中晚期原发性肝癌血供的单层动态血管造影CT研究

目的 :运用单层动态肝动脉及间接门静脉血管造影CT观察评价中晚期原发性肝癌的血供特点。方法 :确诊且未接受过介入治疗的中晚期原发性肝癌 33例 ,行经导管动脉化疗栓塞(TACE)前 ,运用联合导管技术 ,在肝动脉造影CT(CTHA)、动脉性门静脉造影CT(CTAP)中运用单层动态扫描技术进行造影检查 ,绘制时间 -密度曲线 ,进行比较和综合分析。结果 :全组肝癌均存在肝动脉供血 ,2 9例为明确的单纯肝动脉供血 ,4例为肝动脉和侧支动脉供血 ;未见明确的门静脉供血表现。在CTHA和CTAP单层动态扫描上 ,时间 -密度曲线显示 :肝癌组织在CTHA上呈显著的强化 (P <0 0 5 ) ,在CTAP上无显著强化 (P >0 0 5 ) ;比较CTHA和CTAP单层动态扫描与术后复查碘油CT的肿瘤同层面横截面积 ,未见显著性差异 (P >0 0 5 )。结论 :中晚期肝癌血供以肝动脉供血占绝对优势 ,少数可见侧支动脉供血 ,未见门静脉供血     

Macrophage skewing by Phd2 haplodeficiency prevents ischaemia by inducing arteriogenesis

PHD2 serves as an oxygen sensor that rescues blood supply by regulating vessel formation and shape in case of oxygen shortage. However, it is unknown whether PHD2 can influence arteriogenesis. Here we studied the role of PHD2 in collateral artery growth by using hindlimb ischaemia as a model, a process that compensates for the lack of blood flow in case of major arterial occlusion. We show that Phd2 (also known as Egln1) haplodeficient (Phd2(+/-)) mice displayed preformed collateral arteries that preserved limb perfusion and prevented tissue necrosis in ischaemia. Improved arteriogenesis in Phd2(+/-) mice was due to an expansion of tissue-resident, M2-like macrophages and their increased release of arteriogenic factors, leading to enhanced smooth muscle cell (SMC) recruitment and growth. Both chronic and acute deletion of one Phd2 allele in macrophages was sufficient to skew their polarization towards a pro-arteriogenic phenotype. Mechanistically, collateral vessel preconditioning relied on the activation of canonical NF-κB pathway in Phd2(+/-) macrophages. These results unravel how PHD2 regulates arteriogenesis and artery homeostasis by controlling a specific differentiation state in macrophages and suggest new treatment options for ischaemic disorders.     

高压氧治疗肢体创伤术后组织血运障碍30例疗效分析

对我院高压氧治疗30例肢体创伤术后组织血运障碍的病人进行了疗效对照观察,结果表明治疗组治愈率80.0%,较对照组高(P＜0.01).认为高压氧能改善患肢的血运障碍,减轻或消除患肢组织水肿,促进侧枝循环建立,提高植皮及断指再植的成活率.对肢体创伤术后出现的血运障碍,断指再植或原位缝合术后的病人应尽早应用高压氧治疗.     

Therapeutic angiogenesis induced by human hepatocyte growth factor gene in hindlimb ischemia of dogs

A preclinical study of treating peripheral srtery occlusive disease(PAD) was performed by using a hepatocyte growth factor(HGF) gene-expressing vector,plasmid pUDKH,in a dog model with complete ischemia of one hindlimb.After ligation of femoral artery of one hindlimb,pUDKH was transferred directly into the ischemic limb muscles.The angiogenic activity of the plasmid pUDKH was evaluated.On D 30 after injecting once of pUDKH at differ-ent doses into local muscles immediately after operation,the degree of augmentation of collateral vessel formation was significantly greater than that treated by blank vector.In addition,the blood flow rate of femoral artery in dogs treated with pUDKH was recovered on D90,while the folw rate was only 1/5 tp 1/3 in control dogs.The pulse amplitude of pUDKH-treated dogs was recovered on D90,but it was hardly detectable in most of the control dogs.The side effects of intramuscular transfection of pUDKH were also investi-gated,and no significant positive change was found.It is suggested that angiogenesis induced by HGF gene has the potential for clincal use in the treatment of peripheral arte-rial diseases.     

Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis.

Inefficient vascular supply and the resultant reduction in tissue oxygen tension often lead to neovascularization in order to satisfy the needs of the tissue. Examples include the compensatory development of collateral blood vessels in ischaemic tissues that are otherwise quiescent for angiogenesis and angiogenesis associated with the healing of hypoxic wounds. But the presumptive hypoxia-induced angiogenic factors that mediate this feedback response have not been identified. Here we show that vascular endothelial growth factor (VEGF; also known as vascular permeability factor) probably functions as a hypoxia-inducible angiogenic factor. VEGF messenger RNA levels are dramatically increased within a few hours of exposing different cell cultures to hypoxia and return to background when normal oxygen supply is resumed. In situ analysis of tumour specimens undergoing neovascularization show that the production of VEGF is specifically induced in a subset of glioblastoma cells distinguished by their immediate proximity to necrotic foci (presumably hypoxic regions) and the clustering of capillaries alongside VEGF-producing cells.     

现代企业制度下银行运行机制的转换

银行运行机制的转换受到旧企业制度的制约,建立现代企业制度构成了银行运行机制转换的基本条件。重要的是把银行运行机制与现代企业制度结合起来,寻求转换银行运行机制的途径。它们包括:(1)重塑银企关系;(2)实行资产负债比率管理;(3)建立股份制商业银行;(4)发放抵押贷款和担保贷款;(5)向企业提供调控与服务。     

Therapeutic induction of angiogenesis by direct myocardial administration of an adenovirus vector encoding human hepatocyte growth factor gene and its safety

After the study in vitro and in rats, we assessed further the effects and safety of local angiogen therapy using intramyocardial delivery of an adenovirus carrying hepatocyte growth factor gene (Ad-HGF) in a canine ischemia model. The angiogenic activity of Ad-HGF was evaluated from three aspects. First, the augmentation of collateral vessel development was assessed by angiography 30 d after surgery. The results showed that the density of collateral vessels in treated group was higher than that of control group. Secondly, infarct size was evaluated by TTC staining and image analysis. The results showed that the infarct size of treated group was smaller than that of control group. Thirdly, the myocardial regional blood flow was determined by the method of colored microspheres. The results showed that the blood flow recovered to the level before ligation in treated group, but that of the control group was lower than normal level. In addition, during the study of chronic toxicity, we tested the anti-adenovirus antibodies by neutralization method. The antibodies yielded after the fourth injection decreased slowly from peak level and disappeared 12 weeks after drug withdrawal. Overall, Ad-HGF can promote angiogenesis in ischemic myocardium and reduce infarct size. So this method may be considered as a therapeutic angiogenesis induction strategy for ischemic disease including myocardial infarction and peripheral artery disease. At the same time, Ad-HGF could induce the yield of anti-adenovirus antibodies to neutralize adenovirus, which may be the mechanism of adenovirus clearance.     

花背蟾蜍胃肠的血供研究

用血管铸型法对15只花背蟾蜍（Bufo raddei)胃肠的动脉和静脉进行了解剖学观察,结果显示：花背蟾蜍胃肠的动脉均来自腹腔肠系膜动脉,胃的营养由胃左动脉和胃右动脉供应;肠由肠系膜前动脉和肠系膜后动脉共同营养,胃的静脉包插胃左静脉和胃右静脉,分别收集胃左侧面和胃右侧面胃壁的静脉血,经肝门静脉回流;肠的静脉有肠系膜前静脉和肠系膜后静脉,前者收集十二指肠和回肠前段肠壁的静脉血,后者收集回肠后段和直肠壁的静脉血,最后经肝门静回流,与此同时,将花背蟾蜍胃肠的血供与其它动物进行了比较。     

臂内外侧和前臂后筋膜瓣肘关节成形术的应用解剖

目的：为肘关节成形术填充物的选用提供解剖学基础.方法：在20侧经动脉灌注颜料的上肢标本上,解剖观测了臂内外侧筋膜、前臂后筋膜的血管来源、分支分布;血管蒂长度及筋膜瓣的切取面积等.结果：观测了以尺、桡侧返动脉为蒂的臂内外侧筋膜瓣和以骨间后动脉为蒂的前臂后筋膜瓣,这些筋膜的血管蒂长,血供丰富,可取面积大,质地坚韧致密.结论：臂内外侧筋膜瓣和前臂后筋膜瓣可作为肘关节成形术的填充物,讨论了临床应用解剖学要点.     

指动脉分支在指尖离断再植中的应用

目的探讨指动脉分支在指尖离断再植中应用的方法和疗效.方法 1998年8月～2004年9月,应用指动脉分支移位法,对指尖离断进行再植27例,共32指.结果 32指中成活31指,成活率96.8%.术后随访4～6个月,再植指外形、指尖部感觉恢复优良,效果满意.结论指动脉分支移位法,适用于指尖离断再植.