The poly-lactic acid membrane is characterized by its non-toxicity, non-carcinogenic and the property of degradation in the body in animal experiment, this membrane was wrapped around the tenorrhaphy site. The results showed that 3 to 9 weeks after operation there was an intact space surrounding the tendon, and the membrane began to degradate at 24 weeks, might achieve the purpose to prevent the formation of adhesion. From Nov. 1985 to Sept. 1989, this membrane was applied to 20 tendons of 14 patients. The follow-up results showed that the satisfactory rate was 81.8% .the indications of using poly-lacic acid membrane were primary, delayed primary and secondary suture of flexor tendon injuries in areas of the fingers.
Objective To determine the effectiveness of sodium hyaluronate (SHA) in preventing intraperitoneal (IP) adhesion. Methods Thirty-eight rats were randomly divided into A,B,C groups, normal saline, 6% Dextran-40 or SHA were applied on the present serosal injury respectively, during operation. Biopsy was taken on the 14th postoperative day.Results There were statistically significant differences in the extent of adhesion among three groups (Ｐ＜0.01). Mild inflammatory changes and less fibrous proliferation were found in group C by microscopy and decreased production of collagen (by fibroblast) and active mesothelial cells proliferation were observed in group C under electron microscope. Conclusion SHA appeares to reduce the extent of postoperative IP adhesion, which is more satisfactory than Dextran-40.
Objective To explore the effects of Zhaoke defibrase and anti alpha;vbeta;3mAb (23C6) on the adhesion and immigration of bovine retinal vascular endothelial cells. Methods The culture dishes coated with vitronectin (Vn) and collagen，assays of adhesion and immigration were performed 60 minutes after different concentration of Zhaoke defibrase and anti-alpha;vbeta;3 mAb was added to the bovine retinal vascular endothelial cells. The apoptosis of bovine retinal vascular endothelial cells induced by Zhaoke defibrase and anti-alpha;vbeta;3 mAb was detected by electron microscopy. Results Both Zhaoke defibrase and anti-alpha;vbeta;3 mAb inhibited the adhesion and immigration of bovine retinal vascular endothelial cells in a dose-dependent manner. The inhibited concentration (IC50) of Zhaoke defibrase was less than 0.05 mu;mol/L, while (IC50) of anti-alpha;vbeta;3 mAb was more than 2.5 mu;mol/L. 81.8% endothelial cells adhering to Vn were inhibited by 0.1 mu;mol/L Zhaoke defibrase, while 76.3% by endothelial cells adhering to Vn were inhibited by 10 mu;mol/L anti-alpha;vbeta;3 mAb. Typical apoptosis cells were found in bovine retinal vascular endothelial cells after affected by Zhaoke defibrase and anti-alpha;vbeta;3 mAb. Conclusion Both Zhaoke defibrase and anti- alpha;vbeta;3mAb can significantly inhibit the adhesion and immigration of bovine retinal vascular endothelial cells to extracellular matrix， and the mechanism may lie in inducing the apoptosis of endothelial cells. (Chin J Ocul Fundus Dis, 2005,21:118-121)
ObjectiveTo observe the effect of interleukin-8 (IL-8) on the adhesion and migration of retinal vascular endothelial cells (RCEC). MethodsA cell experiment. Human RCEC (hRCEC) was divided into normal control group (N group), advanced glycation end product (AGE) treatment group (AGE group), and AGE-induced combined IL-8 antagonist SB225002 treatment group (AGE+SB group). The effect of AGE on IL-8 expression in hRCEC was observed by Western blot. The effect of SB225002 on hRCEC migration was observed by cell scratch assay. The effects of SB225002 on leukocyte adhesion and reactive oxygen species (ROS) on hRCEC were detected by flow cytometry. Student-t test was performed between the two groups. One-way analysis of variance was performed among the three groups. ResultsCompared with group N, the expression level of IL-8 in cells of AGE group was significantly increased, with statistical significance (t=25.661, P＜0.001). Compared with N group and AGE+SB group, cell mobility in AGE group was significantly increased (F=29.776), leukocyte adhesion number was significantly increased (F=38.159, 38.556), ROS expression level was significantly increased (F=22.336), and the differences were statistically significant (P＜0.05). ConclusionIL-8 antagonist SB225002 may down-regulate hRCEC adhesion and migration by inhibiting ROS expression.
ObjectiveTo explore the relationship among plasma cytokines’ level, adhesion molecules expression and skin damage in patients with chronic venous insufficiency (CVI) of lower extremities.MethodsIn 32 patients with CVI and 8 normal individuals as control, blood TNFα, IL1β and IL2R were assayed with ELISA method; serum endothelial cellintercellular adhesion molecule1(ECICAM1), polymorphonuclearCD18(PMNCD18) and polymorphonuclearCD11b(PMNCD11b) were assayed with immunohistochemical method; and ultrastructure of diseased veins was examined by electroscope.ResultsThe results showed that the level of plasma TNFα and IL1β increased remarkably in Class 2-3 compared with Class 1 and control (P＜0.05), IL2R had no difference in Class 1,2,3(Pgt;0.05). The index of ECICAM1 and PMNCD11b positively expression increased remarkably in Class 2-3 compared with that in Class 1 and control. The index of PMNCD18 expression in Class 2-3 and Class 1 was greatly higher than that in control (P＜0.05). The expression of ICAM1 was positively correlated with that of CD11b/CD18. Electron microcopy showed that the change in microvessel was mainly PMN adhesion with endothelial cells (ECs) and trapped in microvessels.ConclusionThe results suggest that activated monocyte may release TNFα and IL1β, upregulate ICAM1 and CD11b/CD18 expression, and mediate the PMN adhesion to ECs, thus causing ECs and tissue damage. It may be one of important mechanism of venous ulcer.
Abstract： Objective To observe the significance of the changes of cell adhesion molecules (CAM) CD11b/CD18 and sPselectin during the perioperative period of open heart surgery under cardiopulmonary bypass (CPB), and investigate the roles of CD11b/CD18 and sPselectin in systemic inflammatory response triggered by CPB. Methods Thirty patients including 18 males and 12 females, age ranged from 29 to 55 years (45.3±8.1 years) having undergone valvular replacement for rheumatic heart disease in our hospital were selected as the subjects of this research. After anesthesia induction, radial arterial blood sample was collected at six different time points including the time prior to skin incision, and 30 min, 1 h, 6 h, 12 h and 24 h following the start of CPB. The expression levels of CD11b/CD18 were tested by flow cytometry, and concentration of sP-selectin in the plasma was measured with enzymelinked immunosorbent assay(ELISA). Results The expression of CD11b/CD18 was elevated at 30min after CPB, and it reached the peak (581.44±215.26) at 6 h after CPB with significant differences (Plt;0.05). Its expression started to drop at 12 h after CPB, but it was still higher than the expression level before CPB. The expression returned under the level before CPB at 24 h after CPB with insignificance differences (Pgt;0.05). The expression of sPselectin in the peripheral blood started to rise evidently at 30 min after CPB, reaching the peak (51.44±10.06 ng/ml) with significant differences (Plt;0.05). Its expression level decreased at 12 h after CPB and fell back below the level before CPB with insignificant differences (Pgt;0.05). Conclusion CPB can cause the expression of CD11b/CD18 and sPselectin to rise in the peripheral blood, which may play an important role in the systemic inflammatory response triggered by CPB.
Objective To assess an effect of 5-fluorouracil (5-FU) applied topically on the tendon adhesion and the healing process after the flexor tendon repair in Leghorn chickens. Methods Thirtytwo white Leghorn chickens, aged 4 months and weighing 1.5-1.7 kg, were randomly divided into 2 groups: Group A andGroup B, with 16 chickens in each group. The flexor digitorum profundus tendons of the 2nd, 3rd and 4th toes were transected and repaired. The repair site in Group A was given 5-FU in a concentration of 25 mg/ml with a soaked sponge that wascut into pieces 7 mm×20 mm×1 mm in size, and the synovial sheath of the repair site was wrapped with the 5-FU-soaked sponge for 1 min for 4 times. The repair site in Group B was served as a control, with no 5-FU but with the sterile normal saline. At 3 and 6 weeks postoperatively, the repaired tendons and the tendon adhesion formation were examined macroscopically and histologically，and the repaired tendons were tested biomechanically. The tissue blocks from the tendon repair site were examined under the transmission electron microscope. Results At 3 and 6 weeks postoperatively, the macroscopic and histological observation showed that the peritendinous adhesions in Group A were looser when compared with those in Group B. The length of the tendon gliding and the extent of yieldance to exercise were found to be 4.85±1.31 mm, 0.67±0.42 mm and 5.74±1.61 mm, 1.55±0.35 mm respectively at 3 and 6 weeks after operation in Group A，but 2.99±0.51mm，0.24±0.14 mm and 3.65±0.54 mm, 1.22±0.16 mm in Group B.Group A was significantly greater in the abovementioned parameters than Group B (P＜0.05).At 3 weeks after operation, the ultimate breaking strength was 20.28±4.92 N in Group A and 21.29±4.88 N in Group B, with no statistically significant difference found between the two groups (P＞0.05). At 6 weeks, the ultimate breaking strength was 47.12±6.76 N in Group A but 39.31±7.20 N in Group B, with a significant difference between the two groups (P＜0.05). Conclusion 5-fuorouracil, when appliedtopically, can reduce the tendon adhesion, with no inhibition of the intrinsic healing mechanism. It is an ideal treatment strategy to prevent peritendinous adhesion.
Objective To explore the effects of exogenous basic fibroblast growth factor (bFGF) on insheathed tendon healing and adhesion formation. Methods Ninety Leghorn chickens were randomly divided into 3 groups (groups A, B and C), 30 animals for each group, and the right third digitorum longus tendon of the chicken was transected to make defect models. In group A, the tendon was sutured in situ after transection. In group B, the tendon was sutured after 0.6 μl fibrin sealant (FS) was applied at repair site. In group C, the tendon was sutured after 0.6 μl FS mixed with 500 ng bFGF was appliedat repair site. At 1, 2, 4 and 8 weeks after operation, the tendons of 6 chickens in each group were harvested for morphological and histological evaluation. Six specimens of each group was obtained for biomechanical test at 8 weeks. Results The gross observation showed that the differences of grading of tendon adhesion were not significant between groups A, B, and C 8 weeks after operation(Pgt;0.05). Histological evaluation showedthat there were no significant differences in fibroblast counting and the content of collagen fibers between groups A and B(P＞0.05). The angiogenesis, fibroblast proliferation and collagen production in the sheath, epitendon and parenchyma at repair site in group C occurred earlier and were more than those in groups A and B, showing significant differences (Plt;0.05). The biomechanical tests showed that the gliding excursionof the tendon in group A, B and C were 3.44±0.43、3.51±0.56 and 2.84±0.42 mm respectively; the work of flexion were 14.87±1.72、14.08±1.85 and 20.62±3.52 Nmm respectively; the ultimate tensile strength of the tendon was10.34±1.45，11.26±1.83 and 15.02±2.20 N respectively; showing no significant differences between groups A and B(Pgt;0.05), but showing significant differences between group C and groups A, B(Plt;0.05). Conclusion The exogenous bFGF at tendon repair site can facilitate insheathed tendon healing, but also increase the tendon adhesion formation.
Objective To study the prevention of postoperative adhesion using carboxymethylcellulose(CMC). Methods The literature was reviewed extensively, concerning the physical and chemical characters of CMC, the mechanism of preventing adhesion, the effect on healing of anastomoses, the experimental researches and the clinical application. Results CMC was a polysaccharide with favorable biocompatibility, biodegradation, stable physical and chemical characters, and it can prevent postoperative adhesion. Conclusion CMC is with a wide outlook in prevention of postoperative adhesion.
Objective To investigate the clinical effect of chitosan in prevention of knee dysfunction due to adhesion after operation for patellar fracture. Methods From March to October 1999, 40 cases of patellar fracturewere treated by internal fixation, with intraarticular injection of 2% chitosan in only 24 cases after fixation and with no chitosan injection in 16 cases(control group). The function of the knee joint, including extension and flexion, was evaluated 1month and 1 year after operation respectively. Results One month after operation, the knees with chitosan injection could actively move in the average range of 104°±23°, and the knees in the control group could move in the average range of72°±16°, which showed significant difference between two groups(P＜0.01); 1 year after operation, the range of movement of the knees with injection was 165°±38° on average, and that of the knees in the control group was 110°± 31°, which also indicated significant difference between two groups (P＜0.05). Conclusion Medical chitosan could effectively prevent or reduce the post-operative adhesion of knee joint after patellar operation.