Venous pressure monitoring is an important indicator for the arteriovenous fistula evaluation. Direct static venous pressure monitoring is recognized as the most accurate way of venous pressure monitoring, which is widely used in the functional monitoring, functional evaluation of arteriovenous fistula, the diagnosis of complications and the evaluation of surgical efficacy. Venous pressure monitoring has obvious advantages and disadvantages, so it is necessary to improve relevant knowledge to correctly guide clinical diagnosis and treatment. In this paper, the study of static venous pressure monitoring of arteriovenous fistula was summarized, in order to improve the understanding of the significance and clinical application of static venous pressure monitoring of arteriovenous fistula.
Objective To investigate the biological response and chemotaxis of endothel ial cells on template materials with different protein concentrations on the same surface, to provide the evidence for deep understanding of chemical induced cell motil ity. Methods Microcontact printing technique was employed to fabricate template materials with four different concentrations of collagen (50, 100, 200, 300 μg/mL) on the same substrate. Scanning electron microscopy was employed to characterize the qual ity of polydimethylsiloxane (PDMS) stamp. Confocal laser scanning microscopy (CLSM) was util ized to characterize the absorption of different concentrations of FITC conjugated collagen (50, 100, 200, 300 μg/mL) on the substrates surfaces. Software was used to analyze the fluorescence intensity of adsorbed protein on the substrates. Albumin was then used to block the substrates for cell culture of human umbil ical vein endothel ial cells (hUVEC). Substrates with no collagen adsorption were used as control samples. The influence of different concentrations of collagen on the prol iferation of hUVEC was investigated via MTT assay at 6, 24, 48 and 72 hours of culture. The cytoskeletal structures of cells were characterized by CLSM. The cell’ s migration speed and absolute displacement were measured by path measurement of single cell after 24 hours of culture. Results Fabricated PDMS stamps with complete pattern were flat. Template substrates were fully covered with evenly distributed collagen protein. The fluorescence intensities were 38.51 ± 1.63, 55.21 ± 3.88, 73.17 ± 3.59, and 80.95 ± 1.12 in adsorbed FTIC conjugated collagen with 50, 100, 200 and 300 μg/mL, respectively. Endothel ial cells spread better on various substrates coated with collagen than those of control samples. The prol iferation of endothel ial cells on collagen coated substrateswas significantly higher than that of control group (P lt; 0.05). With collagen concentration increasing from 50 µg/mL to 300µg/mL, the prol iferation abil ities and absolute displacements of endothel ial cells significantly increased (P lt; 0.05). Except for the group with 300 μg/mL, the migration speed of endothel ial cells on collagen coated substrates was significantly lower (P lt; 0.05) than that of control group. However, the migration speed of endothel ial cells on collagen coated substrates significantly increased (P lt; 0.05) along with collagen concentration increasing from 50 µg/mL to 300 µg/mL. Conclusion It is feasible to acquire domains with different protein concentrations on the same substrate using microcontact printing technique for investigating cell’s chemotaxis.
ObjectiveTo explore the role of arteriovenous axillary loop graft (AVALG) on chest for establishing hemodialysis access in patients with chronic renal failure. MethodsA retrospective analysis was made on the clinical data of 12 patients with chronic renal failure who underwent an AVALG on chest for hemodialysis access between December 2010 and May 2014. There were 2 males and 10 females with an average age of 65.25 years (range, 46-75 years). The main causes were chronic glomerulonephritis in 6 cases, diabetic nephropathy in 4 cases, and both kidney resection because of urinary tract tumors in 2 cases. The disease duration was 2-12 years (mean, 6 years). The 12 patients all underwent 5-14 times (mean, 7 times) failed prior vascular accesses [arteriovenous fistula (AVF）and arteriovenous graft (AVG)] leading to exhaustion of venous access sites on the upper extremities. ResultsThe AVALG on chest were functionally useful for hemodialysis access, 2-3 times per week, and the blood flow was 250-350 mL/minute; the average time for the first dialysis was 48 days (range, 42-93 days). All patients were followed up 12-54 months (mean, 20.92 months). There was no death during perioperative period. The primary patency rates at 6 and 12 months were 91.7% and 83.3% respectively, and the secondary patency rates at 6 and 12 months were both 100%. After operation, infection (1 case), thrombosis (2 cases), bleeding (2 cases), and swollen (1 case) occurred, which were all cured after corresponding treatment. ConclusionAVALG on chest is a supplementary option for chronic renal failure patients with inadequate upper extremity venous access sites after repeat occlusion.
OBJECTIVE To compare the permeability and incidence rate of complication of arteriovenous internal fistula made by autogenous, homologous, and artificial Teflon blood vessels. METHODS Two hundred and forty one cases with arteriovenous internal fistula made by autogenous, homologous, and artificial Teflon blood vessels were followed up to compare the permeability and incidence rate of complication at 6 months, 1 year, 3 years, and 5 years. RESULTS The incidence rate of complication of autogenous blood vessels was lowest, it had no statistical differences compared with arteriovenous internal fistula made by homologous blood vessels. The permeability of arteriovenous internal fistula made by homologous blood vessels was highest, and it had no statistical differences compared with autogenous blood vessels. The permeability of arteriovenous internal fistula made by artificial Teflon blood vessels was lowest, but the incidence rate of complication was highest, and it had significantly statistical differences compared with arteriovenous internal fistula made by autogenous blood vessels (P lt; 0.01). CONCLUSION Arteriovenous internal fistulas made by autogenous and homologous blood vessels have high permeability and low incidence rate of complication, they are superior to the arteriovenous internal fistula made by artificial Teflon blood vessels.
Immuno-fluorescence technique can qualitatively determine certain nuclear translocation, of which NF-κB/p65 implicates the activation of NF-κB signal pathways. Immuno-fluorescence analysis software with independent property rights is able to quantitatively analyze dynamic location of NF-κB/p65 by computing relative fluorescence units in nuclei and cytoplasm. We verified the quantitative analysis by Western Blot. When we applied the software to analysis of nuclear translocation in lipopolysaccharide (LPS) induced (0.5 h, 1 h, 2 h, 4 h) primary human umbilical vein endothelial cells (HUVECs), we found that nuclear translocation peak showed up at 2h as with calculated Western blot verification results, indicating that the inventive immuno-fluorescence analysis software can be applied to the quantitative analysis of immuno-fluorescence.
The formation of an arteriovenous fistual for dialysis by routine interrupted sutures anastomosing the vein and artery is difficult to perform and time-consuming. A new method, telescopic adhesive anastomosis was studied and applied in 10 hemodialysis patients, who were in need of an arteriovenous fistula. The external diameter of the vessels anastomosed was 2.40 +/- 0.20 mm (radial artery) or 2.40 +/- 0.35 mm (cephalic vein). After thorough debridement of the vascular ends, the arterial end was put in the venous lumen. In order to fix the telescopic vessels, two stitches were applied 180 degrees apart from each other and tied. Each stitch was inserted from vein (penetrating the whole wall) to artery (just through the adventitia and partial thickness of the media vasorum). The distance from the stitch to the edge of the vein was 0.5 mm, and that of the artery was approximated to the external diameter of the vessle. The medical adhesive was then applied for sealing the anastomotic adventitia. Ten seconds were given for the solidification of the adhesive. The patients were followed up for 8 months. The patency rate was 100%, and the rate of blood flow was more than 300 ml/min (measured by ultrasonography). It was shown that this method could be managed easily and quickly, and the so-formed fistula would fulfill the need of hemodialysis.
ObjectiveTo explore the role of chest wall arteriovenous graft (CWAVG) for establishing hemodialysis access in patients with end-stage renal disease.MethodsA retrospective analysis was made on the clinical data of 12 patients with end-stage renal disease who underwent CWAVG for establishing hemodialysis access between January 2014 and June 2015. There were 3 males and 9 females with an average age of 63.6 years (range, 54-82 years). The renal disease causes were chronic glomerulonephritis in 2 cases, hypertensive renal damage in 4 cases, diabetic nephropathy in 1 case, both kidney resection because of urinary tract tumors in 3 cases, and causes unknown in 2 cases. Hemodialysis time ranged from 1 to 144 months, with an average of 38.4 months. The 12 patients all underwent 1-14 times (mean, 4.2 times) anterior pathway failure in CWAVG, all of which were caused by repeated occlusion of dialysis pathway or poor vascular condition of upper extremity, resulting in the exhaustion of vascular pathway in upper extremity.ResultsAll patients were followed up 30-48 months (mean, 35.4 months). Two patients died, including 1 case of digestive tract hemorrhage, 1 case of heart failure. The other 10 CWAVGs were functionally useful for hemodialysis access about 6 weeks after operations. The primary patency rates at 6, 12, 18, 24, and 30 months were 83.3%, 75.0%, 33.3%, 33.3%, and 16.7%, respectively, and the cumulative patency rates at 6, 12, 18, 24, and 30 months were 83.3%, 75.0%, 50.0%, 33.3%, and 16.7%, respectively. Among 8 cases of CWAVG dysfunction, 6 cases had thrombosis, 1 case had seroma, and 1 case had vertebral artery stealing. Among them, 4 patients underwent hemodialysis using tunneled-cuffed catheter, 3 patients using fistula or graft on other limbs, and 1 patient was not treated with hemodialysis.ConclusionAlthough the long-term patency rate of CWAVG is yet to be further increased by improvement of treatment strategies, but it is still a supplementary option for end-stage renal disease patients with inadequate upper extremity venous access sites.