Canine peripheral vascular arteriosclerosis following myointimal fragmentation and atherogenic diet

The development of arteriosclerotic peripheral vascular lesions following balloon catheter and mechanical fragmentation of the arterial myointima combined with an atherogenic diet was studied in a canine model. The ileofemoral arteries of five mongrel dogs (mean wt 22 +/- 2 kg) were selectively cannulated and subjected to balloon catheter and mechanical myointimal injury by repeated longitudinal and transverse shearing forces. Twenty grams of hydrogenated coconut oil and a 5.0% cholesterol diet were fed to the animals daily during the study period. Followup angiographic studies obtained at 4 weeks (n = 2), 10 weeks (n = 3), 16 weeks (n = 3), and 24 weeks (n = 2) demonstrated changes of progressive peripheral vascular occlusion. Concurrent duplex Doppler studies correlated well with the angiographic results. At 10 (n = 1), 18 (n = 2), and 24 (n = 2) weeks, the animals were sacrificed and the vessels were perfusion-fixed in situ with 2% glutaraldehyde or formaldehyde solutions and excised. Histological examination demonstrated extensive arteriosclerotic changes including (i) fragmentation and reduplication of the internal elastic membrane, (ii) myointimal hyperplasia with fibroblastic proliferation including the development of fibrous intimal plaques, and (iii) transmigration and proliferation of smooth muscle cells with scattered monohistiocytes. The specimens showed a range of stenotic changes from 25% to total occlusion of the vascular lumen. These preliminary data demonstrate the feasibility of providing intense arteriosclerotic myointimal histologic changes in the canine peripheral vasculature within a 24-week period. Further refinement of this methodology may provide a practical model for studies of localized peripheral vascular occlusive disease.     

Immunohistochemical evidence of canine morbillivirus (canine distemper) infection in coatis (Nasua nasua) from Southern Brazil

The pathological and immunohistochemical (IHC) findings associated with infection due to canine morbilivírus (canine distemper virus, CDV) are described in coatis (Nasua nasua). Tissue fragments of coatis (n = 13) that died at the Bela Vista Sanctuary, Paraná, Southern Brazil, were routinely processed for histopathology to identify the main histopathologic patterns as compared to that of the domestic dog. Selected formalin‐fixed paraffin‐embedded (FFPE) tissue fragments of the lungs, liver, urinary bladder and small intestine were used in IHC assays designed to identify the antigens of CDV, canine adenovirus (CAdV‐1 and CAdV‐2) and canine parvovirus type 2 (CPV‐2). The main histopathologic patterns identified were interstitial pneumonia (n = 9), interstitial nephritis (n = 6), atrophic enteritis (n = 4) and ballooning degeneration of the uroepithelium (n = 3). Positive immunolabelling for intralesional antigens of CDV was identified in the lung with interstitial pneumonia (n = 3), in the intestine (n = 2) and in the degenerated epithelium of the urinary bladder (n = 2). Antigens of CPV‐2, CAdV‐1 and CAdV‐2 were not identified in any FFPE tissue sections evaluated. These findings indicate that these wild carnivores were infected by a viral disease pathogen common to the domestic dog and develop similar histopathologic findings. Collectively, these findings suggest that these coatis were infected by CDV and can serve as a potential host for this infectious disease pathogen.     

Deployment and Healing of an ePTFE Encapsulated Stent Endograft in the Canine Aorta

n = 3), 1 month (n= 3), 3 months (n= 3), 6 months (n= 9), and 1 year (n= 3). Dimensions of the infrarenal aorta were determined with intravascular ultrasound (IVUS) and angiography prior to deployment of devices. Real-time fluoroscopy and IVUS were used to monitor device deployment with both imaging modalities repeated following implantation. Gross inspection and microscopic evaluation was performed on the explanted specimens following in vivo evaluation by CT scan, IVUS, and angiography prior to retrieval of the specimens. The prostheses were easily deployed from the femoral access site. Oversizing of the deployment balloon compared to the aortic diameter was necessary to accommodate the 10% device recoil observed following balloon deflation, however, all devices were seated against the aortic wall as evidenced by IVUS. At explant, all devices ware widely patent with limited luminal thrombosis observed in four specimens (19%). Devices were well-incorporated by cellular ingrowth into the ePTFE with the formation of neointima. No device migration or postdeployment recoil was observed. ePTFE graft material between stents protruded slightly into the vessel lumen accounting for a 10% luminal reduction. Fully supported ELG's consisting of balloon expandable stents encapsulated in ePTFE are easily deployed using a low-profile delivery system. Specimens demonstrated uniform long-term patency and healing up to 1 year in a canine aortic model. Those preliminary findings support further study of this fully supported prosthesis in the treatment of arterial disease.     

Early inhibition of myointimal proliferation by angiopeptin after balloon catheter injury in the rabbit

Purpose: Coronary artery restenosis after percutaneous transluminal angioplasty occurs in more than 40% of patients. Angiopeptin, a stable synthetic octapeptide analogue of somatostatin, attenuates accelerated coronary artery myointimal thickening in rabbit cardiac allografts and myointimal thickening after arterial injury. In this study the temporal relationship between the angiopeptin treatment schedule and efficacy was explored. The relationship between inhibition of myointimal thickening by angiopeptin and inhibition of vascular cell proliferation was also examined.Methods: The aorta and the common and external iliac arteries of the rabbit underwent balloon injury. Angiopeptin (2 to 200 μg/kg/day) was administered for 1 day before injury and for 1, 5, and 21 days after injury. Morphometric studies were performed to determine measurement of intimal thickening. Inhibition of vascular cell proliferation by angiopeptin was evaluated by tritiated thymidine incorporation into the balloon-injured rabbit aorta. Thymidine was either administered intraperitoneally or added ex vivo to aorta segments of rabbits treated with angiopeptin (2, 20, or 200 μg/kg/day) from 1 day before injury until sacrifice 72 hours later.Results: Administration of angiopeptin (2 to 200 μg/kg/day) significantly reduced intimal thickening by approximately 50% in all three vessels when evaluated 3 weeks after injury. This inhibitory effect was unrelated to duration of treatment and dose. Treatment initiated at the time of injury was found to be effective, but delaying treatment for 8, 18, or 27 hours abrogated the inhibitory effect of angiopeptin on myointimal thickening. Angiopeptin treatment significantly decreased thymidine-labeled muclei of smooth muscle cells in vitro. Angiopeptin treatment similarly inhibited thymidine uptake in vitro by balloon-injured aorta segments.Conclusion: Angiopeptin significantly inhibits myointimal thickening by inhibiting vascular cell proliferation. Administration of angiopeptin for 2 days is as efficacious as 3 weeks treatment in inhibiting myointimal thickening. Delaying treatment for as little as 8 hours after injury abrogates the inhibitory effects of angiopeptin. This speaks to the importance of early events immediately after vascular tissue injury, suggesting that angiopeptin inhibits the expression of early genes causally related to the vascular injury response and thereby triggering vascular cell proliferation. (J VASC SURG 1994;19:1084–91.)     

The Effects of Losartan in Preserving the Structural Integrity of Decellularized Small Diameter Vascular Allograft Conduit Implants In Vivo

Decellularization is a proposed method of preparing nonautologous biological arterial vascular scaffolding; however, the fate of the supporting medial elastic fiber, which is important in preserving the vascular structural integrity, is uncertain. The influence of losartan on preserving the medial elastic fiber integrity in decellularized small diameter vascular conduits (SDVC) was investigated. Decellularized infrarenal abdominal aortic allografts were implanted in Sprague‐Dawley rats treated either with (study rats, n = 6) or without oral losartan (control rats, n = 6) and graded 8 weeks later according to a remodeling scoring system (1‐mild, 2‐moderate, 3‐severe) which we devised based on the intimal hyperplasia degree, morphologic changes, and elastic fiber fragmentation of the conduits. DAPI immunohistochemistry analysis was performed in 47 (25 decellularization only and 22 losartan treatment) cross‐sectional slide specimens. The losartan versus decellularization only SDVC showed a significantly lower medial elastic fragmentation score (1.32 vs. 2.24, P < 0.001), superior medial layer preservation, and relatively more normal appearing intimal cellular morphology. The results suggested rats receiving decellularized SDVCs treated with losartan may yield superior medial layer elastic fiber preservation.     

Coral Reef Aorta: A Long-Term Study of 21 Patients

n = 11, 52%), renovascular stenosis (n= 9, 43%) with concurrent renovascular hypertension (n= 5, 24%), and angina abdominalis (n= 7, 33%). Most patients had multiorgan vascular disease such as iliofemoral arterial occlusive disease (n= 14, 66%), coronary artery obstruction (n= 8, 38%), or obstruction of the carotid artery (n= 6, 28%). Risk factors did not differ between coral reef patients and those with other occlusive vascular diseases. All patients were treated through vascular operations, including open thromboendarterectomy of the suprarenal (n= 9, 43%), infrarenal (n= 4, 19%), or supra- and infrarenal aorta (n= 8, 38%), and thromboendarterectomy of the following vessels: celiac artery (n= 7, 33%), superior mesenteric artery (n= 12, 57%), inferior mesenteric artery (n= 3, 14%), unilateral renal artery (n= 3, 14%), or bilateral renal artery (n= 9, 43%). Bypass reconstructions were performed in 39% (n= 8). A thoracoabdominal approach was used in 14 patients (67%) and a median laparotomy in 7 (33%). Our results show that coral reef aorta is not confined to either gender. It appears most frequently in the context of general atherosclerotic disease and patients benefit from timely diagnosis and operation before onset of severe, life-threatening visceral and renal complications.     

Renal hemodynamic effects of L-NAME during postnatal maturation in conscious lambs

The purpose of the present study was to investigate the effects of the L-arginine analogue, N ^G -nitro-L-arginine methyl ester, L-NAME, in modulating renal hemodynamics during postnatal maturation in conscious chronically instrumented lambs. To this end, renal hemodynamic responses to intravenous injection of 10, 20, and 40 mg/kg L-NAME, as well as its inactive enantiomer D-NAME, were measured for 4 h in conscious lambs approximately 1 week (n=10), 3 weeks (n=12), and 6 weeks (n=14) of age. Administration of L-NAME was associated with an increase in renal vascular resistance (RVR) leading to a decrease in renal blood flow. One-week-old lambs were more sensitive to the effects of L-NAME, a marked increase in RVR occurring after the smallest dose administered at 1 week but not at 3 and 6 weeks of age. Renal hemodynamic effects of L-NAME as well as the duration of the responses were also age dependent, such that changes in RVR were greatest and most prolonged in 1-week-old lambs. In addition, a smaller dose of L-NAME was required to attenuate acetylcholine-induced renal vasodilation in lambs aged 1 week compared with older animals. Our data provide new evidence to support the premise that endogenously produced nitric oxide plays a predominant role in regulating renal vascular tone early in life. Received: 27 November 2000 / Revised: 30 May 2001 / Accepted: 6 June 2001     

Indwelling esophageal balloon catheter for benign esophageal stenosis in infants and children

Background

Balloon dilatation of benign esophageal strictures is an established mode of therapy in adults and children. There remains a group of patients with refractory stenosis despite dilatation at regular intervals. An indwelling balloon catheter may offer an alternative.

Methods

This is a retrospective study of 19 children who underwent esophagoscopy between 2004 and 2012 with placement of an indwelling balloon catheter for refractory esophageal stenosis. Total number of endoscopies, number of endoscopies with indwelling balloon catheter, as well as complications, reoperations, and mortality due to use of the balloon catheter were studied.

Results

Patient age ranged from 4 weeks to 15 years. The indwelling balloon catheter was used to treat refractory stenosis after corrective surgery of long gap esophageal atresia (n = 5), esophageal atresia with distal fistula (n = 2), refractory esophageal stenosis due to caustic esophageal burns (n = 7), reflux (n = 2), and stenosis of unknown cause (n = 3). With the indwelling balloon catheter in place, the mean number of endoscopies equalled four. Complications were restenosis after a symptom-free period for which a new indwelling balloon catheter was necessary (n = 3). Two others needed two to five additional dilations: balloon leakage requiring replacement (n = 7 in 5 patients), sputum retention (n = 1), and dislodgement (n = 5 in 4 patients). More importantly, there was no mortality or the need for any patient to undergo a surgical resection.

Conclusions

The indwelling balloon catheter is safe to use and can be used by parents at home. More importantly it obviates the need for rethoracotomy/-scopy or esophageal replacement.     

Role of adhesion molecules in the induction of restenosis after angioplasty in the lower limb

OBJECTIVE: The adhesion molecules P selectin, E selectin, intercellular adhesion molecule, vascular cellular adhesion molecule (VCAM), and monocyte chemoattractant protein 1 play a important role in the development of arteriosclerotic lesions and are considered main contributors to restenosis after angioplasty. We expected that the serum levels of these markers would increase in the early phase of the first few weeks after angioplasty. METHODS: We assessed prospectively the levels of soluble forms of adhesion molecules on the day before and then 24 hours and 2 and 4 weeks after angioplasty in arteries of the lower limb by using enzyme-linked immunosorbent assays. We investigated the distribution pattern of these markers in 44 patients (25 male and 19 female; age, 67.7 +/- 8.5 years [mean +/- SD]) presenting with intermittent claudication (Fontaine stage IIb). Twelve patients (27.3%) underwent diagnostic angiography, 32 (72.2%) received interventional treatment, 22 (68.8%) received balloon angioplasty, and 10 (31.2%) required stent placement. RESULTS: Ten (31.3%) of the treated patients developed restenosis within 6 months. These patients had significantly higher levels of P selectin (P = .034), E selectin (P = .006), and VCAM (P = .050) at all time points. E selectin, VCAM, and monocyte chemoattractant protein 1 levels increased between 24 hours and 4 weeks after angiographic procedures, thus indicating that the angiographic procedure itself leads to activation and inflammation of the endothelium. CONCLUSIONS: This study emphasizes a meaningful role of the adhesion molecules E selectin, P selectin, and VCAM as interesting contributors to restenosis formation after percutaneous transluminal angioplasty.     

Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome

Background: Laparoscopic resection is not an established treatment for tumors of the pancreas. We report our preliminary experience with this innovative approach to pancreatic disease. Methods: Thirty two patients with pancreatic disease were included in the study on an intention-to-treat basis. The preoperative indications for surgery were as follows: neuroendocrine tumors (n=13), unspecified tumors (n=11), cysts (n=2), idiopathic thrombocytopenic purpura with ectopic spleen (n=2), annular pancreas (n=1), trauma (n=1), aneurysm of the splenic artery (n=1), and adenocarcinoma (n=1). Results: Enucleations (n=7) and distal pancreatectomy with (n=12) and without splenectomy (n=5) were performed. Three patients underwent laparoscopic exploration only. Four procedures (13%) were converted to an open technique. One resection was converted to a hand-assisted procedure. The mortality rate for patients undergoing laparoscopic resection was 8.3% (two of 24). Complications occurred after resection in nine of 24 procedures (38%). The median hospital stay was 5.5 days (range, 2–22). Postoperatively, opioid medication was given for a median of 2 days (range, 0–13). Conclusion: Resection of the pancreas can be performed safely via the laparoscopic approach with all the potential benefits to the patients of minimally invasive surgery.     

老年患者TASC C、D级髂股动脉闭塞的腔内治疗

目的探讨对泛大西洋协作组织(TASC)C、D级髂股动脉闭塞老年患者行腔内治疗的疗效。方法 104例老年TASC C、D级髂股动脉闭塞患者接受微创腔内介入手术,其中TASC C型73例、TASC D型31例,闭塞长度4.25~17.61cm,平均(13.46±1.24)cm。对腔内介入治疗的临床疗效、并发症、术后随访等情况进行分析。结果 94例成功开通闭塞动脉,技术成功率90.38%(94/104),其中单纯球囊扩张12例、联合支架植入92例。围手术期发生并发症8例,并发症发生率为7.69%(8/104),包括急性动脉血栓2例、穿刺处假性动脉瘤形成1例、心功能衰竭4例、对比剂肾病1例。术后7天踝肱指数由术前的0.32±0.12增至0.81±0.11(P0.01)。术后6个月、12个月各随访78例和53例患者,通畅率分别为88.46%(69/78)、81.13%(43/53)。结论对老年TASC C、D级髂股动脉闭塞患者,微创腔内介入治疗手术成功率高,并发症少,可取得满意的临床疗效。     

Benzoporphyrin Derivative Monacid Ring A (Verteporfin) Alone Has No Inhibitory Effect on Intimal Hyperplasia: In Vitro and In Vivo Results

ABSTRACT Benzoporphyrin derivative monoacid ring A (Verteporfin, BPD-MA), a photosensitizing drug, has been suggested as having inhibitory effects on smooth muscle cell (SMC) proliferation in rabbit aortic intimal injuries. The effect of BPD-MA on vascular SMCs in the absence of light stimulation in vitro and in vivo was studied using models of intimal hyperplasia. Human SMCs were incubated with BPDMA for 4 h in darkness. A small (20%) but significant decrease in viability (n = 42, p &lt; .05) was noted for BPD-MA concentrations above 15 mu g/mL. This was an all-or-none phenomenon with no further decrease in viability at higher concentrations. Treatment with BPD-MA was also carried out in vivo using a balloon injury model of intimal hyperplasia in rabbit aortas. Thirty-three rabbits were randomized into five groups and given intravenous BPD-MA (2 mg/kg) according to the following schedule: Group 1 (n = 8), BPD-MA 25 min prior to injury; Group 2 (n = 8), BPD-MA 25 min prior to injury plus a second dose 4 weeks later; Group 3 (n = 4), BPD-MA immediately postinjury; Group 4 (n = 7), BPD-MA immediately postinjury plus a second dose 4 weeks later; or Group 5 (n = 6), no drug (control group). No statistically significant difference was seen in the amount of intimal hyperplasia that developed in the five groups.     

Transthoracic Intra-aortic Balloon Pump in Open Heart Operations: Techniques and Outcome

Objective - During open heart surgery, direct transthoracic insertion of the intra-aortic balloon pump (IABP) is an alternative to the routine transfemoral insertion especially in the presence of severe peripheral vascular disease. Methods - Over 19 years (1980-1998), 646 patients were treated with IABP. In 24 of them, the balloon was inserted transthoracic (TIABP) due to failure of transfemoral insertion in 13 or extensive occlusive aorto-iliac disease in 11 cases. Results - Early mortality was 58.3% in patients having TIABP compared to 46.1% in patients with transfemoral IABP insertion (p &gt; 0.2). Of the 24 patients receiving IABP transthoracic, none suffered vascular injury (i.e. perforation or dissection). Complications which could be related to TIABP occurred in 10 patients: 3 balloon ruptures, 1 mediastinal haemorrhage, 3 cerebrovascular accidents, 1 post-operative mediastinitis, and 2 late graft infections. Conclusions - TIABP is a useful alternative when transfemoral insertion of IABP is not feasible or hazardous because of occluded or severely diseased ilio-femoral arteries. Being a second choice and a more invasive treatment, transthoracic IABP is associated with increased mortality.     

乳腺髓样癌的超声造影特征与病理对照

目的分析乳腺髓样癌的超声造影特征,并与病理学对照。方法回顾性分析13例乳腺髓样癌患者的超声造影形态学特征,比较造影前后肿块横径、肿块与周围乳腺正常组织的时间-强度曲线定量参数,并进行统计学分析。将超声造影表现与病理表现相对照。结果乳腺髓样癌超声造影显示肿块形态不规则、边界清晰、内部均匀增强分别为10、11、11例,与病理形态学特征相符合。造影前后肿块横径差异无统计学意义(P=0.61),与病理学膨胀性生长方式相符合。与周围乳腺正常组织相比,髓样癌造影剂到达时间和达峰时间显著提前(P=0.034、0.021),峰值强度显著提高(P=0.005),与病理学上病灶内血管密度增高且分布均匀、病灶周边有较大管径血管的特征相符合。结论乳腺髓样癌特征性的超声造影表现有其病理学依据,可作为临床超声诊断和鉴别诊断的依据。     

紫杉醇涂层球囊治疗股腘动脉支架内再狭窄与术后患者死亡的关系:Meta分析

目的采用Meta分析评价紫杉醇涂层球囊治疗股腘动脉支架内再狭窄(ISR)与术后患者死亡的关系。方法检索PubMed、Cochrane、EMbase、中国知网、维普数据库、万方医学网中自建库至2021年9月1日关于紫杉醇涂层球囊治疗股腘动脉ISR的随机对照试验,根据纳入和排除标准筛选文献。以RevMan 5.3软件进行Meta分析。结果共纳入4项研究、351例股腘动脉ISR患者;其中试验组(n=183)均接受紫杉醇涂层药物球囊、对照组(n=168)均接受普通球囊干预;术后随访0.5~26.0个月,平均(18.5±7.6)个月。异质性分析显示文献间无明显异质性,故采用固定效应模型进行分析。试验组总死亡率为4.92%(9/183),对照组为4.76%(8/168),差异无统计学意义,风险比(RR)为1.02[95%CI(0.41,2.52),P=0.96]。术后6个月内、6~12个月及12~24个月,试验组死亡率分别为2.90%(4/138)、2.33%(3/129)及2.70%(2/74),对照组分别为3.28%(4/122)、3.39%(4/118)及0(0/69),组间各时间段死亡率差异均无统计学意义,RR分别为0.88[95%CI(0.27,2.94),P=0.84]、0.71[95%CI(0.16,3.06),P=0.64]及4.73[95%CI(0.24,95.09),P=0.31]。结论紫杉醇涂层球囊治疗股腘动脉ISR与术后患者死亡未见明显关联。     

Impact of duloxetine on male fertility: A randomised controlled clinical trial

This study assessed the impact of duloxetine (serotonin and norepinephrine reuptake inhibitor) on semen parameters, sperm DNA fragmentation and serum hormones. We performed a double-blind, placebo-controlled, randomised clinical trial of duloxetine 60mg or placebo daily for 6 weeks (5 weeks full dose and 1 week taper). The primary outcome was the proportion of men with abnormal DNA fragmentation during and after duloxetine administration. Secondary outcomes were changes in semen parameters and hormones on treatment (2 and 6 weeks) and after discontinuation (8 and 10 weeks). Sixty-eight healthy males aged 18–65 were included. Duloxetine was not associated with an increase in the proportion of participants with abnormal sperm DNA fragmentation terminal deoxynucleotidyl transferase dUTP nick-end labelling scores (>25%) on treatment (p = 0.09) or after treatment (p = 0.56), nor did median sperm DNA fragmentation increase on treatment. Compared with placebo, there were no changes in bulk semen parameters during treatment. Limited changes in hormonal values were detected. This first published human study of a serotonin and norepinephrine reuptake inhibitor on male fertility revealed no clinically meaningful effects on sperm DNA fragmentation, semen parameters or serum hormones. Duloxetine, and possibly other serotonin and norepinephrine reuptake inhibitors, may be considered for men desiring fertility who require antidepressant treatment.     

Bridging a 30 mm defect in the canine ulnar nerve using vessel‐containing conduits with implantation of bone marrow stromal cells

Previously, we showed that undifferentiated bone marrow stromal cell (uBMSC) implantation and vessel insertion into a nerve conduit facilitated peripheral nerve regeneration in a rodent model. In this study, we investigated the efficacy of the uBMSC‐laden vessel‐containing conduit in repair of segmental nerve defects, using a canine model. Eight beagle dogs were used in this study. Thirty‐millimeter ulnar nerve defects were repaired with the conduits (right forelimbs, n = 8) or autografts (left forelimbs, n = 7). In the conduit group, the ulnar artery was inserted into the l‐lactide/ε‐caprolactone tube, which was filled with autologous uBMSCs obtained from the ilium. In the autograft group, the reversed nerve segments were sutured in situ. At 8 weeks, one dog with only nerve repair with the conduit was sacrificed and the regenerated nerve in the conduit underwent immunohistochemistry for investigation of the differentiation capability of the implanted uBMSCs. In the remaining seven dogs, the repaired nerves underwent electrophysiological examination at 12 and 24 weeks and morphometric measurements at 24 weeks. The wet weight of hypothenar muscles was measured at 24 weeks. At 8 weeks, almost 35% of the implanted uBMSCs expressed glial markers. At 12 weeks, amplitude (0.4 ± 0.4mV) and conduction velocity (18.9 ± 14.3m/s) were significantly lower in the conduit group than in the autograft group (3.2 ± 2.5 mV, 34.9 ± 12.1 m/s, P < 0.05). Although the nerve regeneration in the conduit group was inferior when compared with the autograft group at 24 weeks, there were no significant differences between both groups, regarding amplitude (10.9 ± 7.3 vs. 25.3 ± 20.1 mV; P = 0.11), conduction velocity (23.5 ± 8.7 vs 31.6 ± 20.0m/s; P = 0.35), myelinated axon number (7032 ± 4188 vs 7165 ± 1814; P = 0.94), diameter (1.73 ± 0.31 vs 2.09 ± 0.39μm; P = 0.09), or muscle weight (1.02 ± 0.40 vs 1.19 ± 0.26g; P = 0.36). In conclusion, this study showed that vessel‐containing tubes with uBMSC implantation may be an option for treatment of peripheral nerve injuries. However, further investigations are needed. © 2015 Wiley Periodicals, Inc. Microsurgery 36:316–324, 2016.     

改良式球囊血栓抽吸术治疗急性下肢深静脉血栓

目的探讨采用改良式球囊血栓抽吸术配合腘静脉入路深静脉置管溶栓治疗下肢深静脉血栓(DVT)的技术、方法和疗效。方法对76例DVT患者采用改良式球囊血栓抽吸术配合经皮腘静静脉穿刺深静脉置管溶栓治疗(治疗组),对137例急性期DVT患者采用患肢足背静脉溶栓方法治疗(对照组),比较两组患者的疗效。结果治疗组,76例患者的治疗效果满意,技术成功率100%,治疗前后血管周径差差异有统计学意义(t=2.91,P0.01),血管通畅率90.79%(69/76),并发症发生率15.79%(12/76);对照组治疗前后血管周径差差异有统计学意义(t=2.21,P=0.03),血管通畅率59.85%(82/137),并发症发生率24.82%(34/137)。结论采用改良式球囊血栓抽吸术联合腘静静脉入路深静脉置管溶栓技术治疗DVT是一种安全、有效的方法,且疗效满意。     

Semen analysis of Golden Retriever healthy dogs and those affected by muscular dystrophy

This study aimed to characterise canine flow cytometry semen analysis, as well as seminal reactive oxygen species dosage using the Golden Retriever breed as model of study. Moreover, we searched for the influence of muscular dystrophy in Golden Retriever dogs on semen parameters. Thirty‐seven semen samples were obtained from healthy Golden Retrievers (n = 15) and from muscular dystrophy affected dogs (n = 22). Sperm‐rich fractions were analysed by standardised breeding soundness examination in addition to the assay of fluorescence assisted cell sorting for acrosome integrity, mitochondrial activity and DNA fragmentation. Volume of ejaculate, per cent of motile spermatozoa and vigour were similar between groups; there were no differences in the per cent of minor and major defects. Integrity of acrosomal membrane, mitochondrial potential and sperm DNA fragmentation had no significant differences between groups either. Animals from control group had higher concentration of spontaneous seminal oxidative species in comparison with affected animals. Dogs affected by dystrophy had seminal parameters similar to those observed in healthy dogs except for the lower concentration of oxidative species. Future studies aiming to establish reference values for canine seminal parameters should be considered preferably with distinction of breeds.     

基于平扫MRI机器学习模型评估兔肝纤维化分期

目的观察基于平扫MRI的机器学习模型评估肝纤维分期的价值。方法随机将35只雄性大白兔分入实验组30只、对照组5只。实验组予颈部皮下注射四氯化碳与橄榄油1∶1混合溶液,建立肝纤维化模型,每周2次;对照组每周2次颈部皮下注射等量生理盐水;均注射10周。于注药后第5、6、7、10周末分批次采集腹部脂肪抑制T1WI(T1WI-FS);而后麻醉处死动物并取出肝脏,经HE及Masson染色后依据METAVIR评分系统将肝纤维化分为F0～4期。结合病理结果,依次于各期肝叶勾画感兴趣区(ROI)、提取纹理特征、选择特征;而后采用半监督学习(SSL)与主动学习(AL)相结合算法构建分类器模型,统计五期分类识别及两两分类识别评估肝纤维化分期的准确率。结果实验组造模过程中2只兔死亡,对照组全部存活。共对35只兔选取180个ROI,病理结果显示F0期32个、F1期37个、F2期33个、F3期54个、F4期24个。五期分类识别中,分类器模型对F0、1、2、3、4期评估准确率分别为87.50%(28/32)、40.54%(15/37)、66.6%(22/33)、64.81%(35/54)及37.50%(9/24),平均准确率60.56%(109/180)。两两分类识别中,分类器模型评估F0 vs F1～4、F0 vs F1～2、F0 vs F3～4、F1～2 vs F3～4、F0～2 vs F3～4的平均准确率分别为95.56%(172/180)、95.10%(97/102)、96.36%(106/110)、68.92%(102/148)及65.56%(118/180)。结论基于平扫MRI的SSL与AL相结合机器学习模型可有效评估兔模型肝纤维化分期。