High-energy extracorporeal shockwave therapy in a patellar tendon animal model: a vascularization focused study

OBJECTIVE:

The aim of this study was to analyze the effect of high-energy extracorporeal shockwave therapy on tendon angiogenesis in the patellar tendons of rabbits. We sought to investigate whether different voltage and number pulses modify the angiogenesis pattern.

INTRODUCTION:

High-energy extracorporeal shockwave therapy is an option in the treatment of orthopedic diseases such as chronic tendonitis. Despite its potential clinical applicability, there have been few studies on this technique that examine both its clinical effectiveness and its effect on angiogenesis.

METHODS:

High-energy extracorporeal shockwave therapy was applied at the tibial insertion of the left patellar ligament in 30 rabbits that were separated into six groups that differed in terms of the voltage and number of pulses that were applied by high-energy extracorporeal shockwave therapy. The tibial insertion in the right legs of the animals was used as the control. After six weeks, we performed histological analysis on the region and quantified the number of blood vessels.

RESULTS:

No significant differences in the number of blood vessels between the left and right patellar tendons were found within groups. Additionally, no significant differences in the number of blood vessels in the left patellar tendons were found between groups.

CONCLUSIONS:

The application of high-energy extracorporeal shockwave therapy did not cause a change in vascularization in the patellar tendon in rabbits.     

Adrenomedulline improves ischemic left colonic anastomotic healing in an experimental rodent model

BACKGROUND:

Leakage from colonic anastomosis is a major complication causing increased mortality and morbidity. Ischemia is a well-known cause of this event. This study was designed to investigate the effects of adrenomedullin on the healing of ischemic colon anastomosis in a rat model.

METHODS

Standardized left colon resection 3 cm above the peritoneal reflection and colonic anastomosis were performed in 40 Wistar rats that were divided into four groups. To mimic ischemia, the mesocolon was ligated 2 cm from either side of the anastomosis in all of the groups. The control groups (1 and 2) received no further treatment. The experimental groups (3 and 4) received adrenomedullin treatment. Adrenomedullin therapy was started in the perioperative period in group 3 and 4 rats (the therapeutic groups). Group 1 and group 3 rats were sacrificed on postoperative day 3. Group 2 and group 4 rats were sacrificed on postoperative day 7. After careful relaparotomy, bursting pressure, hydroxyproline, malondialdehyde, interleukin 6, nitric oxide, vascular endothelial growth factor, and tumor necrosis factor alpha levels were measured. Histopathological characteristics of the anastomosis were analyzed.

RESULTS

The group 3 animals had a significantly higher bursting pressure than group 1 (p<0.05). Hydroxyproline levels in group 1 were significantly lower than in group 3 (p<0.05). The mean bursting pressure was significantly different between group 2 and group 4 (p<0.05). Hydroxyproline levels in groups 3 and 4 were significantly increased by adrenomedullin therapy relative to the control groups (p<0.05). When all groups were compared, malondialdehyde and nitric oxide were significantly lower in the control groups (p<0.05). When vascular endothelial growth factor levels were compared, no statistically significant difference between groups was observed. Interleukin 6 and tumor necrosis factor alpha were significantly decreased by adrenomedullin therapy (p<0.05). The healing parameters and inflammatory changes (e.g., granulocytic cell infiltration, necrosis, and exudate) were significantly different among all groups (p<0.05).

CONCLUSION

Adrenomedullin had positive effects on histopathologic anastomotic healing in this experimental model of ischemic colon anastomosis.     

Early ovarian cancer: 3-D power Doppler

Transvaginal sonography plays an important role in the assessment of the morphology of ovarian lesions. However, the accuracy of the technique is limited due to the significant number of false-positive results. Color Doppler imaging and pulsed Doppler spectral analysis enable evaluation of ovarian tumor blood flow, analysis of the distribution of blood vessels, and quantitative measurement of blood flow velocity waveforms. These parameters increase the sensitivity and specificity of ultrasound evaluation of ovarian tumors. Unfortunately, there is no consensus as to which Doppler parameters and cutoff values are the most predictive of malignancy. Three-dimensional (3-D) power Doppler ultrasound provides a new tool to evaluate features of tumor vascularity. Three-dimensional ultrasound and 3-D power Doppler imaging in patients with “positive” findings on standard ultrasound tests, which encompass annual gray-scale transvaginal sonography followed by transvaginal color Doppler ultrasound in selected cases, represent a novel approach for early and accurate detection of ovarian cancer through screening. Combined evaluations of morphology and neovascularity by 3-D power Doppler ultrasound may improve early detection of ovarian carcinoma. Contrast-enhanced 3-D power Doppler sonography facilitates visualization of adnexal tumor vessels, which may aid in differentiating benign from malignant adnexal lesions.     

内皮祖细胞移植治疗慢性深静脉血栓形成的实验研究

目的 研究内皮祖细胞(endothelial progenitor cells,EPCs)移植对慢性深静脉血栓的治疗作用. 方法 Ficoll法分离大鼠骨髓单个核细胞(bone marrow-derived mononuclear cells,BMMNCs),采用内皮祖细胞培养基(EGM-2MV)诱导分化为骨髓源性EPCs.建立大鼠慢性深静脉血栓模型,饲养至10 d,并分三组:A组(25只):单纯EPCs组,移植1 ml含有10~6 个EPCs细胞悬液;B组(25只):EGM-2MV培养基对照组,移植1 ml EGM-2MV培养基;C组(25只):空白对照组.移植后第14天取出血栓段下腔静脉及血栓,应用HE染色及vWF免疫组化染色观察血栓机化再通情况,高倍镜下计数血栓内毛细血管数目;Western blot检测血管内皮生长凶子(VEGF)、碱性成纤维细胞生长因子(bFGF)的蛋白表达变化;实验数据采用SPSS13.0软件进行分析.结果 体外成功培养了骨髓源性EPCs和构建了大鼠慢性深静脉血栓模型,EPCs移植后A组VEGF、bFGF的表达有明显的上调(P＜0.05).B组和C组之间差异无统计学意义(P＞0.05).移植后A组血栓再通毛细血管数目明显高于B、C组.免疫组化染色vWF确定再通管道为新牛血管,管道为内皮细胞组成.结论 EPCs为内皮细胞的前体细胞,移植到深静脉血栓中能够促进血管新生,加快血栓的机化和再通.     

胃癌组织中Cox-2的表达与肿瘤血管生成及周围静脉血微转移的关系

目的 研究胃癌组织中Cox-2的表达及其与肿瘤血管生成和周围静脉血微转移的关系.方法 用免疫组织化学法检测42例胃癌组织中Cox-2的表达和微血管密度(MVD),用巢式RT-PCR法检测胃癌病人外周血癌细胞微转移.结果 本组有24例胃癌组织中Cox-2表达阳性.Cox-2阳性肿瘤的MVD计数显著大于Cox-2阴性者(P＜0.01).有13例周围静脉血中CK19mRNA表达阳性.Cox-2阳性胃癌病人外周血微转移阳性率显著高于Cox-2阴性者(P＜0.05).结论 胃癌组织中Cox-2表达的增加与胃癌组织血管化程度及周围静脉血微转移密切相关.     

引导骨再生技术对血管化组织工程骨修复兔股骨缺损过程中骨形态发生蛋白-2成骨及表达的影响

目的 探讨引导骨再生(GBR)技术对血管化组织工程骨修复兔股骨缺损过程中局部骨形态发生蛋白-2(BMP-2)的成骨量及表达的影响,以明确GBR技术在血管化组织工程骨应用中的作用. 方法 将兔自体骨髓基质干细胞经诱导后与β-磷酸三钙材料复合,植入制备的兔股骨缺损处并在材料侧槽中植入股动静脉束,其中实验组9例,血管化组织工程骨用可吸收性GBR屏障膜包裹;对照组9例,单纯植入血管化组织工程骨,分别于术后4、8、12周通过形态学检测新生骨量,ELISA法检测骨缺损局部BMP-2的表达量. 结果 随着时间进展各组成骨量逐渐增加(实验组4、8、12周时新生骨的相对面积比分别为7.31%±0.55%,35.23%±3.07%,76.09%±3.71%,对照组4、8、12周时新生骨的相对面积比分别为17.26%±1.17%,54.50%±4.26%,82.57%±4.11%,差异均有统计学意义(P<0.05);且同一时间点实验组成骨量低于对照组,差异有统计学意义(P<0.05);术后4、8、12周时实验组骨缺损局部BMP-2 OD值分别为0.334±0.012,0.245±0.008,0.172±0.009,对照组骨缺损局部BMP-2 OD值分别为0.389±0.008,0.289±0.008,0.189±0.009;术后4周时两组骨缺损内BMP-2表达量均达峰值,此后即开始出现不同程度的下降;术后4、8、12周时骨缺损局部BMP-2表达量实验组均低于对照组,差异均有统计学意义(P<0.05). 结论 GBR屏障膜会降低血管化组织工程骨修复兔股骨缺损局部的成骨量,并减少骨缺损过程中局部BMP-2的表达量.     

疏血通注射液对大鼠随意型皮瓣存活的影响

目的研究疏血通注射液对大鼠背部随意型皮瓣存活的影响。方法采用改良的大鼠McFarlane皮瓣制作方法,将Sprague Dawley大鼠随机分为疏血通实验组和生理盐水对照组,实验组每只每天腹腔注射疏血通注射液1．5mL／kg,对照组每只每天腹腔注射生理盐水1．5mL／kg。术后第7天处死大鼠分别进行皮瓣存活面积比的检测,并取皮瓣近、中、远区组织切片光镜下观察,免疫组化法检测血管内皮生长因子（VEGF）的表达。结果术后7d,实验组皮瓣的存活面积比为（72．52±2．23）％,对照组皮瓣的存活面积比为（50．36±2．37）％,实验组存活面积比显著高于对照组（P〈0．01）。实验组中区皮瓣的组织水肿、炎症细胞浸润情况明显比对照组减轻,并且出现大量的新生血管,中区新生血管密度（27．42±4．21）个／mm^2,与对照组（17．45±5．43）个／mm^2差异有统计学意义（P〈0．05）。实验组VEGF表达量为4731．24±448．99,对照组为2466．01±801．67,差异有统计学意义（P〈0．01）。结论疏血通注射液可能通过增加VEGF表达等途径,促进皮瓣新生血管增生,改善皮瓣血供,减轻炎症反应,从而改善大鼠随意型皮瓣的存活。     

胃癌组织中p53和血管内皮生长因子的表达与血管生成的关系及其意义

目的　探讨胃癌组织中p53与血管内皮生长因子(VEGF)表达和血管生成的关系。方法　应用免疫组织化学技术对60例胃癌组织进行p53、VEGF表达和肿瘤组织微血管密度MVD检测。结果　MVD以及p53和VEGF的表达与胃癌病灶的大小(P＜0.05)、浸润深度(P＜0.01)、淋巴结转移(P＜0.01)和TNM分期(P＜0.01)密切相关。p53的表达与VEGF的表达显著相关（χ     

微血流模式背景下超声造影评估颈动脉斑块稳定性的价值

目的 评估微血流模式造影在计量位于颈动脉之间斑块内新长出的血管密度与数量的临床价值.方法 选取郑州大学第一附属医院148例颈动脉粥样硬化患者,共255枚颈动脉斑块,主要包括低回声和混合回声的斑块.常规超声扫查患者双侧颈动脉,同时记录斑块的相关信息,然后对颈动脉斑块进行超声造影(CEUS)检查及微血流模式(SMI)环境下...     

脉络膜新生血管的研究进展

目的:深入研究脉络膜新生血管的形成过程,为临床诊断、治疗及预防提供理论依据。方法:阅读国内外有关文献并进行综述。结果与结论:脉络膜新生血管的形成是一个极其复杂的生物过程,多种细胞和大量的血管生成调节剂参与其中。