Tunica albuginea versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective randomised pilot study

Objective:The objective of the study was to compare the outcome of tunica albuginea urethroplasty(TAU)and buccal mucosa graft(BMG)urethroplasty for anterior urethral stricture.Methods:Thirty patients who met the inclusion criteria were randomised into two groups:TAU(Group A)and BMG urethroplasty(Group B).Surgical outcome was evaluated with pre-and post-operative work-up involving retrograde urethrogram,voiding cystourethrogram,uroflowmetry,and urethroscopy.Patients were followed up till 1 year.Results:Mean duration of surgery was statistically significant between two groups(p=0.0005).Maximum urine flow rate was comparable when compared between two groups(p=0.22)but statistically significant when compared pre-and post-operatively(p<0.001).At follow-up of 1 year,the successful outcomes were 80% in Group A and 87%in Group B.A total of five patients who had unsuccessful results required redo urethroplasty.Complications were minimal in both the groups.Conclusion:TAU provides outcomes equivalent to those of BMG urethroplasty.TAU has less operative time,easy to perform,and beneficial in patients with poor oral hygiene.

Ultrastructural changes of penile tunica albuginea in diabetic rats

Aim: To clarify the ultrastructural changes of penile tunica albuginea (TA) in streptozotocin (STZ)-induced diabetic rats. Methods: Intraperitoneal injection of STZ was used to induce diabetes mellitus (DM) in 12 Sprague Dawley rats. Ten rats (age and weight-matched) were used as control. Blood samples from the tail snips of the rats were used for the determination of serum glucose levels with SureStep Plus Blood Meter. At week 4 and 10 after the injection, half of the rats in each group were sacrificed and penile samples were obtained from the middle third of the penile shaft for the examination of TA under scanning electron microscopy. Results: In the diabetic group, the serum glucose levels were higher (P<0.01 at both time points) and the TA were thinner (P<0.05) than those of the controls. In the control group, the fibers of TA were rich and arranged regularly and undulated, while in the diabetic group, the fibers were diminished, lost the undulations and were arranged irregularly. Conclusion: In rats, DM appeared to impair the penile TA ultrastructures and this impairment could contribute to diabetic erectile dysfunction in part by impairing the veno-occlusive function.

Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie＇s disease with erectile dysfunction

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie＇s disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie＇s disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months （range 14-82 months）, the penis was completely straightened in 59 （95%） patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie＇s disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting.

The role of tunica vaginalis flap in staged repair of hypospadias

Objective:The surgical repair of hypospadias is done in two stages in a select group of patients with severe anomaly.The first stage(Ⅰ)procedure consists of correction of penile shaft curvature and second stage(Ⅱ)repair involves the creation of a neourethra.This neourethra needs a cover of an intermediate layer in order to have good functional and cosmetic results.Among the various local flaps,tunica vaginalis flap is a good option for the use as an intermediate layer.Methods:We have managed 22 patients of chordee with hypospadias by staged repair.In Stage I,chordee correction was done by dividing the urethral plate and covering the penile shaft with dorsal prepucial flaps.In Stage Ⅱ,a neourethra was created and covered with tunica vaginalis flap either through the same incision(14/22)or via a subcutaneous tunnel(8/22).An indwelling catheter was kept for 10 to 12 days.Results:Eighteen(81.8%)patients had successful functional and cosmetic repair.Two patients(9.1%)had urethrocutaneous fistula of which one healed on subsequent dilatation while the other one(4.5%)needed repair.Overall fistula formation rate was 4.5%.In two patients,the external urinary meatus could be made upto subglanular or coronal level.Conclusion:Staged repair of chordee with hypospadias is valuable in selected group of patients and tunica vaginalis flap is an excellent intermediate layer to cover the neourethra.However preoperative counseling is particularly essential in patients where the external urinary meatus can be created at coronal or subglanular level.

Interstitial tissue-specific gene expression in mouse testis by intra-tunica albuguineal injection of recombinant baculovirus

The purpose of this study is to establish a gene delivery system for interstitial tissue-specific protein expression in mice testes using modified recombinant baculovirus. Green fluorescent protein （GFP）-expressing recombinant baculovirus （GFP-baculovirus）, in which the insect cell-specific polyhedron promoter was replaced by the cytomegalovirus （CMV）-IE promoter, was used to transfect testicular cells in vitro, and for intra-tunica albuguineal injection of the interstitial tissue of the testis. GFP expression was monitored in frozen testes sections by fluorescence microscopy. Expression of GFP in testicular tissues was also assessed by reverse transcription polymerase chain reaction （RT-PCR）, and protein expression was assessed by Western blot. Testicular cells in vitro were infected efficiently by modified recombinant GFP-baculovirus. lntra-tunica albuguineal injection of GFP- baculovirus into the mouse testis resulted in a high level of GFP expression in the interstitial tissues. RT-PCR analysis clearly showed GFP gene expression in the testis, particularly interstitial tissues. Intra-tunica albuguineal injection of a modified baculovirus that encoded recombinant rat insulin-like growth factor binding protein （IGFBP）-5 resulted in an increase in IGFBP-5 in testis and semen. In conclusion, we have developed an efficient delivery system for gene expression in vivo in testicular cells, particularly cells of the interstitial tissue using intratunica albuguineal injection of a modified recombinant baculovirus. This method will be particularly relevant for application that requires gene delivery and protein expression in the testicular cells of the outer seminiferous tubule of the testis.

Tunica vaginalis testis metastasis as the first clinical manifestation of pancreatic adenocarcinoma:A case report

BACKGROUND Metastases from pancreas or ampullary malignancies are common,but the spread to testicle and paratesticular tissue is exceedingly rare.To the best of our knowledge,fewer than 30 cases have been reported in the literature.More rarely,metastasis to tunica vaginalis testis occurs without involvement of the testes and epididymis.CASE SUMMARY A 65-year-old male who complained of painless swelling of the left scrotum for over 1 wk was referred to the Department of Urology.Scrotal ultrasound showed left testicular hydrocele with paratesticular masses.Chest computed tomography revealed lung metastasis and enlarged left supraclavicular lymph node.The blood tumor markersalpha-fetoprotein,human chorionic gonadotropin,and serum lactate dehydrogenase were withinnormal limits.The preoperative diagnosis was left testicular tumor with lung metastasis.Then radical orchidectomy of the left testicle and high ligation of the spermatic cord were performed,and postoperative histopathology suggested metastatic tumors that was confirmed by an abdominal computed tomographic scan.The positive computed tomography findings,in conjunction with the expression of cytokeratin 7(CK7),CK20,CK5/6,and absence of expression of Wilms’tumor suppressor gene 1,calretinin,melanocyte,prostate-specific antigen,thyroid transcription factor-1,GATA binding protein 3,caudal type homeobox 2,and napsinA supported the diagnosis of pancreatic adenocarcinoma.The outcome of this patient was unsatisfactory,and he died 3 mo later.CONCLUSION This case suggests that pancreatic metastatic carcinoma must be considered in the differential diagnosis of scrotal enlargement.The advanced age of the patient wassuggestive of a secondary testicular tumor.In addition,careful physical examination and ultrasonography as well as radiological examination have become a standard modality.

Outcomes of surgical correction of Peyronie’s disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft

Objective:Peyronie’s disease(PD)is an abnormal wound healing in the penile tunica albuginea.After fibrotic plaque excision,different graft materials have been used to repair the defects,but the optimal graft remains unknown.This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.Methods:A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021.The patients were divided into two groups depending on the type of graft used.For 15 patients in Group B,testicular tunica vaginalis grafts were used to repair the defect,while for 18 patients in Group A,bovine pericardium grafts were used.Data of the patient’s age,comorbidities,sexual function,penile curvature,postoperative complications,need for further treatment,change in penile length,and satisfaction were gathered and compared between the groups.Sexual function was evaluated using the 5-item version of the International Index of Erectile Function(IIEF-5),and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.Results:There was no difference in age,comorbidities,degree of curvature,perioperative IIEF-5,operative time,plaque size,or complication rates.After surgery,a statistically significant improvement in curvature degree(p<0.05)and satisfactory penile appearance(p<0.05)were seen in both groups without any superiority between the two groups(p=0.423 and p=0.840,respectively).With a 30-month follow-up,the IIEF-5 was consistent in both groups,with no statistical significance between the groups(p=0.492).The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance(p=0.255 and p=0.101,respectively).Conclusion:Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.

Isolated ventral congenital penile curvature treated by incisionless plication of tunica albuginea in adults:A prospective case series

Background:Numerous surgical techniques are available for the correction of isolated ventral congenital penile curvature(IVCPC).This study aimed to assess the outcomes and predictors of IVCPC treatment in adults using an incisionless plication technique.Materials and methods:This prospective case series examined patients with IVCPC who were treated in our hospital between October 2017 and February 2020 using incisionless plication of the tunica albuginea(Essed-Schroeder technique)with a covering pair of absorbable sutures.The primary outcomes were successful correction(defined as a residual curvature≤15 degrees)and patient satisfaction.Postoperative follow-ups were performed at 3,6,and 12 months.Results:A total of 23 patients were treated for IVCPC with a mean(range)age of 25.3(18-31)years.Eighteen patients(78.3%)were single with cosmetic complaints,whereas the other 5 patients(21.7%)were married and presented with a difficult vaginal intromission.The mean(range)curvature,length,and operative time were 40(30-50)degrees,15(10-19)cm,and 82(65-100)minutes,respectively.Postoperative penile pain and numbness occurred in 13 patients(56.5%)and 7 patients(30.4%)only within the first month,respectively.Palpable suture knots were reported in 15 patients(65.5%)without being bothersome up to 12 months.The postoperative means(ranges)of penile curvature and length were significantly different from that of the preoperative values at 3(5[0-20]degrees and 14.5[9-18.5]cm),6(5[0-20]degrees and 14.5[9-18.5]cm),and 12 months(5[0-30]degrees and 14.5[9-18.5]cm;all p<0.001).Age,preoperative penile curvature,penile length,postoperative pain,wound infections,and knot palpation insignificantly affected curvature recurrence.Seventeen patients(73.9%)were very satisfied with their surgical outcomes.Conclusions:Incisionless plication of the tunica albuginea is effective and safe for the correction of IVCPC in adults with high success and patient satisfaction rates.

睾丸鞘膜高分化乳头状间皮肿瘤1例

间皮肿瘤起源于体腔内浆膜层表面的间皮细胞,常见于胸膜和腹膜,罕见于睾丸鞘膜[1]。根据2022年WHO《泌尿和男性生殖系统肿瘤分类(第5版)》,睾丸附属器官间皮肿瘤分为腺瘤样瘤、高分化乳头状间皮肿瘤(well-differentiated papillary mesothelial tumour,WDPMT)和恶性间皮瘤[2]。作为间皮肿瘤中极其罕见的类型,睾丸鞘膜WDPMT患者常无特异性临床表现和影像学特征,常因鞘膜积液、阴囊肿物、腹股沟疝等手术后意外发现[3]。

Microsurgical tunica albuginea transplantation in an animal model

Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at -80~C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.

显微镜下白膜斑块电动磨削及移植物修补术治疗阴茎硬结症21例报告

目的探讨在显微镜下应用电动磨钻进行白膜斑块磨削后,应用睾丸鞘膜或牛心包进行修补治疗阴茎硬结症的手术技巧和经验。方法采用回顾性队列研究方法,收集我院于2021年1月至2023年5月收治的因阴茎硬结症导致阴茎严重弯曲并行显微镜下白膜斑块电动磨削及移植物修补术治疗的21例患者的临床资料和信息,观察其短期和中期疗效。结果本组21例患者中12例(57.1%)采用单侧鞘膜修补,3例(14.3%)采用双侧鞘膜修补,6例(28.6%)采用牛心包修补。手术时长(272±69)min,术后随访(12.1±7.2)个月。17例(81.0%)患者勃起时阴茎完全伸直,无弯曲,无缩窄,4例(19.0%)略有背侧弯曲,但弯曲度<10°,患者均对其阴茎勃起时形态满意。术后测量阴茎长度变化[+(1.1±0.5)]cm,9例(42.9%)诉术后早期存在阴茎头感觉麻木感,持续(3.2±1.9)个月后自行消失。患者均能够顺利完成性生活,阴茎勃起硬度评分为3.8分。手术后整体满意率为90.5%。结论显微镜下Buck’s筋膜的精细分离有利于可靠保护阴茎背侧神经血管;应用电动磨钻进行白膜斑块的磨削可更加充分而精准地松解白膜;应用睾丸鞘膜或牛心包进行白膜缺损修补治疗阴茎硬结症总体效果良好,患者综合满意度高,值得推广应用。

1例精索静脉曲张并发睾丸鞘膜积液的护理体会

本文总结1例左侧精索静脉曲张伴左侧睾丸鞘膜积液患者的护理经验。术后积极开展个体化疼痛照护和心理干预,加强管路护理,做好血肿、感染等并发症预防措施,出院给予健康指导,减轻患者心理压力,促进患者早期康复。

偏瘫患者肱二头肌长头肌腱炎超声引导下鞘膜液压扩张治疗疗效分析

目的探讨偏瘫患者肱二头肌长头肌腱炎超声引导下鞘膜液压扩张治疗的疗效。方法选取2022年10月—2023年9月滨州市第二人民医院收治的68例偏瘫肱二头肌长头肌腱炎患者为研究对象,根据不同的治疗方式分为扩张组与对照组,各34例。对照组给予塞来昔布口服治疗,扩张组在对照组治疗的基础上给予超声引导下鞘膜液压扩张治疗,比较两组的治疗总有效率、肩关节功能评分、肱二头肌长头肌腱厚度、腱鞘厚度。结果扩张组的治疗总有效率为97.06%(33/34),高于对照组的82.35%(28/34),差异有统计学意义(χ^(2)=3.981,P<0.05)。治疗4周后,两组Constant-Murdey肩关节功能评分均高于治疗前,且扩张组高于对照组,差异有统计学意义(P<0.05)。治疗4周后,两组的肱二头肌长头肌腱厚度、腱鞘厚度均减少,且扩张组均少于对照组,差异有统计学意义(P均<0.05)。结论超声引导下鞘膜液压扩张治疗偏瘫患者肱二头肌长头肌腱炎能促进改善肩关节功能,提高总体治疗效果,改善肌腱厚度、腱鞘厚度。

Anti-lysyl oxidase combined with a vacuum device induces penile lengthening by remodeling the tunica albuginea

This study aimed to explore whether and how anti-lysyl oxidase(anti-LOX)combined with a vacuum device(VD)could promote penile lengthening and to evaluate the effect on erectile function.This study was performed on four groups of adult rats:control,anti-LOX,VD(negative pressure value of-300 mmHg),and anti-LOX+VD.Penile length was measured by a modified VD method and verified on exposed length data.Intracavernous pressure(ICP)and maximum ICP/mean arterial pressure(MAP)ratio were recorded to assess erectile function.For corpus cavernosum,LOX activity and concentrations of pyridinoline,desmosine,hydroxyproline,and elastin were analyzed;transmission electron microscope and Hart’s elastin staining were performed to monitor microstructural changes.Anti-LOX and VD significantly lengthened the penis by 10.8%(3.75 mm)and 8.2%(2.48 mm)compared with the control group,respectively,while anti-LOX+VD achieved the longest penile size(40.58±0.40 mm)which was 17.4%longer than the control group(34.58±0.54 mm).After 1-week washout,no penile retraction was observed.Meanwhile,exposed penile length data confirmed that the penis in the anti-LOX+VD group was also significantly longer.Anti-LOX inhibited LOX activity to reduce pyridinoline level,which led the penile tunica albuginea remodeling.However,it had no effect on hydroxyproline,desmosine,and elastin levels.Moreover,anti-LOX had no impact on erectile function,which was determined by ICP and ICP/MAP ratio.These results suggest that anti-LOX elongates the penis by reducing pyridinoline,which induces tunica albuginea remodeling.This lengthening effect was more obvious when combined with a VD.All procedures had no impact on erectile function.

腹腔镜鞘状突高位结扎术中对侧鞘状突未闭的个体化处理效果

目的探究腹腔镜鞘状突高位结扎术中对侧鞘状突未闭(CPPV)的合理处置方案。方法选取2018年6月-2020年6月在保定市儿童医院接受腹腔镜鞘状突高位结扎术的单侧腹股沟斜疝/鞘膜积液的患儿300例,采用随机数字表法分为两组,每组150例。对照组术中发现CPPV 53例,均给予同期手术处理;研究组术中发现CPPV 58例,对其中符合高位结扎条件的11例给予同期手术处理;比较两组患儿对侧腹股沟斜疝或鞘膜积液的再发率情况。结果术后随访1年,研究组与对照组再发率差异无统计学意义(8.62%vs.1.88%,P>0.05)。单侧鞘膜积液患儿CPPV检出率明显高于腹股沟斜疝患儿(49.07%vs.23.02%,P<0.001);左、右侧鞘状突未闭患儿CPPV检出率分别为42.71%、32.95%,差异无统计学意义(P=0.192);1~2岁年龄段CPPV检出率为62.93%,明显高于其他年龄段(P<0.001)。结论CPPV转化为腹股沟斜疝或鞘膜积液的发生率低,术中可仅对符合条件的患儿进行同期处理。

经血管外膜组织液传输对心肌灌注的研究

目的比较经由血管外膜组织液传输或血液循环的示踪剂在大鼠心肌组织中的分布差异,明确经血管外膜组织液传输的心肌灌注特点。方法采用组织学和Micro-CT成像方法,分别研究荧光素钠、硝酸银经由下肢血管外膜传输在心肌组织中灌注的特点。本研究选取2021年9月至2022年9月由中国医学科学院实验动物研究所提供的25只SD大鼠,随机分为空白对照组、血液灌注10 min组、外膜传输1 min组、5 min组和10 min组共5组,每组各5只。分别在右下肢血管外膜附近、或右下肢静脉管腔内给予生理盐水、硝酸银溶液或荧光素钠,留取下肢血管及其周围组织、心肺组织标本,分别进行组织学和Micro-CT成像研究,分别比较荧光素钠和银信号的分布差异。结果组织学分析显示血管外膜给予的荧光素钠并非进入血液,而是经由下肢血管外膜组织液向心性传输进入心肌组织。Micro-CT结果发现,经由下肢血管外膜组织液传输后,在近心端的血管外膜及其周围组织中有大量银信号,而远心端很少[(13.9±0.6)×10^(3)μm^(2)比(0.0±0.0)×10^(3)μm^(2),P<0.0001];血液灌注组下肢血管的近心端和远心端的银信号分布则无显著性差异[(16.2±0.8)×10^(4)μm^(2)比(14.3±0.5)×10^(4)μm^(2),P=0.1976]。分别比较不同时间段的结果,发现随着时间的增加,经由血管外膜传输的示踪剂逐渐分布在心肌组织中,而在心腔内部的分布很少。血液灌注组心肺组织的银信号主要分布于心腔内,而心肌组织中量少。结论与经血液循环的心肌灌注相比,经由下肢血管外膜组织液传输的示踪剂在心肌组织中分布的量更多。说明心肌组织灌注很可能存在血液灌注和血管外膜传输两种途径。

从洒金花朵反演嵌合体变化机制

嵌合体植物不稳定,洒金花朵则是其不稳定的极端表现。反演洒金花朵发育过程,推知花瓣原基为二维码式异质细胞嵌合体,经典嵌合体理论将其归结为不稳定性,而对不稳定性成因的阐述存在两大矛盾,因而无力解释洒金花朵的形成机制。利用结合了原套-原体、细胞组织分区两个学说的茎端生长锥综合结构模型,提出挤出-打印假说,阐明茎端生长锥中心区的子细胞输出过程,进而设想中心区“打印”二维码式周边区环带,从而圆满解释了洒金花朵的形成机制,揭示了嵌合体不稳定的本质。

Penile Fracture—Report on Three Cases from Cape Coast, Ghana

Introduction: Penile fracture is a urological emergency that occurs when the penis in an erect state suffers a blunt trauma resulting in a rupture of the tunica albuginea of either one or both corpora cavernosa. It is often caused by vigorous sexual intercourse, hence the incidence of penile fracture is under-reported. We therefore present our experience of the clinical presentation and surgical management of penile fracture. Presentation of Cases: We report three cases of penile fracture and all were diagnosed based on their clinical presentation and examination findings. The patients include two middle aged men and one young man, all with history of hearing a popping sound and experiencing sudden onset pain with detumescence of the penis. No radiological investigations were carried out. An emergency surgical repair was done for all patients. Discussion: All the patients had no urethral injury on presentation and underwent immediate surgical repair. The erectile and voiding function of each patient was preserved. Conclusion: The management of penile fracture involves early diagnosis and immediate surgical repair. Early intervention is necessary to preserve penile function.

氨氯地平联合阿托伐他汀钙对高血压颈动脉内膜中层厚度的影响

目的研究苯磺酸左旋氨氯地平联合应用阿托伐他汀钙对高血压患者颈动脉内膜中层厚度(IMT)的影响。方法将原发性高血压患者168例,随机分为实验组(84例)和对照组(84例),对照组使用苯磺酸左旋氨氯地平2.5mg,1次/d,2周后,血压未降至140/90mmHg(1mmHg=0.133kPa)以下者,增加剂量至5mg(2.5mg/次,2次/d),实验组在对照组基础上,加用阿托伐他汀钙10mg,1次/晚,治疗12个月,比较两组IMT、血压、空服血糖及血脂水平。结果实验组治疗12个月后,颈动脉IMT、收缩压、舒张压、TG、TC、LDL-C均显著降低,治疗后的IMT(0.76±0.07)mm,与治疗前(0.95±0.07)mm及对照组治疗前后的(0.97±0.05)mm、(0.84±0.06)mm比较,差异均有统计学意义(P<0.05)。两组间血糖、心率比较差异无统计学意义。结论高血压患者苯磺酸左旋氨氯地平联合阿托伐他汀钙治疗能更好的延缓颈动脉IMT进展。

内皮祖细胞移植对血管内膜修复的影响

目的:从脾源性单个核细胞中分离并扩增血管内皮祖细胞(EPCs),研究EPCs移植对血管损伤后内膜修复的影响。方法:大鼠脾源性单个核细胞贴壁培养法定向扩增EPCs,检测其内皮细胞特性。荧光标记EPCs从尾静脉移植到颈动脉内皮损伤的大鼠体内。结果:脾源性单个核细胞体外可诱导出内皮祖细胞,表现为表达内皮细胞特异性标志。移植后,EPCs可归巢至血管损伤部位。EPCs移植组在球囊损伤2周后血管新生内膜明显减少,血管腔狭窄程度显著减轻。EPCs移植组新生内膜/中膜比值显著低于单纯球囊损伤组及M199组(0.82±0.09vs1.52±0.21,1.48±0.19,P<0.01)。EPCs移植组PCNA阳性表达细胞明显少于单纯球囊损伤组及M199组(19.25±3.96vs31.42±5.23,29.37±3.16,P<0.05)。结论:EPCs能有效移植到内皮损伤血管段,参与损伤血管的内膜修复过程。