legs anterior skin and tibia, 3 cases were the femur fracture with injury of femoral artery and tissue’s defect, 2 cases were defect of five fingers, 12 cases were complicated palmar amputation. RESULT: 15 cases with tissue transplantation and 12 cases with limb replantation were all survival without infection or necrosis. After the following-up for 3 years (ranged from 1 to 5 years), the function of injured limbs were satisfactory, 19 patients had resumed their original work. So, to bridge by "Y" type vein is a good method for repairing the defect of blood vessels in tissue transplantation and complicated palmar amputation, but skilled microsurgery technique is required.
In order to develope a new method to overcome the difficulties in anastomosis of blood vessels with different diameter, phleboplasty was utilized at the join-point to expand the diameter of branched vein graft, with a funnel-shaped stoma formed consequently. After successfully experimented in fresh blood vessels in vitro, the method was practised clinically to repair injured arteries in extremities, with the outcome that phleboplasty of branched vein graft could enlarge the diameter by 1-1.25 times, and with satisfied effects in 3 clinic cases. So, the conclusion was that: phleboplasty of branched vein graft was a new effective and convinient method to repair injured arteries with different diameters
In order to investigate the effect of vascular beds on the vascular wall of autogenously grafted vein, femoral veins were reversely placed in between the cut ends of collateral femoral arteries in 11 dogs with atraumatic technique. The grafted veins were covered with vivid muscle or skin respectively after being assured to be patent, and investigated by histomorphologic method and computerized image analysis technique at postoperative intervals of 1 week, 4 weeks and 16 weeks. The results showed that: 1. One graft developed pseudoaneurysm at 1 week, and two grafts were occulded in skin-covered group, whereas, no complications occurred in muscle-covered group. 2. Intimal thickening of grafts in skin-covered group was much more obvious than that in the muscle-covered group (P lt; 0.05). 3. The relative contents of microstructural components of the graft wall showed no significant difference quantitatively between the two groups. So, the conclusion was: 1. Subcutaneous transplantation appeared to be a potential causative factor in inducing short-term excessive dilatation and long-term intimal hyperplasia of vein graft. 2. Muscular covering is of priority in blood vessel graft.
Objective To transplant intravenously human brain-derived neurotrophic factor (hBDNF) genemodified bone marrow mesenchymal stem cells (BMSCs) marked with enhanced green fluorescent protein (EGFP) to injured spinal cord of adult rats, then to observe the viabil ity of the cells and the expressions of the gene in spinal cord, as well as theinfluence of neurological morphological repairing and functional reconstruction. Methods Ninety-six male SD rats weighing (250 ± 20) g were randomly divided into 4 groups: hBDNF-EGFP-BMSCs transplantation group (group A, n=24), Ad5-EGFPBMSCs transplantation group (group B, n=24), control group (group C, n=24), and sham operation group (group D, n=24). In groups A, B, and C, the spinal cord injury models were prepared according to the modified Allen method at the level of T10 segment, and after 3 days, 1 mL hBDNF-EGFP-BMSCs suspension, 1 mL Ad5-EGFP-BMSCs suspension and 1 mL 0.1 mol/L phosphate buffered sal ine (PBS) were injected into tail vein, respectively; in group D, the spinal cord was exposed without injury and injection. At 24 hours after injury and 1, 3, 5 weeks after intravenous transplantation, the structure and neurological function of rats were evaluated by the Basso-Beattie-Bresnahan (BBB) score, cortical somatosensory evoked potential (CSEP) and transmission electron microscope. The viabil ity and distribution of BMSCs in the spinal cord were observed by fluorescent inverted phase contrast microscope and the level of hBDNF protein expression in the spinal cord was observed and analyzed with Western blot. Meanwhile, the expressions of neurofilament 200 (NF-200) and synaptophysin I was analyzed with immunohi stochemistry. Results After intravenous transplantation, the neurological function was significantly improved in group A. The BBB scores and CSEP in group A were significantly higher than those in groups B and C (P lt; 0.05) at 3 and 5 weeks. The green fluorescence expressions were observed at the site of injured spinal cord in groups A and B at 1, 3, and 5 weeks. The hBDNF proteinexpression was detected after 1, 3, and 5 weeks of intravenous transplantation in group A, while it could not be detected in groups B, C, and D by Western blot. The expressions of NF-200 and synaptophysin I were ber and ber with transplanting time in groups A, B, and C. The expressions of NF-200 and synaptophysin I were best at 5 weeks, and the expressions in group A were ber than those in groups B and C (P lt; 0.05). And the expressions of NF-200 in groups A, B, and C were significantly ber than those in group D (P lt; 0.05), whereas the expressions of synaptophysin I in groups A, B, and C were significantly weaker than those in group D (P lt; 0.05). Ultramicrostructure of spinal cords in group A was almost normal. Conclusion Transplanted hBDNF-EGFP-BMSCs can survive and assemble at the injured area of spinal cord, and express hBDNF. Intravenous implantation of hBDNF-EGFP-BMSCs could promote the restoration of injured spinal cord and improve neurological functions.
The femoral veins were excised from 28 dogs and distended with pressure of 40, 80 and 120 kPa, respectively before grafted to femoral arteries. The veins were harvested at different times and Pollak sections were prepared which revealed different stains of elastin, collagen and smooth muscle in each section. The sections were led to image analysis system to computerize the relative contents of theabove components. The results were as follows: Elastin decreased significantly at 4 weeks (P lt;0.01), and was constant between 4 and 16 weeks. No statistical difference was found in 40, 80 kPa and the control group (P gt;0.05), but the elastin of 120 kPa group by the 16th week was still decreasing. Collagen of each group had no difference, but C/E increased significantly with time. Smooth muscle contents were correlated positively with time, and negatively with the pressure at 1 week, then positively with the pressure at 16th week. The changes of the above trends were the same as development of intimal hyperplasia. The contentions were the value of C/E was determined by the arterial pressure but that of 120 kPa pressure was more higher. The preimplant pressure distension was a possible significantfactor leading to excessive intimal hyperplasia of early and middle stage of autogenous vein grafts.
This study was performed on canine femoral veins which were interpositionally implanted into the femoral arteries and the investigation was in terms of zero-stress state, compliance and hemodynamic assessment. The results revealed that the vein grafts had the similar characteristics of compliance with the normal veins. Using Doppler ultrasonography to monitor the blood flow velocity through the vein grafts, the hemodynamic parameters such as pulsatility index (PI) and blood flow volume were evaluated consecutively within one month after the operations .No significant differences were found between these parameters at different time points. It was suggested that autogenous vein graft had an adaptive course when operating in an arterial hemodynamic circumstances and It’s mechanical changes did not bear upon the hemodynamics through the vein graft.
Objective To investigate the effect and mechanism of epigallocatechin-3-gallate (EGCG) on restenosis of the vein graft. Methods Totally 90 Sprague-Dawley rats were randomly divided a the control group, a vein graft group and an EGCG+vein graft group. At week 1, 2 and 4, the intimal and tunica thickness of the venous graft wall was evaluated by hematoxylin-eosin staining, and the expression of Ki-67 was assessed by immunohistochemistry analysis, and then the expression of hairy and enhancer of split-1 (HES1) was measured by Western blot assay. Results At week 2, the intimal thickness (46.76±4.89 μmvs. 8.93±0.82 μm, 46.76±4.89 μmvs. 34.24±3.57 μm), tunica thickness (47.28±4.37vs. 16.33±1.52 μm, 47.28±4.37vs. 36.27±3.29 μm), positive cell rate of Ki-67 (21.59%±2.29%vs. 1.12%±0.22%, 21.59%±2.29%vs. 15.38%±1.30%), expression of HES1 respectively increased in the experimental group than those in the control group and the EGCG+vein graft group (P<0.05, respectively). At week 4, the intimal thickness (66.38±6.23 μmvs. 8.29±0.79 μm, 66.38±6.23 μmvs. 48.39±4.23 μm), tunica thickness (63.27±6.18 μmvs. 15.29±1.49 μm, 63.27±6.18 μmvs. 44.63±4.49 μm), positive cell rate of Ki-67 (33.19%±3.03%vs. 1.09%±0.19%, 33.19%±3.03%vs. 24.37%±2.73%), expression of HES1 increased in the experimental group than those in the control group and EGCG+vein graft group (P<0.05, respectively). Conclusion EGCG may inhibite restenosis of vein graft by inhibiting Notch signal pathway.