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下肢动脉硬化闭塞症的药物治疗

ADVANCES IN THE DIAGNOSIS AND TREATMENT OF ACUTE VASCULAR INJURIES

Clinical Study on the Pathogenesis of Chronic Venous Insufficiency in the Lower Extremities

ObjectiveTo explore the relationship among plasma cytokines’ level, adhesion molecules expression and skin damage in patients with chronic venous insufficiency (CVI) of lower extremities.MethodsIn 32 patients with CVI and 8 normal individuals as control, blood TNFα, IL1β and IL2R were assayed with ELISA method; serum endothelial cellintercellular adhesion molecule1(ECICAM1), polymorphonuclearCD18(PMNCD18) and polymorphonuclearCD11b(PMNCD11b) were assayed with immunohistochemical method; and ultrastructure of diseased veins was examined by electroscope.ResultsThe results showed that the level of plasma TNFα and IL1β increased remarkably in Class 2-3 compared with Class 1 and control (P＜0.05), IL2R had no difference in Class 1,2,3(Pgt;0.05). The index of ECICAM1 and PMNCD11b positively expression increased remarkably in Class 2-3 compared with that in Class 1 and control. The index of PMNCD18 expression in Class 2-3 and Class 1 was greatly higher than that in control (P＜0.05). The expression of ICAM1 was positively correlated with that of CD11b/CD18. Electron microcopy showed that the change in microvessel was mainly PMN adhesion with endothelial cells (ECs) and trapped in microvessels.ConclusionThe results suggest that activated monocyte may release TNFα and IL1β, upregulate ICAM1 and CD11b/CD18 expression, and mediate the PMN adhesion to ECs, thus causing ECs and tissue damage. It may be one of important mechanism of venous ulcer.

ROLE OF PRE-COATING IN ARTIFICIAL VESSEL ENDOTHELIALIZATION

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.

Recognition on Surgical Treatment of Chronic Venous Insufficiency in Lower Limb at Present

周围静脉疾病是临床上的常见病和多发病，其发病率为20%～40%，皮肤营养障碍占2%～5%［1，２］ ,发病率比动脉疾病约高10倍，发病机理比动脉疾病复杂，分类方法亦不一致，至今存在着争论。下肢慢性静脉功能不全（chronic venous insufficiency,CVI）按其病因可分为原发性、继发性及先天性; 按解剖范围可分为浅、深和交通静脉3个系统，亦即包括浅静脉曲张、深静脉瓣膜功能不全、深静脉血栓形成后遗症、交通静脉瓣膜功能不全等［３，４］。多年来下肢浅静脉曲张主张施行大隐静脉高位结扎加剥脱术，但术后复发者较多。近年来，随着国内、外学者对CVI的深入研究，尤其是对深静脉瓣膜功能不全的认识，使传统下肢浅静脉曲张的概念发生了根本转变。下肢浅静脉曲张已不再被认为是一个独立的疾病，而是一种可由多种不同病因引起的共同临床表现……

Diagnosis and Treatment of the Infected Pseudoaneurysm of the Lower Limbs

ADVANCES IN CLINICAL APPLICATION OF HERNIOPLASTY BY HIGH MOLECULAR MATERIAL

Objective To study the advances in clinical application of hernioplasty by high molecular material. Methods The literature in the recent years on the advances of hernioplasty by high molecular material was reviewed. Results At present time many operative techniques of hernioplasty by high molecular material have been developed. The representative techniques were ①Rives-Stoppa′s mesh inlay hernioplasty; ②Lichtenstein′s tesion-free herniorrhaphy; ③mesh plug hernioplasty; ④Gilbert′s sutureless hernioplasty; ⑤laparoscopic inguinal hernioplasty. The reparing high molecular material was divided into absorbable and unabsorbable material, the former included polyglycolic-acid and polyglaction, the later consists of polypropylene polyester and expanded polytetrafluoroethylene.Conclusion The clinical application of henioplasty by high molecular material is increasing. According to the hernia type and patient condition, excellent outcome will be achieved by the application of proper repairing method and repair material.

高分子材料在血管外科的应用

Relationship Between Nuclear Factor-Kappa B and Restenosis after Angioplasty

ObjectiveTo discuss the role of nuclear factor-kappa B in restenosis after angioplasty.MethodsRelated literatures of recent 5 years were reviewed.ResultsNuclear factor-kappa B could lead to hyperplasia of vascular intima which resulted from proliferation and decrease of apoptosis of vascular smooth muscle cells.ConclusionNuclear factor-kappa B plays an important role in restenosis after angioplasty.

Effect of Radix Salviae Miltiorrhizae on Patency and Proliferation Lesion of Autologous Vein to Artery Grafts in the EarlyMiddle Stage

ObjectiveTo assess the effects of Radix Salviae Miltiorrhizae (RSM) on patency and proliferation lesion of autologous vein to artery grafts in the earlymiddle stage.MethodsAutologous jugular vein was grafted into abdominal artery in the rats. The rats were divided into two groups: RSM group and control group. The rats in RSM group were fed with RSM ［24 g/(kg·d )］,which began 1 day before operation and continued until harvesting. Vein grafts were harvested at 1,3 days, 1, 2, 4 and 8 weeks after surgery for examining the patency, thickness of intimamedia and expression of proliferating cell nuclear antigen (PCNA). ResultsNo significant differences existed in patency of vein grafts between the two groups (Pgt;0.05). The intimamedia thickness of the vein grafts in RSM group decreased 1/3 compared with control group at 2, 4 and 8 weeks (P＜0.01). The PCNA positive cells in RSM group reduced significantly as compared to the control group (P＜0.01). ConclusionRSM can inhibit proliferation lesion of vein grafts but has no influence on patency of vein grafts in the earlymiddle stage.