不对称入口速度剖面对颈动脉分叉模型不定常流场和壁面切应力的影响

目的研究不对称入口速度剖面对动脉粥样硬化易发部位壁面切应力的影响。方法建立颈动脉TF-AHCB数值模型,设置不对称速度剖面入口条件,用CFD作数值模拟。计算不同时相、不同入口条件下的颈动脉窦流场和壁面切应力分布,分析与动脉粥样硬化有关的流场特征和切应力特征。结果入口速度剖面偏斜可以增加颈动脉窦壁面低切应力区面积,提高切应力梯度。结论不对称入口速度剖面可能是诱发动脉粥样硬化发生的一个危险因子。     

血管壁弹性模量对颈动脉狭窄血流储备分数的影响

目的探索将血流储备分数(fractional flow reserve,FFR)引入颈动脉狭窄评估的可行性,并且分析血管壁弹性模量对颈动脉狭窄中血液动力学参数和FFR计算结果的影响。方法利用计算机辅助设计软件建立颈动脉分叉标准模型并获得不同狭窄率的模型。假设血管壁为线弹性材料,血液为不可压缩牛顿流体,在脉动流条件下,利用有限元分析软件进行颈动脉狭窄模型中血液流动的流固耦数值模拟,获得各种血液动力学参数,并计算相应的FFR值。结果当弹性模量固定时,随着狭窄率增加,模型中狭窄部位的FFR逐渐减小,且此时其弹性壁与刚性壁的FFR相对差异随着狭窄率的增加而增加;当狭窄率固定为70%时,随着弹性模量增加,FFR会逐渐减小。结论采用FFR对颈动脉狭窄程度进行功能性评估需要考虑血管壁弹性的影响;狭窄率越大,血管壁弹性模量对FFR的影响越大。     

药物洗脱支架高度对药物浓度和壁面切应力分布影响的数值分析

目的研究药物洗脱支架(drug-eluting stent,DES)突起高度对药物释放动力学和血流动力学的影响,为DES的优化设计提供依据。方法采用计算流体动力学(computational fluid dynamics,CFD)方法,对血流动力学和药物释放动力学进行耦合分析,考虑3种不同突起高度支架,研究血管壁组织中药物含量和壁面切应力的分布。结果支架突起高度的增加将有利于药物的沉积,但将增加低切应力区长度。比较而言,血管壁中药物含量随着突起高度增加的幅度远小于低切应力区长度的增加。结论综合考虑药物浓度和壁面切应力两种因素,建议适当降低支架的突起高度,以便更有效地降低再狭窄产生的几率。     

磁场对人体三维分叉颈动脉血液流动的影响规律

目的 通过CT影像重构三维血管模型,研究外加均匀磁场对血液动力学行为的影响规律。方法 采用计算流体动力学理论和磁流体力学方法,建立体外均匀磁场对血液流动影响的数学模型,运用多物理场耦合模拟软件COMSOL Multiphysics进行仿真模拟,探究磁场强度对血液流动速度、压力和剪切应力的影响。结果 随着磁场强度的增加,血管中心处的流速受到了更加显著的抑制。壁面压力随着磁场强度的增加而减小,且磁场在血流分叉前对壁面处压力的影响明显,而在血流分叉后对壁面压力的影响减弱。血流进入分支血管后,壁面切应力显著增加,同时磁场对切应力的影响也显著增强。结论 人体血液具有磁流体力学特性,一定强度范围的磁场对血液流动产生了明显的影响。研究结果为设计人造强磁场设备、评估人造磁场环境对人体血液动力学的影响以及诊断人造磁场环境产生的疾病提供理论依据。     

壁面厚度对一体化小腿假肢应力分布的影响

一体化假肢是以聚合物为材料从接受腔到假腿一体成型的新型下肢假肢 ,它比传统型假肢更经济、美观、轻便 ,具有较大的应用前景。如同传统假肢 ,应力分析对于一体化假肢的构型设计和优化具有重要的意义。由于假肢中的应力大小及分布与其所用材料的力学特性密切相关。本文的工作是基于一实验用内骨架一体化小腿假肢的真实几何构型 ,考虑残端软组织和骨 ,建立一体化小腿假肢的三维有限元模型 ;在保持假肢的几何形状不变的前提下 ,建立三个不同壁面厚度的一体化小腿假肢的三维模型 ,应用有限元分析方法 ,计算这些模型在模拟 Heel Off步态时相的载荷作用下的应力分布 ,分析壁面厚度对一体化小腿假肢应力分布的影响 ,为一体化小腿假肢壁面厚度的设计标准提供参考。结果表明 ,可以通过适当增加壁面厚度来减小一体化假肢的应力及软组织表面的压力。     

不同型式流体切应力对血管内皮细胞生理生化的影响

血管内皮细胞经常处于血液流动力的作用下 ,它能感知血流力的变化 ,在调节血管的功能和结构中起着重要作用。血液流动力的变化与某些血管性疾病的发生发展有着密切的关系 ,因此血液流动力对内皮细胞的影响受到广泛关注。本文就流体切应力对内皮细胞生理、生化影响的研究进展作一简要综述。     

不同型式流体切应力对血管内皮细胞生理生化的影响

血管内皮细胞经常处于血液流动力的作用下,它能感知血流力的变化,在调节血管的功能和结构中起状重要作用。血液流动力的变化与某些血客性疾病的发生发展有着密切的关系,因此血液流动力对内皮细胞的影响受到广泛关注。本文就流体切应力对内皮细胞生理、生化影响的研究进展作一简要综述。     

不同材质斑块的狭窄颈动脉模型中新型锌合金支架的支撑性能研究

目的研究在不同斑块类型的理想化狭窄颈动脉模型中新型锌合金支架的受力变形情况,为新型锌合金支架的设计与应用提供科学的参考意见。方法运用Pro/E三维建模软件构建理想化的50%狭窄率血管模型和一种I型连接筋血管支架;利用ABAQUS有限元分析软件,模拟支架受相同位移扩张条件作用下分别在钙化和非钙化斑块的理想化狭窄血管中的扩张过程。通过计算支架狗骨头率和残余狭窄率评估支架的支撑性能。结果在斑块材料属性分别为钙化和非钙化的模型中,支架扩张阶段的最大应力分别为433.4 MPa、432.4 MPa,回弹阶段的最大应力值分别为266.1 MPa、259.4 MPa;支架狗骨头率分别为44.5%、33.3%,血管残余狭窄率为40.8%、30.2%。结论支架在扩张过程中受到的von Mises应力都小于材料的应力强度极限,且血管狭窄率都有明显的下降。对于两种斑块类型的狭窄血管,新型锌合金支架都起到了一定的支撑作用。     

磨牙根分叉病变对固定义齿应力分布的影响

目的：研究磨牙根分叉病变对固定桥应力大小分布的影响。方法：采取CT平描的方法获得健康年轻人下颌牙及其周围组织的二维数据．通过计算机三维重建技术生成下颌第二前磨牙缺失的双端三单位固定义齿的有限元数学模型,在同等水平向载荷和垂直向载荷下分析了磨牙根分叉病变对固定桥应力大小分布的影响。结果：当磨牙根分叉区牙槽骨无吸收时,固定桥双侧两基牙应力大小分布均匀;当磨牙端根分叉区牙槽骨吸收达30％,前磨牙端牙槽骨无病变时,磨牙端根分叉区表现为应力集中;当前磨牙端和磨牙端根分叉区牙槽骨同时吸收达10％时,固定桥两侧基牙均表现为应力集中。结论：磨牙根分叉病变对固定义齿应力分布的影响较为明显,尤其是与前磨牙端基牙牙槽骨同时吸收时对基牙应力分布的影响最大。     

固定器刚度对不同类型骨折愈合的影响

目的 系统探讨固定器刚度变化（0.05~7.50 kN/mm）对AO/OTA分型下7种不同类型骨折（A1：简单螺旋、A2：简单斜形、A3：简单横形、B2：楔形螺旋形、B3：楔形碎片形、C2：复杂多段、C3：复杂不规则）愈合效果的影响。方法 以长骨骨折髓内钉固定为研究对象,基于应变调控组织分化理论,结合模糊逻辑控制算法和有限元分析技术,数值模拟骨折愈合过程。结果 中等固定器刚度（1.5~2.5 kN/mm）可以在保证骨折生物力学性能恢复的情况下缩短愈合时间。但是,每种骨折类型对应的适宜刚度不尽相同,且其愈合效果对固定器刚度变化的敏感度不一。对于A型骨折,当固定器刚度为1.5 kN/mm时,骨折断端生物力学性能恢复最佳,并且固定器刚度变化对愈合效果影响较大;对于B、C型骨折,当固定器刚度在1.5 kN/mm以上时,刚度变化对生物力学性能恢复没有显著影响。结论 骨折愈合效果受固定器刚度和骨折类型的共同影响。在临床骨折治疗中,固定器的选用应充分考虑骨折类型。     

In vitro measurements of velocity and wall shear stress in a novel sequential anastomotic graft design model under pulsatile flow conditions

This study documents the superior hemodynamics of a novel coupled sequential anastomoses (SQA) graft design in comparison with the routine conventional end-to-side (ETS) anastomoses in coronary artery bypass grafts (CABG). The flow fields inside three polydimethylsiloxane (PDMS) models of coronary artery bypass grafts, including the coupled SQA graft design, a conventional ETS anastomosis, and a parallel side-to-side (STS) anastomosis, are investigated under pulsatile flow conditions using particle image velocimetry (PIV). The velocity field and distributions of wall shear stress (WSS) in the models are studied and compared with each other. The measurement results and WSS distributions, computed from the near wall velocity gradients reveal that the novel coupled SQA design provides: (i) a uniform and smooth flow at its ETS anastomosis, without any stagnation point on the artery bed and vortex formation in the heel region of the ETS anastomosis within the coronary artery; (ii) more favorable WSS distribution; and (iii) a spare route for the blood flow to the coronary artery, to avoid re-operation in case of re-stenosis in either of the anastomoses. This in vitro investigation complements the previous computational studies of blood flow in this coupled SQA design, and is another necessary step taken toward the clinical application of this novel design. At this point and prior to the clinical adoption of this novel design, in vivo animal trials are warranted, in order to investigate the biological effects and overall performance of this anastomotic configuration in vivo.     

支架参数对血管壁面剪切应力的影响

目的研究不同支架参数对血管壁面再狭窄的影响,为设计支架形式提供参考和依据。方法根据支柱的螺纹节距、支柱数目、支柱线径、支架突入流域深度、支柱截面形状对支架进行分组,利用三维计算流体动力学(computational fluid dynamics,CFD)模拟方法研究各个参数的不同设置对血管壁面剪切应力分布的影响。结果支架的支柱线径对壁面剪切应力影响最为显著,并且支架参数中节距变短、支柱数目增加、线径变宽、突入流域深度增加会导致壁面低剪切应力区域面积增加;相对于三角形与正方形截面形状,圆形截面支架导致的低剪切应力区域面积更少。结论支架在设计过程中应采用圆形截面,而且应尽可能缩小线径,增长节距,减少支柱数目,减小突入流域深度。     

振荡流动对组织工程用灌注式生物 反应器中剪切力分布影响

目的 考察振荡流动以及三维支架孔径和孔隙率对生物反应器内流速和剪切力分布的影响,并根据理论计算结果为脱细胞骨三维支架和灌注式生物反应器制备提出优化方法。方法 针对实验室前期制备的骨组织工程用脱细胞骨三维支架和灌注式生物反应器,将脱细胞骨三维支架简化为各向同性的多孔介质,对生物反应器内的流速和剪切力分布进行理论建模。结果 振荡流作用时,多孔支架材料内速度和达西剪切力呈现一致的变化规律,不同半径处流速和达西剪切力差异减小,有利于在骨组织工程中对种子细胞进行均匀三维培养。提高入口灌流速度可提高平均达西剪切力;增加多孔支架孔径或孔隙率对支架内流速峰值影响不大,但会显著降低平均达西剪切力;提高入口振荡流动振荡频率可降低支架内流速最大峰值,显著减小不同半径处流速的差异。结论 适宜的振荡流易产生利于骨组织工程干细胞所需剪切力,研究结果有望为优化骨组织工程中种子细胞的三维培养方法提供理论指导。     

The effect of inlet velocity profile on the bifurcation COPD airway flow

The effect of inlet velocity profile on the flow features in obstructed airways is investigated in this study. In reality, the inlet velocity distributions on such models, which are extracted from medial branches of natural human lung, should be neither uniform, nor symmetric parabolic, but skewed-parabolic due to having been skewed by the upper carina ridges. Four different three-dimensional three-generation models based on the 23 generations model of Weibel have been considered, respectively. The fully three-dimensional incompressible laminar Navier-Stokes equations and continuity equation have been solved using CFD solver on unstructured tetrahedral meshes. To reduce the complexity of the simulations, only one Reynolds number of 900 was used in this calculation. Four types of inlet boundary conditions, namely uniform, parabolic, positive-skewed parabolic (skewed to the positive x-direction), and negative-skewed parabolic, were imposed on the obstructed airway models, which were considered to be obstructed at either the second generation or the third generation airways, respectively. The results show that the inlet velocity profile has significant influence on the flow patterns, mass distributions, and pressure drops in either the symmetric model, or the three obstructed models. The three generation airways may not be enough to study the bifurcation flow in chronic obstructive pulmonary disease (COPD) airways, and a four-generation or more airway model is necessary to get better predictive results.     

高血压与低切应力对大鼠颈总动脉血管重建的影响

目的研究高血压与低切应力对血管重建的影响及其机制,这对于阐明血管疾病的发病机理以及提供诊断、治疗的一些基本原理都将有重要的理论和实际意义。方法通过腹主动脉缩窄,结扎左颈总动脉的部分分支建立高血压、左颈总动脉低切应力以及高血压伴有低切应力大鼠动物模型。几何形态学方法观测左颈总动脉的壁厚及壁厚/内径比的变化;金属蛋白酶谱法分析MMP-2活性;免疫印迹法检测信号通路分子p-Akt分子以及Rho GDIα的表达变化。结果高血压和低切应力均可诱导颈总动脉MMP-2活性和壁厚及壁厚/内径比显著增加;当高血压伴有低切应力时,两者的协同作用诱导颈总动脉MMP-2活性和壁厚及壁厚/内径比进一步增加,从而促进血管重建。低切应力可诱导颈总动脉p-Akt的表达水平,且与低切应力大小相关,切应力低,p-Akt的表达水平高。当高血压伴有低切应力时,两者的协同作用诱导p-Akt的表达水平进一步增加。高血压和低切应力可诱导颈总动脉RhoGDIα表达增加;当高血压伴有低切应力时,两者的协同作用诱导颈总动脉Rho GDIα表达进一步增加。结论高血压与切应力协同作用对血管重建的影响最为显著,Akt和Rho GDIα信号通路参与了高血压与低切应力诱导的血管重建过程。     

Effects of shear stress on endothelial cells: go with the flow

Haemodynamic forces influence the functional properties of vascular endothelium. Endothelial cells (ECs) have a variety of receptors, which sense flow and transmit mechanical signals through mechanosensitive signalling pathways to recipient molecules that lead to phenotypic and functional changes. Arterial architecture varies greatly exhibiting bifurcations, branch points and curved regions, which are exposed to various flow patterns. Clinical studies showed that atherosclerotic plaques develop preferentially at arterial branches and curvatures, that is in the regions exposed to disturbed flow and shear stress. In the atheroprone regions, the endothelium has a proinflammatory phenotype associated with low nitric oxide production, reduced barrier function and increased proadhesive, procoagulant and proproliferative properties. Atheroresistant regions are exposed to laminar flow and high shear stress that induce prosurvival antioxidant signals and maintain the quiescent phenotype in ECs. Indeed, various flow patterns contribute to phenotypic and functional heterogeneity of arterial endothelium whose response to proatherogenic stimuli is differentiated. This may explain the preferential development of endothelial dysfunction in arterial sites with disturbed flow.     

Blood flow rate and wall shear stress in seven major cephalic arteries of humans

Blood flow rate () in relation to arterial lumen radius (r_i) is commonly modelled according to theoretical equations and paradigms, including Murray’s Law ( ∝ ) and da Vinci’s Rule ( ∝ ). Wall shear stress (τ) is independent of r_i with Murray’s Law (τ ∝ ) and decreases with da Vinci’s Rule (τ ∝ ). These paradigms are tested empirically with a meta-analysis of the relationships between and r_i in seven major arteries of the human cephalic circulation from 19 imaging studies in which both variables were presented. The analysis shows that ∝ and τ ∝ , more consistent with da Vinci’s Rule than Murray’s Law. This meta-analysis provides standard values for , r_i and τ in the human cephalic arteries that may be a useful baseline in future investigations. On average, the paired internal carotid arteries supply 75%, and the vertebral arteries supply 25%, of total brain blood flow. The internal carotid arteries contribute blood entirely to the anterior and middle cerebral arteries and also partly to the posterior cerebral arteries via the posterior communicating arteries of the circle of Willis. On average, the internal carotid arteries provide 88% of the blood flow to the cerebrum and the vertebral arteries only 12%.     

Distribution of shear stress over smooth muscle cells in deformable arterial wall

A biphasic, anisotropic model of the deformable aortic wall in combination with computational fluid dynamics is used to investigate the variation of shear stress over smooth muscle cells (SMCs) with transmural pressure. The media layer is modeled as a porous medium consisting of SMCs and a homogeneous porous medium of interstitial fluid and elastin, collagen and proteoglycans fibers. Interstitial fluid enters the media through fenestral pores, which are distributed over the internal elastic lamina (IEL). The IEL is considered as an impermeable barrier to fluid flow except at fenestral pores. The thickness and the radius of aortic wall vary with transmural pressure ranging from 10 to 180 mm Hg. It is assumed that SMCs are cylinders with a circular cross section at 0 mm Hg. As the transmural pressure increases, SMCs elongate with simultaneous change of cross sectional shape into ellipse according to the strain field in the media. Results demonstrate that the variation of shear stress within the media layer is significantly dependent on the configuration and cross sectional shape of SMCs. In the staggered array of SMCs, the shear stress over the first SMC nearest to the IEL is about 2.2 times lower than that of the square array. The shear stress even over the second nearest SMC to the IEL is considerably higher (about 15%) in the staggered array. In addition to configuration and cross sectional shape of SMCs, the variation of structural properties of the media layer with pressure and the sensitivity of the local shear stress to the minimum distance between SMCs and the IEL (reducing with transmural pressure) between SMCs and the IEL are studied. At 180 mm Hg, the ratio of the local shear stress of the nearest SMC to that of the second nearest SMC is 4.8 in the square array, whereas it reduces to about 1.8 in the staggered array. The importance of the fluid shear stress is associated with its role in the biomolecular state of smooth muscle cells bearing the shear stress.     

增强型体外反搏对早期动脉粥样硬化斑块局部应力环境影响的实验与仿真研究

采用动物实验与数值仿真相结合的方法,研究增强型体外反搏（EECP）对发生早期粥样硬化斑块动脉的局部应力水平的影响,评价临床中该疗法增加粥样硬化斑块失稳的风险。首先以35月龄左右雄性猪2头为实验体,进行反搏前后状态的基础血流动力学在体测量,反搏压介于0.025～0.04MPa;进而建立血流动力学数值仿真模型,模拟斑块出现及生长过程中,EECP对其局部应力水平及应力震荡特性的影响。模拟计算结果显示,EECP使动脉的应力水平及应力震荡特性均有显著增加;早期小规模斑块的存在令局部应力水平进一步提升,但将降低应力的震荡水平。EECP使两实验体的动脉内压峰值水平最高提升10.62%及16.18%,此时若动脉存在斑块（H=0.2D）,其局部壁面切应力（WSS）峰值水平将分别提高135.54%及235.71%,震荡剪切指数（OSI）达到0.083及0.069。由于反搏产生的高舒张压明显提升了斑块的局部应力水平,同时反搏的“双脉冲”作用模式使动脉的OSI水平大幅增加,我们推测其慢性作用可能会促进斑块本身疲劳的进程,从而对斑块的稳定性产生不利影响;但EECP对心动周期里壁面切应力水平的提升可能对斑块本身的发展具有抑制作用。