OBJECTIVE: To study the effect of color doppler flow imaging(CDFI) technique in the design of axial pattern flap. METHODS: From April 1996 to June 1999, 10 patients with residual wound were adopted in this study. Among them, there were seven males and three females, the area of wounds ranged from 6 cm x 8 cm to 15 cm x 20 cm. Before operation, the axial pattern flaps were designed by traditional method, then CDFI technique with high frequency(5.0-7.5 MHz) was used for examining the major supply artery of the flap. At last, the modified flaps were transferred to cover the wounds. RESULTS: All the patients except one case completed the operation successfully. The cosmetic and function of the flaps were excellent. CONCLUSION: CDFI is a simple, direct and accurate method for detecting the supply artery of axial pattern flap. This technique should be popularized to avoid the blindness of flap design.
Objective To evaluate repair and reconstructionof the femoral pseudoaneurysm caused by drug injection. Methods From May 2000 to May 2005, 15 cases of femoral pseudoaneurysm caused by drug injection underwent operation treatment. All patients were male, aging 20-36 years. The disease course was 18-52 days(mean 35 days) and the course of druginjection was 3-17 months. The locations were the left side in 5 cases and theright side in 10 cases. After having been bandaged with pressure and supportedwith nutrition, they had been all operated. One case received fistula repair, and 14 cases received vascular grafting with ePTFE man-made blood vessel. Results The wounds healed by the first intention in 14 cases. All limbs survived. The complexion, temperature and response of involved leg were in gear. The postoperative color ultrasound Doppler detection showed that all the vascular grafts were of patency. The function of the involved limbs restored to normal. Conclusion Complete debridement, vascular reconstruction and better microsurgery skill were the key factors of treating successfullythe femoral pseudoaneurysm caused by drug injection.
OBJECTIVE: To measure the length and extent of the injured blood vessels in an avulsion amputation model. METHODS: Twenty rabbits were randomly divided into 2 groups. Group A was a sharp amputation group, and group B was an avulsion amputation group. The length and extent of the injured blood vessel was observed with naked eye, operation microscope and electron microscope, and the limbs were replanted. Group A and B were explored at three days and ten days after the replantation respectively. The patency rate and healing process were compared. RESULTS: All the severed ends of vessels in group A were neat with almost the same injured range in the three layers of the vessel wall about 1 mm away from the severed end. The vessels of group B were damaged seriously, the endothelial cells were deleted. The "jumping-like" damage could be observed in the elastic fibers. The injury of 2 to 3 mm away from the normal vessel wall could be observed by operation microscope. CONCLUSION: The damage of avulsion amputation vessels was irregular, 2 to 3 mm or more tissues should be excised under the microscope in the process of operation in order to ensure the healthy intact blood vessel walls.
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
This paper reported the use of superficial temporal vessels pedicled postauricular island flap for the reconstruction of eye socket. Six cases were treated by this method since 1988 with universal satisfactory results. The disign of the flap was diseribed. The operative procedure was detailed, and the advantages of the flap were evaluated: 1. The donor defect was hidden behind the ear; 2. The flap has a relatively long pedicle, hence easy for distant transfer, and 3. the blood supply was highly reliable.
Objective To study the effect of vein-occlusion on the replanted limb survival in SD rats at different stages. Methods Twenty-five adultSD rats were randomly divided into 5 groups according to the time of the femoral vein occlusion after the replanted limbs:2- ,3- ，4 -，6-，and 8- day groups. The limbs were observed through naked eye, measurement of dermal temperature and angiography. Results No formation of collateral veinlet was found, and necrosis wasseen in the replanted limbs of 2- , 3- day groups. Reflux-vein was gradually increased in the replanted limbs of 4，6，and 8 day groups. Angiographic score of capillary density and dermal temperaturein the thigh muscles were greater in groups 4-，6-，and 8- day than in groups 2 and 3 day. Conclusion Within 2 and 3 days，the replanted limbs of SD rats will necrose because of vein-occlusion; and 4 days later the replanted limbs can survive depending on the reflux-vein of new collateral veinlet.
Objective To understand the value of pre-coating in artificial vessel endothelialization. Methods Literature concerning precoating in artificial vessel endothelialization was extensively reviewed. Results Pre-coating included chemical coatings(collagen, fibronectin, laminin, poly-l-lysin, gelatin andextracellular matrix), pre-clotting(plasma, blood, serum and fibrin glue), chemical bonding (heparin, RGD and lectins) and surface modification. Most of them could enhance the adhesion of the endothelial cells. Conclusion Pre-coating couldimprove endothelialization, but further research is needed to search for the appropriate concentration and incubation time.
Abstract: Objective To study the pathophysiological mechanism of the morphological change of immature pulmonary vessels in the piglet model of congenital heart defect with decreased pulmonary blood flow established with balloon atrial septostomy and pulmonary artery banding. Methods Twenty piglets at an age of one to two months were divided into three groups with random number table. For the control group (group C,n=6), small incisions were carried out on the right chest to produce a transient reduction in the pulmonary blood; for the lowmedium pulmonary artery stenosis group (group T1, n=7), the balloon dilator was delivered through the surface of the right atrium and septostomy and pulmonary artery banding were performed, and the systolic transpulmonary artery banding pressure (Trans-PABP) was controlled to be 20.30 mm Hg; For the severe pulmonary artery stenosis group (group T2, n=7), the same surgical procedures with group T1 were performed while TransPABP was controlled to be more [CM(159mm]than 3050 mm Hg.At 2 months after surgery respectively,a lung tissue of 1.0 cm×0.8 cm×0.8 cm from the lateral segment of the right middle lobe was taken out to be observed under optic microscope. The morphological change of the distal arterioles was detected. Furthermore, the content of vascular endothelial growth factor (VEGF) and matrix metalloproteinase2( MMP2) were also examined by the method of enzymelinked immunosorbent assay (ELISA). Results The model was successfully established in all the survival piglets of the group T1 and group T2. Two months after operation, the inner diameter of the pulmonary arterioles in group T1 was significantly higher than that in group C (82.89±10.72 μm vs.74.12±9.28 μm;t=－5.892, Plt;0.05), so as group T2 (85.47±5.25 μm vs.74.12±9.28 μm;t=-6.325, Plt;0.05); the number of arterioles per square centimeter (NAPSC) of group T1 was significantly lower than that of the group C (229.70±88.00 entries/cm 2 vs. 431.50±40.60 entries/cm2; t=39.526, Plt;0.05), so as group T2 (210.00±40.30 entries/cm2 vs. 431.50±40.60 entries/cm2; t=67.858, Plt;0.05). Two months after operation, the lung expression of MMP -2 and VEGF in group T1 was significantly lower than that in group C (58.30±19.60 ng/ml vs. 81.20±16.70 ng/ml, t=14.261, Plt;0.05; 17.80±3.00 pg/ml vs. 21.40±3.80 pg/ml, t=8.482, P＜0.05), so does group T2 (42.10±15.20 ng/ml vs. 81.20±16.70 ng/ml, t=27.318, P＜0.05; 12.30±3.20 pg/ml vs. 21.40±3.80 pg/ml, t=15.139, P＜0.05). Conclusion Structural remodeling of pulmonary extracellular matrix is an important feature of the piglet model of congenital heart defect with decreased pulmonary blood flow. The arterioles show significant hypoplasia or degradation. Change in the structural proteins and cytokines during the reduction of blood in the lung is the key to structural remodeling.
Since Oct. 1990, the 2nd metatarso-phalangeal joint and big-toe nail composite graft with the neuro-vascular bundle was transplanted to reconstruct the thumb in 4 cases. The transplants were all survived. The follow-up through 5 months, a comparatively good function and appearance were achieved.The applied anatomy, the surgical technique and the matters needing attention were detailed.
ObjectiveTo investigate the expression of keratinocyte growth factor (KGF) and cyclooxygen-ase-2 (COX-2) protein and microvessel density (MVD), and to explore their function and mechanism in the multistep process of gastric cancer. MethodsThe expressions of KGF and COX-2 protein in 64 samples of gastric cancer and 30 cases of normal gastric mucosa tissues were detected by immunohistochemistry. The MVD was detected by staining the endothelial cells in microvessles using anti-CD34 antibody. ResultsThe positive rate of KGF and COX-2 protein expression in gastric cancer were 65.6% (42/64) and 79.7% (51/64), respectively, which was significantly higher than that in normal gastric mucosa tissues 〔(23.3%, 7/30), P=0.046; (13.3%, 4/30), P=0.008〕. The MVD of gastric cancer was 31.8±8.0, which was significantly higher than that of normal gastric mucosa tissues (14.3±6.1), P=0.000. The MVD in gastric cancer with coexpressive KGF and COX-2 protein was 35.9±5.7, which was significant higher than that with non-coexpressive KGF and COX-2 protein (25.7±7.0), P=0.000. Both the expression of KGF and COX-2 protein were related to the invasion of serosa, lymph node metastasis and TNM staging (Plt;0.05, Plt;0.01). The MVD of gastric cancer tissues was related to lymph node metastasis and TNM staging (Plt;0.05), but unrelated to patient’s age, gender, and differentiation of tumor (Pgt;0.05). The co-expression of KGF and COX-2 protein was frequently found in patients with deeper invasion of serosa, lymph node metastasis, and higher TNM staging (Plt;0.05), but which was not associated withpatient’sage, gender, and differentiation of tumor (Pgt;0.05). The expression of KGF protein was positively correlated to the expression of COX-2 protein (r=0.610, P=0.000). There was positive correlation between MVD and the expression of KGF (r=0.675, P=0.000) and COX-2 protein (r=0.657, P=0.000) in gastric cancer, respectively. ConclusionKGF and COX-2 highly expressed by gastric cancer, which may be involved in the invasion and metastasis of gastric cancer by synergisticly promoting the angiogenesis.