BACKGROUND:Shengji Yuhong col agen showed good curative effect of promoting angiogenesis and tissue healing compared with Shengji Yuhong Gao and col agen alone or gelatin alone.
OBJECTIVE:To explore the curative effect and mechanism of subcutaneous implantation of Shengji Yuhong col agen in rabbits in promoting angiogenesis and repair.
METHODS:Shengji Yuhong col agen as the experimental group and collagen as the control group was implanted inside the rabbit subcutaneous pockets of the back of New Zealand rabbits. The implanted samples and
surrounding tissues were obtained at 3, 7, 14, 28 and 56 days fol owing surgery. Pathological sections were made and the repair of surrounding tissue was observed. Hemoglobin levels in col agen were measured.
Immunofluorescence and CD34 dyeing marking method were utilized to observe capil ary angiogenesis. Western blot assay was employed to examine vascular endothelial growth factor and angiogenin-1 expression.
Immunohistochemistry was used to observe the secretion of typeⅠ and Ⅲ col agen on the surrounding tissues.
RESULTS AND CONCLUSION:The experimental group showed increased subcutaneous vascularization. There were reduced inflammatory exudation, granulation tissue hyperplasia, and mature fiber connective tissue at 28 days.
Angiogenesis and hemoglobin contents were greater in the experimental group than in the control group (P<0.05 or P<0.01). At 3 and 7 days fol owing surgery, vascular endothelial growth factor and angiogenin-1 expression was greater in the experimental group than that in the control group (P<0.05 or P<0.01). The secretion of type Ⅰ col agen was
identical between the experimental and control groups. However, the secretion of type Ⅲ col agen was higher in the experimental group than in the control group at 28 and 56 days (P<0.05), and the proportion of type Ⅰ and Ⅲ
col agen was lower in the experimental group than in the control group at 28 and 56 days (P<0.01). These suggested that Shengji Yuhong col agen can significantly promote angiogenesis in the surrounding tissues with the possible
mechanisms of adjusting the protein expression of vascular endothelial growth factor and angiogenin-1. At the same time, it has the function of regulating col agen formation with better ratio of typeⅠ and type Ⅲ col agen to acquire higher
quality of wound healing with reduced scar formation.

To study the expression of angiotensin converting enzyme 2 (ACE2) and angiotensin (Ang) 1-7 specific receptor Mas protain in renal blood vessels of metabolic syndrome ( MS) rats and its anti-oxidative effect. A total of 80 male SD rats were divided into four groups: the normal control group (NC, the same volume of normal saline), the MS group (high fat diet), the MS + Astragali Radix group (MS + HQ, 6 g x kg(-1) x d(-1) in gavage) and the MS + Valsartan group (MS + XST, 30 mg x kg(-1) x d(-1) in gavage). After four weeks of intervention, their general indexes, biochemical indexes and blood pressure were measured; plasma and renal tissue Ang II, malondialdehyde (MDA) and superoxide demutase (SOD) levels were measured with radioimmunoassay. The protein expressions of Mas receptor, AT1R, ACE and ACE2 were detected by western blot analysis. According to the result, compared with the NC group, the MS group and the MS + HQ group showed significant increases in systolic and diastolic pressures, body weight, fasting glucose, fasting insulin, triglycerides, free fatty acid and Ang II level of MS rats (P < 0.05). The MS + XST group showed notable decreases in systolic and diastolic pressures than that of the MS group. The MS group showed significant increases in the SOD activity and NO level and decrease in the MDA level after being intervened with Astragali Radix. ACE and AT1R protein expressions in renal tissues of the MS group were higher than that in the NC group, but with lower ACE2 and -Mas receptor expressions (all P < 0.05). Compared with the MS group, the MS + HQ group showed significant increase in Mas receptor expression in renal tissues, whereas the MS + XST group showed notable decrease in AT1R (all P < 0.05). In conclusion, Astragali Radix can increase the Mas receptor expressions in renal tissues, decrease ACE expression and change local Ang II, MDA, NO and SOD in kidneys, so as to protect early damages in renal tissues.
Angiotensin I ; metabolism ; Animals ; Astragalus Plant ; chemistry ; Blood Glucose ; metabolism ; Blood Pressure ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Kidney ; drug effects ; injuries ; metabolism ; Male ; Malondialdehyde ; metabolism ; Metabolic Syndrome ; drug therapy ; genetics ; metabolism ; physiopathology ; Peptide Fragments ; metabolism ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, G-Protein-Coupled ; genetics ; metabolism ; Signal Transduction ; drug effects

To observe the serum samples and the anti-inflammatory effect of Tripterygium wilfordii in treating RA by using the pharmacokinetic-pharmacodynamic model, make a correlation analysis on concentration-time and effect-time curves, and explore RORγt, IL-17, STAT3, IL-6 mRNA transcriptional levels in rats by PCR. Methotrexate, tripterine and high-dose T. wilfordii could down-regulate RORγt, IL-17, STAT3, IL-6 mRNA transcriptional levels in AA rat lymph nodes. The study on PK-PD model showed correlations between inflammatory factors and blood concentration of T. wilfordii. T. wilfordii and its main active constituent tripterine could show the inflammatory effect and treat RA by inhibiting IL-17 cytokine.
Animals ; Arthritis, Rheumatoid ; drug therapy ; immunology ; Biomarkers ; Female ; Interleukin-17 ; antagonists & inhibitors ; genetics ; Interleukin-6 ; genetics ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Tripterygium ; Triterpenes ; pharmacokinetics ; pharmacology

Objective To evaluate the clinical efficacy and safety of Shenfu injection in the treatment of leukopenia induced by chemotherapy docetaxel, epirubicin and cyclophosphamide adjuvant chemotherapy ( TEC chemotherapy) after surgery of breast cancer.Methods A total of 106 patients with breast cancer were randomly divided into control group ( n=53 ) and treatment group ( n =53 ) .Control group was re-ceived 75 mg? m-2 docetaxel, intravenous infusion on day 1 +50 mg? m-2 epirubicin, intravenous infusion on day 1 +500 mg? m-2 cy-clophosphamide, intravenous infusion on day 1, 3 weeks for a course. Treatment group was given 50 mL Shenfu injection added 500 mL of 5%glucose intravenous infusion and plus the treatment of control group, 1 to 10 days for a course.Patients of two groups were received 2 courses of treatment.The clinical efficacy, the incidence of leukopenia, white blood cell count to improve the rate and quality of life before and after treatment, and adverse drug reactions in two groups were compared.Results After treatment, total effective rate in treatment group was significantly higher than that in control group (84.91%vs 69.81%, P<0.05).After treatment 7,10 d, leukopenia rates in treatment group were 9.43%and 11.32%, significantly lower than 37.74%and 30.19%in control group (P<0.05).After treatment, the white blood cell count in the two groups all decreased than those before treatment, and the degree of decline in treatment group was higher than that in control group (P<0.05).After treatment, the rate of improvement of quality of life in treatment group was significantly higher than that in control group (88.68%vs 54.72%, P<0.05).The incidence of adverse drug reactions in treatment group was significantly lower than that in control group ( P<0.05).Conclusion Shenfu injection has a definitive clinical efficacy for the treatment of chemotherapy-induced leukopenia, which may improve immune function and the quality of life, worthy of further promotion in clinical practice.

OBJECTIVETo explore the potential causes and the optimal treatments of recurrent venous ulceration of lower limbs after initial operation.

METHODSData of patients admitted between January 2000 and June 2010 for recurrent ulceration in lower limbs after previous operation were retrospectively analyzed. Altogether 81 limbs in 73 patients were recruited. There were 55 male patients (60 limbs) and 18 female patients (21 limbs). The average age was 52.6 years (ranging from 31 to 73 years). All the patients had received at least one surgery procedures before recurrence. The average time between ulceration recurrence and the last operation was 10.6 months (ranging from 5 to 37 months). Average diameter of ulcers was 3.7 cm (ranging from 1.3 to 6.5 cm). Color duplex sonography before re-treatment revealed incompetent calf perforators in 57 limbs (70.4%), primary deep vein insufficiency in 38 limbs (46.9%), post-DVT syndrome in 16 limbs (19.8%), reflux of accessory saphenous veins in 11 limbs (13.6%) and residual/re-opened great saphenous vein in 8 limbs (9.9%). Managements including stripping of great saphenous vein, ligation around the ulcer, percutanous ligation of varicose veins, valvoplasty, and adjuvant compressive therapy were adopted according to different venous abnormality.

RESULTSAll the patients were followed. All the ulcers healed and hemodynamic indexes were greatly improved 6 months after re-operation. Only 3 limbs (3.7%) suffered again from recurrence 1 year after re-operation.

CONCLUSIONSIncompetent perforators in calf, primary or secondary deep vein insufficiency and incorrectly treated saphenous veins are main causes for recurrent venous ulceration in our series. Management of residual vein abnormalities can still achieve satisfying clinical outcome.

Adult ; Aged ; Female ; Humans ; Leg ; blood supply ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Varicose Ulcer ; etiology ; surgery ; Varicose Veins ; etiology ; surgery

BACKGROUNDThe endovascular treatment of abdominal aortic aneurysm (AAA) has improved greatly in the last 15 years. The present study aimed to evaluate the endografting experience for the treatment of unfavorable abdominal aortic aneurysm (uAAA).

METHODSDuring December 2001 and December 2007, 41 patients with uAAA were treated with endografting using concomitant techniques. Patients were followed up for 1 to 48 months (mean 20.5 months).

RESULTSTechnical success rate was 97.6% (40/41) with 1 failure converted to open surgery for an unaccessed iliac stenosis. Nine (22.5%) type I endoleaks (5 proximal and 4 distal) were observed on the completion angiograms and successfully corrected with aortic cuffs and iliac extensions during the procedure. Twenty-two of the planed adjunctive procedures were concomitantly performed just before endograft-implantation. There were 2 (5.0%) type I endoleaks at 30 days; one type I patient was treated by open conversion, another type I patient died from a rupture before treatment in the ward, causing a 2.5% of initial mortality. The two type II endoleaks were observed without aneurismal expansion. No buttock or leg claudication or ischemic colitis occured. During late follow-up, one additional death occurred from stroke. One new type I endoleak was encountered from thrombocytopenia, which caused a 2.6% secondary endoleak that converted to an open surgery in the third month after a failed transabdominal banding of the aortic neck in the second month. All type II endoleaks had disappeared in the third and sixth month. The Endografts did not present signs of material fatigue and no other type of endoleak formed. One patient presented with left limb ischemia, which underwent percutaneous transluminal angioplasty. There was no additional aneurysm rupture or any endograft imgration.

CONCLUSIONThe endografting with concomitant procedures is a feasible and efficient alternative for managing unfavorable AAAs, achieving low morbidity and mortality rates and has a good clinical outcome.

Aged ; Angiography ; Aortic Aneurysm, Abdominal ; diagnosis ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Humans ; Male ; Middle Aged ; Stents ; Survival Analysis ; Treatment Outcome

OBJECTIVETo evaluate the single or staged endovascular stent-graft repair for aortic dissection with multi-tears.

METHODSThe stent-grafts were inserted through the femoral artery to seal the tears of dissection.

RESULTSBetween January 2001 and June 2004, 8 patients with aortic dissection underwent stent-graft placement. There were 5 tears in one patient, 4 tears in two patients, 3 tears in two patients and 2 tears in three patients. There were 11 tears located at descending thoracic aorta, 11 at abdominal aorta and 4 at iliac artery. Six patients underwent operation in single stage, and 2 in staged maneuver. Total 23 stent-grafts were used, including 20 straight type grafts and 3 bifurcated grafts. Placement of the stent-graft was technically successful in all patients. Follow-up with CT or MRA examination after 3, 6, 12 and 24 months postoperatively showed the dissection disappeared with thrombosis in the false lumen, no endoleak occurred. All patients survived to present.

CONCLUSIONSingle or staged endovascular stent-graft repair is a promising, safe and effective procedure for aortic dissection with multi-tears.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Angiography, Digital Subtraction ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVETo study cardiopulmonary physiology during exercise in patients after extracardiac total cavopulmonary connection (ECTCPC).

METHODSTwenty-six patients were studied after ECTCPC by exercise testing with bicycle treadmill protocol. Heart rate (HR), blood pressure (BP), respiratory frequency (RF) and pulse oxygen saturation (SpO(2)) were measured continuously; twenty-six patients suffered from Fallot 4 underwent biventricular repair were also studied as control group.

RESULTSIn ECTCPC group, HR, BP, SpO(2) and RF all increased with exercise below 3 grade; when exceed 4 grade, BP, SpO(2) decreased and RF kept increasing. Compared with control group, HR, RF were higher (t = 2.13, P < 0.05; t = 2.31, P < 0.05), SpO(2) was lower (t = 2.46, P < 0.05) under the quiescent condition; When exceed 3 grade, HR, BP, SpO(2) decreased more significantly, but RF increased continuously. In fenestration group after ECTCPC, HR reached the top at 5 grades, but in group without fenestration it reached the top at 3 grades; In the whole process of exercising, RF kept higher and SpO(2) kept lower in fenestration group.

CONCLUSIONSThe ECTCPC patients showed obviously exercise limitation. Totally bypass of sinoatrial node in this operation may have some adverse effects on the integer regulation of HR.

Adolescent ; Adult ; Child ; Child, Preschool ; Exercise Test ; Female ; Follow-Up Studies ; Fontan Procedure ; methods ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Male ; Physical Endurance ; physiology ; Postoperative Period

OBJECTIVETo study endovascular treatment of DeBakey type I aortic dissecting aneurysm.

METHODSSeven patients with DeBakey I aortic dissecting aneurysms were treated. Diagnoses were confirmed by MRA, CT and angiography. The intimal tear entry was in the ascending aorta, 2.5 approximately 6.0 cm from the ostia of the coronary arteries, and 0.5 approximately 4.0 cm from the brachiocephalic trunk opening. Endovascular stent-grafts were deployed via a left common carotid artery (LCCA) approach in 2 cases and right femoral artery (RFA) approach in 5 cases. Prior to treatment, a left subclavicular artery (LSA)-LCCA shunt was established to ensure blood supply to the LCCA during surgery in 2 cases via LCCA approach, and a LSA-LCCA-right common carotid artery (RCCA) synthetic bypass was established to ensure blood supply to the brain in 2 cases in RFA approach.

RESULTSThe operative success rate was 100%. In 3 cases, endoleak persisted after the first stent was placed, but this was eliminated by placement of a second stent. All patients survived except one who died of acute massive hemorrhage from the upper gastrointestinal tract one month postoperatively. The false lumen in all 6 cases became thrombosed and no endoleak or new aortic dissecting aneurysms developed.

CONCLUSIONSEndovascular treatment of DeBakey type I aortic dissecting aneurysm is feasible, minimally invasive, and effective. Case selection depends on the distance of the coronary artery ostia from the tear entry.

Adult ; Aged ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Stents ; Treatment Outcome

OBJECTIVETo study the effects of inhaled nitric oxide (NO) on pulmonary vascular resistance in patients after total cavopulmonary connection (TCPC).

METHODSFifty-two patients after TCPC were evaluated, of them 24 patients were administered with inhaled nitric oxide in the early postoperative period. The cardiac index (CI) and pulmonary vascular resistance (PVR) were compared before and after inhaled NO.

RESULTSIn experimental group, after inhaled NO, partial pressure of oxygen in artery/fraction of inspired oxygen increased from 161 +/- 17 to 193 +/- 23 (t = 2.75, P < 0.01); CI from (2.86 +/- 0.24) L.min(-1).m(-2) to (3.13 +/- 0.22) L.min(-1).m(-2) (t = 2.25, P < 0.05); PVR decreased from (4.2 +/- 0.5) U/m(2) to (3.8 +/- 1.4) U/m(2) (t = 2.29, P < 0.05); central venous pressure (CVP) from (17.0 +/- 1.8) mm Hg to (15.0 +/- 1.1) mm Hg, decreased 11.7%. Compared with the control group, respirator time decreased from (86 +/- 27) h to (54 +/- 18) h (t = 2.29, P < 0.05); ICU time from (6 +/- 2) d to (4 +/- 2) d (t = 2.32, P < 0.05); But hydrothorax drainage and length of stay had no significant difference.

CONCLUSIONSThough inhaled NO, there is no significant long-term effects in patients after TCPC, but it may play an important role in the management of low cardiac output syndrome and high cava pressure caused by reactive elevated pulmonary vascular resistance in the early postoperative period of TCPC.

Administration, Inhalation ; Adolescent ; Adult ; Arteriovenous Shunt, Surgical ; methods ; Cardiac Output ; drug effects ; Child ; Child, Preschool ; Female ; Humans ; Male ; Nitric Oxide ; administration & dosage ; therapeutic use ; Postoperative Period ; Pulmonary Artery ; physiology ; surgery ; Time Factors ; Vascular Resistance ; drug effects ; Vasodilator Agents ; administration & dosage ; therapeutic use ; Venae Cavae ; surgery