一种多次获得兔血样的实用技术

<正>获得兔血样的传统技术均有缺点:心脏穿刺术需要麻醉,且能造成损伤和导致死亡;反复耳静脉穿刺可引起血肿而使再次取样困难或失败;而心脏导管的插入由于需要时间和专业知识又不切实际。 作者介绍一种更实用的采样新技术:向兔耳中央动脉植入前有针头的柔韧导管。采样材料由1个22号针头,1英吋导管(为一套装有聚四氯乙烯或耐辐射塑料针座静脉注射导管)和一个注射帽组成。这些材料均有市售,操作者只需有相当于静脉穿刺技术即可。 操作方法是:导管植入前将试验兔保定于不锈钢固定器内,用手指拔去动脉穿刺部位的软毛,以食指上下轻弹兔耳,以使动脉怒张。距耳尖3cm处呈向上倾斜25度角作动脉穿刺插入导管,透亮的针座内出     

犬囊状动脉瘤模型的制作

本文报道用“静脉囊镶嵌技术·制成犬的囊状动脉瘤模型。18个模型(6个单侧型,6个分叉型,6个末梢型)造型后2周经IA DSA检查。本模型在分型、血流动力学改变方面与人类囊状脑动脉瘤类似。不同类型的动脉瘤模型既有相同的血流动力学特征,又有各自的特点,这与动脉瘤与载瘤动脉的角度有关。我们认为该模型可应用于研究动脉瘤的血流动力学与血管内栓塞治疗。     

蕲蛇酶对动物实验性血栓的防栓和溶栓作用

采用大鼠颈动脉－颈外静脉回路循环形成的血小板性动脉血栓,用兔脑粉浸出液诱导的大鼠下腔静脉血栓以及用凝血酶诱导的兔耳缘静脉血栓,作为实验性动脉及静脉血栓模型,并分别用阿斯匹林和尿激酶作为阳性对照药,以观察蕲蛇酶对血栓形成的影响。不同剂量的蕲蛇酶（６００,３００和１５０μｇ／ｋｇｉｖ）能使大鼠动脉和静脉血栓形成减少,并呈量效关系。蕲蛇酶对家兔耳缘静脉血栓形成亦表现抑制作用并促进血栓消褪。３００和６００μｇ／ｋｇ对家兔已形成的动脉和静脉血栓,能促使消褪,提示蕲蛇酶亦有溶栓作用     

构建兔颈总动脉粥样硬化斑块模型的新方法及评价

目的 探索经兔耳中央动脉穿刺入路,利用球囊损伤兔颈总动脉内膜联合高脂饲料喂养,构建兔颈总动脉粥样硬化模型的新方法并评价可行性.方法 将兔经高脂饲料预喂养4周后,经兔耳中央动脉穿刺入路,利用球囊损伤右侧兔颈总动脉内膜,再经高脂饲料喂养8周.利用磁共振仪和病理组织学观察兔颈总动脉病变.结果 本研究构建兔颈总动脉粥样硬化动物...     

无下肢静脉疾病症状者左髂总静脉受压的CTA研究

目的:应用多层螺旋CT血管成像(CTA),探讨无下肢静脉疾病症状人群左髂总静脉受压的发生率及其临床意义.方法:对无下肢静脉疾病症状的130例患者行多层螺旋CT下腹部增强扫描,在右髂总动脉跨越左髂总静脉水平,采用多平面重建方法,显示并测量两侧髂总静脉正交断面上的短径及面积.所有数据经统计学处理.结果:在正交断面上,左髂总静脉短径受压率为33.97%±2.01%,面积受压率为9.98%±1.49%,短径受压率明显高于面积受压率(t=9.586,P=0.000).对左髂总静脉面积受压率进行统计分析,平均受压程度为9.98%,左髂总静脉受压大于25%的患者占16.92%(n=22),左髂总静脉受压大于50%的患者占3.85%(n=5),其中4例为女性.结论:在无下肢静脉疾病症状患者中,左髂总静脉明显受压(受压率>50%)者较少.     

复方抗栓酶股动脉注射与静滴治疗下肢动脉闭塞性疾病101例分析

比较股动脉注射与静脉滴注两法给予复方抗栓确治疗下肢动脉闭性疾病的疗效。方法１０１例患者随机分成股动脉注射与静脉滴注复方抗栓酶两组。结果显效率股动脉组６２．３％，静脉组４１．７％。结论复方抗栓酶股动脉注射治疗下肢动脉闭塞性疾病的疗效明显优于静脉滴注（Ｐ＜０．０１）。     

NO在实验性大鼠颈动脉瘤发展中的作用

目的建立一种新的颈动脉动脉瘤模型,观察iNOS在实验性动脉瘤组织局部的表达情况和选择性iNOS抑制剂氨基胍对动脉瘤增大和对血清NO水平的影响。方法50只SD大鼠随机分为3组,应用弹性蛋白酶灌注颈总动脉建立颈动脉梭形动脉瘤模型。A组给予氨基胍干预;B组给予生理盐水;C组为阴性对照。测量颈总动脉直径和血清硝酸盐含量。应用HE、免疫组化和原位杂交评价动脉瘤的病理特征和iNOS的局部表达特点。结果选择性iNOS抑制剂可以明显抑制动脉瘤增大的程度和血清硝酸盐水平。诱导的动脉瘤病理特征和外形与人动脉瘤组织相似,主要表现为动脉瘤壁明显增厚,内弹力膜和弹性膜全部消失,平滑肌细胞层变薄和消失。中膜和外膜管壁大量的炎症细胞浸润,氨基胍明显抑制iNOS的表达。结论应用弹性蛋白酶灌注颈动脉可以在大鼠诱导出梭形动脉瘤。动脉瘤的增大与局部升高的NO有关。     

超声引导下股动脉假性动脉瘤内凝血酶注射加加压治疗的应用价值

目的:评价超声引导下股动脉假性动脉瘤瘤腔内注射凝血酶加加压治疗在治疗医源性股动脉假性动脉瘤中的应用价值。方法:在彩色多普勒超声引导下,采用20 G穿刺针经皮穿刺,对30例经股动脉介入治疗术后形成的股动脉假性动脉瘤患者行瘤腔内注射凝血酶封闭治疗同时行加压压迫治疗,凝血酶浓度为200 U/ml,总量均≤500 U,压迫治疗力量以病人能耐受,足背动脉搏动可触及为标准,加压时间为24小时。结果:30例患者均1次治疗成功,术中及术后无并发症发生,术后随访3个月无复发。结论:超声引导下股动脉假性动脉瘤瘤腔内注射凝血酶加加压治疗在治疗医源性股动脉假性动脉瘤中具有创伤小,操作简便,疗效确切的优点,可作为经股动脉介入治疗术后形成的假性动脉瘤的首选治疗方法。     

超声引导下股动脉假性动脉瘤内凝血酶注射加加压治疗的应用价值

目的：评价超声引导下股动脉假性动脉瘤瘤腔内注射凝血酶加加压治疗在治疗医源性股动脉假性动脉瘤中的应用价值。方法：在彩色多普勒超声引导下,采用20 G穿刺针经皮穿刺,对30例经股动脉介入治疗术后形成的股动脉假性动脉瘤患者行瘤腔内注射凝血酶封闭治疗同时行加压压迫治疗,凝血酶浓度为200 U/ml,总量均≤500 U,压迫治疗力量以病人能耐受,足背动脉搏动可触及为标准,加压时间为24小时。结果：30例患者均1次治疗成功,术中及术后无并发症发生,术后随访3个月无复发。结论：超声引导下股动脉假性动脉瘤瘤腔内注射凝血酶加加压治疗在治疗医源性股动脉假性动脉瘤中具有创伤小,操作简便,疗效确切的优点,可作为经股动脉介入治疗术后形成的假性动脉瘤的首选治疗方法。     

多层螺旋CT测量成年贵州小型猪活体肾参考数据

目的通过测量成年贵州小型猪肾脏各种径线值及体积,建立贵州小型猪肾脏数据。方法采用西门子双源CT对12头成年贵州小型猪(雄性6头,雌性6头)进行薄层容积扫描,原始数据经Aquarius iNtuition4.4软件进行MRP及VR重组,在横断位正中层面测量双肾前后径及左右径,在冠状位最大面测量双肾长径及短径,计算小型猪体积及双肾体积,双肾长径与短径比值,采用统计学软件对肾长径、长短径比值与肾脏体积,肾脏体积与小型猪体积及体重做相关性分析,P0.05为差异有统计学意义。结果左肾前后径及左右径分别为(40.40±1.67)mm及(27.47±1.40)mm,长径及短径分别为(80.36±2.74)mm及(31.79±1.99)mm,左肾体积为(52.78±2.25)cm3,左肾长径与短径比值为(2.42~2.71)∶1;右肾前后径及左右径分别为(40.95±1.43)mm及(26.90±0.65)mm,长径及短径分别为(79.03±2.38)mm及(32.04±2.34)mm,右肾体积为(51.91±2.25)cm3,右肾长径与短径比值为(2.33~2.77)∶1。双肾长径与肾脏体积呈高度正相关(r左=0.92,P0.05;r右=0.88,P0.05),肾脏体积与小型猪体积呈正相关(r左=0.90,P0.05;r右=0.81,P0.05),与体重也呈高度正相关(r左=0.96,P0.05;r右=0.98,P0.05),但肾脏长短径比值与体积呈负相关(r左=-0.51,P0.05;r右=-0.67,P0.05)。结论多层螺旋CT及其后处理软件可准确测量贵州小型猪活体肾脏的多项影像学数据,为人类肾脏疾病的动物模型研究提供参考。     

Kawasaki disease causing saccular aneurysms of the coronary arteries

A 22-year-old man was referred for treatment of a 45 mm saccular aneurysm of the right coronary artery (RCA) and a 15 mm saccular aneurysm of the left anterior descending artery (LAD). The patient developed Kawasaki disease in 1998. The aneurysms were diagnosed in 2002. The RCA showed thrombus formation. Until now the patient had remained asymptomatic. He now presented with effort angina. On coronary angiography and magnetic resonance imaging, an occluded aneurysm of the proximal RCA (45 mm) was seen with a second aneurysm more distally (22 mm).     

Correlation Between the Rupture Risk and 3D Geometric Parameters of Saccular Intracranial Aneurysms

The purpose of this study is to evaluate the association of the location and geometric parameters of intracranial aneurysm with the risk of rupture. A retrospective study consisted of 284 patients diagnosed with saccular intracranial aneurysm between January 2009 and May 2013 at Wuxi Third People’s Hospital was conducted. 3D digital subtraction angiography images from all patients (240 ruptured, 44 unruptured) were obtained and analyzed. The location of the aneurysms and the 3D geometric parameters including the aneurysm depth, the neck size, diameter of the parent artery, aneurysm angle, aspect radio, size ratio, and the neck-to-parent-artery ratio (NPR) were compared between ruptured and unruptured groups. Results: In ruptured group, anterior communicating artery, posterior communicating artery (PCoA), and the bifurcation of internal carotid artery (ICA) were the top three locations for aneurysm occurrence, accounting for 40.00, 30.42, and 12.08 % respectively. While in the unruptured group, top three locations were PCoA (36.36 %), posterior cerebral circulation (18.18 %), and the bifurcation of the ICA (15.91 %). Distribution of aneurysm location is significantly different (p < 0.05) between ruptured and unruptured aneurysms. For the 3D geometric parameters characterizing aneurysm, aneurysm depth (p < 0.05), parent artery diameter (p < 0.05), aneurysm angle (p < 0.01), aspect ratio (p < 0.01), and size ratio (p < 0.01) all showed a significant difference between ruptured and unruptured group. No difference was found in the neck size and the NPR ratio between the two groups. 3D geometric parameters such as aneurysm depth, parent artery diameter, aneurysm angle, aspect ratio, and size ratio can be helpful in evaluating the rupture risk of saccular intracranial aneurysm for a better prevention and prognosis.     

In vitro evaluation of flow divertors in an elastase-induced saccular aneurysm model in rabbit

Endovascular coiling is an acceptable treatment of intracranial aneurysms, yet long term follow-ups suggest that endovascular coiling fails to achieve complete aneurysm occlusions particularly in wide-neck and giant aneurysms. Placing of a stentlike device across the aneurysm neck may be sufficient to occlude the aneurysm by promoting intra-aneurysmal thrombosis; however, conclusive evidence of its efficacy is still lacking. In this study, we investigate in vitro the efficacy of custom designed flow divertors that will be subsequently implanted in a large cohort of animals. The aim of this study is to provide a detailed database against which in vivo results can be analyzed. Six custom designed flow divertors were fabricated and tested in vitro. The design matrix included three different porosities (75%, 70%, and 65%). For each porosity, there were two divertors with one having a nominal pore density double than that of the other. To quantify efficacy, the divertors were implanted in a compliant elastomeric model of an elastase-induced aneurysm model in rabbit and intra-aneurysmal flow changes were evaluated by particle image velocimetry (PIV). PIV results indicate a marked reduction in intra-aneurysmal flow activity after divertor implantation in the innominate artery across the aneurysm neck. The mean hydrodynamic circulation after divertor implantation was reduced to 14% or less of the mean circulation in the control and the mean intra-aneurysmal kinetic energy was reduced to 29% or less of its value in the control. The intra-aneurysmal wall shear rate in this model is low and implantation of the flow divertor did not change the wall shear rate magnitude appreciably. This in vitro experiment evaluates the characteristics of local flow phenomena such as hydrodynamic circulation, kinetic energy, wall shear rate, perforator flow, and changes of these parameters as a result of implantation of stentlike flow divertors in an elastomeric replica of elastase-induced saccular aneurysm model in rabbit. These initial findings offer a database for evaluation of in vivo implantations of such devices in the animal model and help in further development of cerebral aneurysm bypass devices.     

Traumatic aneurysm in persistent sciatic artery

A 59-year-old male patient admitted to our hospital with a pulsatile right gluteal mass with history of formation after blunt trauma. Persistent sciatic artery and its traumatic aneurysm was diagnosed after medical examination followed by peripheric digital substraction angiography. Surgery was performed under general anesthesia, and the patient was discharged from the hospital on postoperative day 7 without any problems. The sciatic artery, a continuation of the internal iliac artery into the popliteal-tibial vessels, represents the major blood supply to the lower limb in early embryologic development. Its persistence is very rare, and the aneurysmatic dilatation is the most common pathology diagnosed. Here, we present a rare case of persistent sciatic artery presenting with a traumatic aneurysm treated by iliopopliteal bypass surgery and ligation of the internal iliac artery proximal to the aneurysm.     

FALSE ANEURYSM OF THE LEFT VENTRICLE: CASE REPORT WITH PRE- AND POSTOPERATIVE EVALUATION

A 66-year-old woman developed chronic congestive heart failure after myocardial infarction of the anterior wall of the left ventricle. Angiographic studies revealed total proximal occlusion of the left anterior descending coronary artery and a large saccular aneurysm located on the anteroapical aspect of the left ventricle. Resection of a false aneurysm at operation resulted in improved cardiac function, and the patient made an uneventful recovery. Repeat evaluation six months later confirmed normal cardiac hemodynamics and left ventricular angiographic characteristics. To our knowledge, this is the first documented case of normalized heart function resulting from resection of a false aneurysm of the left ventricle. Functional classification according to the New York Heart Association improved dramatically, rising from Class IV preoperatively to Class I after operation.     

Morphology of elastase-induced cerebral aneurysm model in rabbit and rapid prototyping of elastomeric transparent replicas

In this work, we describe a methodology to fabricate transparent elastomeric vascular replicas using rapid prototyping techniques. First, the three-dimensional morphology of an elastase-induced aneurysm model in rabbit is acquired. The morphology is reconstructed from in vivo rotational angiography and it is compared with three-dimensional reconstructions obtained by computerized tomography and magnetic resonance imaging of an intraluminal arterial cast that was obtained from the same animal at sacrifice. Results show that resolution of the imaging modality strongly influences the level of detail, such as small side branches, in the final reconstruction. We developed an average morphology model for elastase-induced aneurysms in rabbits including the surrounding vasculature and describe a method for rapid prototyping of vascular models from the three-dimensional morphology. Our replicas can be manufactured in a short period of time and the final product is optically clear. In addition, the elasticity of the models can be controlled to represent arterial elasticity, which makes them ideal for optical investigations of detailed flow dynamics using measurement tools such as particle image velocimetry.     

An inelastic multi-mechanism constitutive equation for cerebral arterial tissue

Intracranial aneurysms (ICA) are abnormal saccular dilations of cerebral arteries, commonly found at apices of arterial bifurcations and outer walls of curved arterial segments. Histological evidence suggests the stages in ICA development include the deformation of a segment of arterial wall into a “bleb” with no identifiable neck region followed by the development of an aneurysm with a clear neck. Afterwards, the aneurysm may undergo further enlargement, possibly with significant biological response including calcification and thrombosis. Past studies of the biomechanics of cerebral aneurysm tissue have been directed at modeling elastic deformations of pre-existing aneurysms. Taking this approach, the aneurysm wall is treated as a different entity than the arterial tissue from which it developed. In the current work, a nonlinear, inelastic, dual-mechanism constitutive equation for cerebral arterial tissue is developed. It is the first to model the recruitment of collagen fibers and degradation of the internal elastic lamina, two important characteristics of early stage aneurysm formation.     

Combination of Periaortic Elastase Incubation and Cholesterol-Rich Diet: A Novel Model of Atherosclerosis in Rabbit Abdominal Aorta

Atherosclerosis, the leading cause of most cardiovascular disease, is a progressive multifaceted inflammatory disease characterized by extracellular matrix degradation and extensive remodeling of artery wall. However, its mechanism has not been completely understood, and animal models are useful to study its pathogenetic process. An analysis of literature on the nature of atherosclerosis indicates that focal accumulation of smooth muscle cells (SMCs) into the intima by plasma factors is fundamental to the entire process of plaque growth. In our previous study, vascular SMCs proliferation was obvious in elastase-induced aorta by day 15, which led to intimal hyperplasia and regression of rabbit aneurysm. Model induced by combination of balloon injury and an atherogenic diet in rabbits is the conventional, but most largely used experimental model of atherosclerosis. Since proliferation and accumulation of intimal SMCs are found in elastase-induced aorta, and hypercholesterolemia is usually induced by cholesterol-rich diets in rabbits, a novel atherosclerosis model may be induced by combination periaortic elastase incubation and cholesterol-rich diet.     

Can aspect ratio be used to categorize intra-aneurysmal hemodynamics?-A study of elastase induced aneurysms in rabbit

Clinical studies suggest that aneurysm aspect ratio (AR) is an important indicator of rupture likelihood. The importance of AR is hypothesized to arise from its influence on intra-aneurysmal hemodynamics. It has been conjectured that slower flow in high AR sacs leads to a cascade of biological activities that weaken the aneurysm wall (Ujiie et al.,1999). However, the connection between AR, hemodynamics and wall weakening has never been proven. Animal models of saccular aneurysms provide a venue for evaluating this conjecture. The focus of this work was to evaluate whether a commonly used elastase induced aneurysm model in rabbits is suitable for a study of this kind from a hemodynamic perspective. In particular, to assess whether hemodynamic factors in low and high AR sacs are statistically different. To achieve this objective, saccular aneurysms were created in 51 rabbits and pulsatile computational fluid dynamics (CFD) studies were performed using rabbit specific inflows. Distinct hemodynamics were found in the low AR (AR<1.8, n=25), and high AR (AR>2.2, n=18) models. A single, stable recirculation zone was present in all low AR aneurysms, whereas a second, transient recirculation zone was also found in the superior aspect of the aneurysm dome for all high AR cases. Aneurysms with AR between 1.8 and 2.2 displayed transitional flow patterns. Differences in values and distributions of hemodynamic parameters were found between low and high AR cases including time averaged wall shear stress, oscillatory shear index, relative residence time and non-dimensional inflow rate. This work lays the foundation for future studies of the dependence of growth and remodeling on AR in the rabbit model and provides a motivation for further studies of the coupling between AR and hemodynamics in human aneurysms.