人体四肢血管零应力状态的实验研究

血管在不受血压作用时，存在残余应力和残余应变。血管的零应力状态指它既不受外载，又没有内部残余应力的状态。先将血管切为短圆环，再将短圆环沿其径向剪开，即可释放其中的残余应力。剪开后的血管环迅速展开成“Ｃ”形，并逐渐趋于一个稳定状态，即零应力状态。零应力状态用其张开角来描述。本文研究了人体四肢主要动脉和静脉的零应力状态。结果表明，股动脉的零应力状态张开角在１１０°左右；而肱动脉、桡动脉、动脉和胫前动脉的零应力状态张开角在１３０°～１６０°之间；锁骨下动脉、髂动脉和胫后动脉的零应力状态张开角在８０°～１１０°之间。下肢静脉的零应力状态张开角明显比相应动脉分支的小。股静脉、静脉和胫后静脉的零应力状态张开角约在４０°～９０°之间；大隐静脉的零应力状态张开角较大，约是１５０°。     

狗主动脉的零应力状态

动脉中存在残余应变。先将血管沿轴线剪为短圆环，再将短圆环沿径向剪开，即可获得血管的零应力状态。血管的零应力状态常用张开角描述。本文研究了狗主动脉零应力状态张开角随位置的变化。结果显示，在主动脉升部，张开角为１２０°；到主动脉弓部，张开角降为９０°；在胸主动脉下部，张开角回升到１００°；在腹主动脉上，张开角又降为８０°。本文还将狗与猪、鼠主动脉零应力状态张开角的数据进行了比较，讨论了种属间的差异。     

实验性低血压大鼠动脉的生物力学特性

为了研究低血压状态下动脉重建后,动脉的生物力学特性的变化,在大鼠左肾动脉起点以下缩窄腹主动脉,建立实验性低血压大鼠模型,按不同的时相点,观察腹主动脉、股动脉和胫前动脉张开角的变化,并进行在体腹主动脉的压力－容积（P－V）关系实验。结果显示,低血压大鼠的动脉血压降低,导致动脉壁的非均匀性生长,表现为动脉零应力状态下张开角减小。低血压状态时,腹主动脉的C／E比值减小,顺应性增加。     

糖尿病大鼠腹主动脉零应力状态

目的：通过腹主动脉零应力状态的研究，探讨糖尿病，高血压大鼠血管力学特性重建的规律。方法：用链脲佐菌素（STZ）分别诱导SD和自发性高血压大鼠（SHR），建立伴有高血压的糖尿病（SHRDM）和不伴有高血压的糖尿病（SDDM）动物模型，利用生物显微镜和图像分析系统对其腹主动脉张开角进行观测。结果：（1）SD组大鼠主动脉张开角在病程1周到4周加大，其后缓慢减小，8周后趋于平衡。（2）SDDM组大鼠主动脉张开角1－4周急剧升高，4－8周急剧降低，16周后又急剧升高，8周，16周时SDDM小于SD（P＜0．05），4周和24周时SDDM大于SD（P＜0．01），（3）SHR张开角的变化趋势恰与SDDM相反，且在1周，8周，16周时大于SD（P＜0．01），而4周又小于SD（P＜0．05）。（4）SHRDM张开角的变化与SDDM趋势相似，但4周时小于SDDM（P＜0．01），8，16周时大于SDDM（P＜0．05），结论：糖尿病，高血压大鼠主动脉壁零应力状态异常，在病程早期两者的变化趋势相反，提示高血压和糖尿病大血管壁均存在明显的不均匀生长，但是不均匀性生长的方式不同。     

狗主动脉弓无载荷状态与零应力状态的实验研究

目的 通过测量计算狗主动脉弓无载荷状态和零应力状态的几何参数,研究狗主动脉弓无载荷状态和零应力状态的几何形态和残余应变分布.方法 实验解剖取出3只狗的胸主动脉弓试样,结合计算机图像测量技术,用统计学方法得到狗主动脉弓的几何形态,用弧长分析法研究狗主动脉弓残余应变.结果 拟合得到无载荷状态和零应力状态下的主动脉内、外边界,获取了血管的弧长、厚度、张开角等信息,得到主动脉弓几何特征和残余应变的分布规律.结论 主动脉弓部血管是内外边界为椭圆状的均匀厚壁筒;主动脉张开角不沿主动脉环向坐标变化,动脉壁内的残余应变是均匀的.     

血管零应力状态对脉搏波波速的影响

Womersley曾用受约束均匀弹性管模型分析动脉中的脉动血液流,由此得出了血流脉搏波波速随血管弹性、血液粘度、脉动频率、血管所受周围结缔组织约束等因素变化的特征。然而,近年来理论和实验研究发现血管存在一个非圆管的零应力状态。沿纵向剪开无载荷状态下的动脉血管环,血管将张开成扇形,以一次性释放所含有的残余应力。进一步的实验表明（Liu＆Fung,1988）零应力状态的展开角活动脉树发生规律性的变化。虽然在体平均压状态下的动脉管是均匀直圆管,其对应的零应力状态却是不均匀的。本文的目的是要分析血管零应力状态的上述不均匀…     

肝内型门脉高压症形成中大鼠门静脉零应力状态的变化

用CCl4注射法制备大鼠肝内型门脉高压模型，通过观察门静脉张开角的大小，研究肝内型门脉高压大鼠在模型建立过程中不同时间点门静脉零应力状态的变化。结果发现，在门脉高压症形成中．大鼠门静脉张开角逐渐增大，从CCl4注射第10周起与对照组相比有显著性差异（P〈0．05）。表明在门脉高压形成过程中，门静脉存在非均匀性生长，门脉高压大鼠门静脉的残余应力和应变大于正常大鼠。     

糖尿病大鼠腹主动脉零应力状态

用链脲佐菌素（streptozotocin,STZ）分别诱导SD和自发性高血压大鼠（SPontaneouslyhypertensiVerats,SHR）,建立伴有（SHRDM）和不伴有（SDDM）高血压的糖尿病动物模型,以SHR大鼠为高血压对照,以SD大鼠为正常的对照组,每组再分为1、4、8、16、24周5个时根点,每个时相点5只动物。利用生物显微镜和图像分析系统对其腹主动脉零应力状态进行研究。用血管的张开角表示其零应力状态。研究结果显示,SD主动脉张开角1周到4周有个急剧加大的过程,其后缓慢减小,至16周后又有所恢复。SDDM加大了SD的上升和下降两段趋势,8周,1…     

自发性高血压大鼠肾动脉的零应力状态

通过观察动脉主干张开角的大小,研究了自发性高血压大鼠（Ｓｐｏｎｔａｎｅｏｕｓｌｙ ｈｙｐｅｒｔｅｎｓｉｖｅ,ｒａｔ,ＳＨＲ）高血压建立后肾动脉零应力状态的变化,并于ＳＨＲ高血压形成前,分别给予口服型ＡｎｇⅡ Ⅰ型受体拮抗剂Ｌｏｓａｒｔａｎ和ＥＴ Ａ型受体拮抗剂ＢＭＳ－１８２８７４,研究内源性ＡｎｇⅡ和ＥＴ在ＳＨＲ肾动脉零应力状态变化中的作用。 现,在高血压已建立的ＳＨＲ,肾动脉主干张开角（１１４．     

犬冠状动脉的零应力状态

用计算机图像分析技术测量了6例杂种犬左、右冠状动脉主干全长的张开角以及时间对它们的影响.结果表明,冠状动脉主干的张开角范围在65°±12°至112°± 30°之间;张开角大小和动脉直径大小无关.冠状动脉零应力状态的观测应该在血管环切开20分钟后进行.冠状动脉在无载荷时存在残余应力,其无载荷状态不能作为血管力学特性分析的参考状态;血管的生理状态,在体是承载生理压力状态,离体即为零应力状态.在血管壁组织形态研究中,应考虑血管的残余应力,应该取血管的生理状态进行组织固定.     

Neonatal necrotizing enterocolitis. Occurrence secondary to thrombosis of abdominal aorta following umbilical arterial catheterization.

A patient had neonatal necrotizing enterocolitis (NNE), secondary to aortic thrombosis following umbilical arterial catheterization. The thrombus occluded the ostium of the inferior mesenteric artery. A review of cases reported in the literature with complications following umbilical arterial catheterization revealed four instances of NNE or NNE-like lesions due to thrombosis of the abdominal aorta or one of its major branches. Thrombosis of the aorta, with occlusion of one or more of its major abdominal branches following umbilical arterial catheterization, should be considered as a potential etiologic factor in certain cases of NNE.     

Extensive aortic thromboembolism due to acquired hypercoagulable state: an autopsy case report

Aortic thrombosis rarely occurs without severe atherosclerosis, aneurysm, or cardiosurgical or traumatic state. Arterial thrombosis is commonly related to an inherited and/or acquired hypercoagulable state. A 50-year-old woman presented with diffuse abdominal pain. One day after her admission, she experienced bloody stools. Computed tomography showed multiple extensive thromboses in the aorta and superior mesentery arteries. She underwent a partial jejunoileostomy and colectomy for extensive bowel infarction. Following surgery, her condition deteriorated and she died on the fourth hospital day. At autopsy, gross examination showed 2 large thrombi (7 and 8 cm in length) in the proximal and descending (thoracic) aorta, with mild atherosclerosis. A mesenteric artery thromboembolus with extensive bowel infarction was present. Postmortem laboratory studies revealed an elevated anticardiolipin immunoglobulin G antibody level. The thrombotic state in this patient was considered multifactorial secondary to acquired risk factors, including obesity, mild aortic atherosclerosis with coronary artery disease, and presence of a high titer anticardiolipin antibody.     

髂主动脉血栓后与正常髂主动脉血流动力学数值模拟对比分析

目的简化基于临床采集的增强CT图像数据进行人体腹主动脉及髂动脉真实三维解剖结构的过程,提高计算流体力学(CFD)计算结果的可靠性,并对比分析正常髂动脉和髂动脉血栓后血管内血流情况,为阐明动脉粥样硬化血栓的形成机制提供理论依据。方法患者A为40岁男性,腹主动脉及髂动脉正常;患者B为60岁女性,腹主动脉正常,但左髂主动脉部分血栓及左髂内动脉血栓。CT图像为医学数字成像与通信标准(DICOM)格式,层间距为0.5 mm,每片图像的平面分辨率为512×512,像素大小为0.5mm。应用医学后处理软件对通过临床采集的增强CT二维图像数据进行三维重构,然后在通用有限元分析软件ANSYS中转换成可用于数值计算的计算机辅助设计(CAD)模型并直接进行CFD模拟计算。结果通过计算可得到A、B研究对象在心动周期内不同时刻的血流动力学参数。B研究对象左和右髂动脉感兴趣区域的平均壁面切应力(0.576 6±0.009 0,3.260 2±0.032 0)明显区别于A研究对象左和右髂动脉感兴趣区域的平均壁面切应力(1.269 8±0.008 0,1.393 2±0.011 0)。结论通过CFD模拟方法的改进,得到更加接近生理解剖特征的血栓后不规则血管三维立体模型,并通过对比A、B研究对象的计算结果,分析了复杂的血流情况如低流速、低壁面切应力等现象与动脉粥样硬化血栓的形成机制存在一定的关系。     

正常大鼠不同动脉血管应力-应变分布的比较

通过充压实验和无载荷状态及零应力状态,我们研究了16只雄性大鼠的胸主动脉、腹主动脉、左颈总动脉、左股动脉和左肺动脉的形态学和应力－应变分布特征,并比较了不同血管间的差异。结果表明,血管的内外周长、管壁和管腔面积、管壁厚度、管壁厚度与内半径之比以及在不同压力负荷下血管外直径的变化,五条动脉之间有显著差异（P＜0.01）。展开角在肺动脉最大,而胸主动脉最小（P＜0.01）。残余应变绝对值和残余应变梯度在股动脉最大,而在胸主动脉最小（P＜0.01）。应力－应变关系分析证明,在周向上,股动脉最硬;在轴向上,胸主动脉最硬。而在这两个方向上,肺动脉最软。本实验表明,无论在形态学指数方面,还是在生物力学特征方面,五条动脉血管间都有显著差异。     

主动脉转流对腹主动脉阻断所致血液动力学等改变的影响

目的:探讨不同流量主动脉转流对腹主动脉暂时性阻断时全身血液动力学等改变的影响。方法:实验建立在小猪腹腔动脉开口以上阻断腹主动脉1h和同时应用辅助主动脉转流的模型,监测血液动力学的变化,并观察组织学的改变。结果:阻断组发生了明显的血液动力学紊乱,尿量明显减少,代谢性酸中毒也极为明显,肝、肾和小肠组织及超微结构均发生了明显的病变。在主动脉转流组血液动力学的紊乱得到明显改善。结论:腹主动脉阻断1h将造成严重的全身血液动力学紊乱,当转流量达到原腹主动脉血流量的70%时主动脉转流能较好地防止这一损伤改变。     

牙髓牙本质复合体中VIP阳性神经纤维的研究

目的:研究血管活性肠肽(VIP)在牙髓牙本质复合体中的表达,探讨其功能。方法:收集人前磨牙,石蜡包埋切片,作免疫组织化学和图象定量分析。结果:VIP阳性神经纤维自根尖孔呈束状进入牙髓,至颈部扇形分开,在冠髓大量分支,部分围绕在血管周围,部分终止于牙髓基质,部分参与形成成牙本质细胞层下Raschkow神经丛,然后发出分支伸入成牙本质细胞层和前期牙本质,但不进入成熟牙本质。VIP阳性神经纤维在冠髓的积分光密度为12.74±1.807,体密度为0.0192±0.0127,线密度为0.0046±0.0029,在前期牙本质的积分光密度为13.07±1.927,线段长度为(19.60±8.597)mm。结论:VIP阳性神经纤维存在于人牙髓牙本质复合体,部分纤维围绕血管,部分纤维止于牙髓基质和前期牙本质,这种分布提示该纤维除与血管运动有关外,可能还与感觉有关,在痛觉传导、血管调节等方面发挥重要作用。     

Umbilical artery catheterization complicated by multiple mycotic aortic aneurysms

A premature infant had three pseudoaneurysms of the thoracic and abdominal aorta secondary to umbilical artery catheterization and sepsis. The infant had septicemia as the direct result of bacterial contamination of an umbilical artery catheter with Staphylococcus aureus. The thoracic pseudoaneurysm caused massive hemothorax and the infant's death. The upper abdominal aortic aneurysm developed at the level of the renal arteries and caused decreased left renal blood flow and renal hypoplasia. The lower abdominal aneurysm involved the right iliac artery and was complicated by mural thrombosis and ischemia of the right leg. To our knowledge, this is the first published case of multiple mycotic aortic aneurysms after umbilical artery catheterization.     

Anterior retroperitoneal rami: Until now unnamed direct branches of the abdominal aorta

The aim of the study was to gain a thorough knowledge of the topography and distribution of until now officially unnamed minute direct branches from abdominal aorta, stemming from its ventral and lateral aspects, supplying surrounding tissue, and to comprise it to the existing studies. The study was performed in fixed cadaverous material collected from India ink injections of abdominal aorta samples with large surrounding retroperitoneal tissue. The 25 samples were dissected under magnifying binocular glass, followed by graphic reconstruction; statistical analysis, and the study was preceded with detailed review of branches from abdominal aorta. For systematization of the segmental anatomy of the abdominal aorta and infrarenal segment of inferior vena cava, we defined three levels in this area. The retroperitoneal branches were most frequently situated simultaneously within all three predefined levels according to renal and inferior mesenteric arteries origin. There were 18% of retroperitoneal branches within Level 1, 39% within Level 2 and 43% within Level 3. They were branches not only from the abdominal aorta, but also from the testicular/ovarian artery, common iliac artery and in one case from the right accessory renal artery. Paired arrangement was recorded mainly cranially to the origin of inferior mesenteric artery, unpaired branches were more frequently found caudally. In conclusion, due to the terminological disunity of these arteries in the clinical literature and total absence in the anatomical literature, we propose to denominate them as anterior retroperitoneal branches of abdominal aorta (rami retroperitoneales anteriores aortae abdominalis). Clin. Anat. 27:894–899, 2014. © 2014 Wiley Periodicals, Inc.     

Effect of remote aortic injury and thrombosis on cholesterol atherosclerosis

Recent tissue culture studies indicate that platelet factors enhance lipoproteins to stimulate proliferation of smooth muscle cells, a key event in atherogenesis. It was of interest to determine if continued remote aortic injury and thrombosis can increase the severity of hypercholesterolemia induced atherosclerosis. Four groups of rabbits were studied, two groups fed 0.5 g cholesterol per day, one group with and one group without massive abdominal aortic white mural non-occlusive thrombosis and injury induced with a permanent indwelling catheter, and two groups fed 1 g cholesterol per day, one group with and one group without similar thrombosis and injury. Serum lipids in the four groups were qualitatively and quantitatively not significantly different from each other at 4, 8, and 12 weeks. When they were sacrificed at 12 weeks the percent intimal surface area in the thoracic aorta (48 ± 22) and arch (75 ± 28) of the rabbits with thrombosis and fed 0.5 g cholesterol per day was significantly (p < 0.01) greater than the percent intimal area (20 ± 14) and (24 ± 18) of the rabbits without thrombosis. The percent intimal area with lesions in the rabbits fed 1 g cholesterol per day with thrombosis (59 ± 25) and (84 ± 30) was significantly greater (p < 0.01) than the percent area (24 ± 29) and (32 ± 32) of the rabbits without thrombosis. Since the effects could not be attributed to differing serum lipid levels it is possible that the increased severity of atherosclerosis in the remote arch and thoracic aorta was related to increased permeability, cell proliferation or collagen synthesis possibly stimulated by circulating factors released from the remote massive non-occlusive thrombus or from circulating platelets activated by contact with the injured abdominal aortic wall.