高压氧联合依达拉奉干预耳撕脱模型兔的皮瓣成活
|
摘要
背景:早期给予高压氧辅助治疗对外伤皮瓣术后患者进行处理,能够减轻水疱、肿胀等症状,使皮瓣的成活率提高,依达拉奉能够有效清除皮瓣损伤区自由基。目的:探讨高压氧处理联合依达拉奉治疗对兔撕脱皮瓣成活的影响及机制。方法:54只健康新西兰白兔由苏州医学院实验动物中心提供。于兔左耳背中央形成1.5 cm×8 cm中央动脉为蒂的矩形皮瓣,应用特殊装置造成碾压撕脱伤,造模成功48只,随机分为4组,每组12只,原位缝合后各组连续治疗3d。对照组不予任何处理;高压氧组予以高压氧治疗;依达拉奉组尾静脉注射依达拉奉3 mg/(kg?d);联合组予以高压氧治疗的同时予以依达拉奉治疗;在治疗后第3天观察皮瓣的微循环变化,治疗后第7天测量皮瓣的成活面积,取存活皮瓣组织苏木精-伊红染色进行组织学观察,RT-PCR和Western Blot检测皮瓣组织细胞间黏附分子1、血管内皮细胞黏附分子1的表达。结果与结论:①激光多普勒和红外线热成像系统检查显示,在联合组血流灌注能达到皮瓣的远端,高压氧组和依达拉奉组血流灌注能够达到皮瓣的中段,而对照组仅能达到近段;②联合组皮瓣存活显著高于其他3组(P <0.05),依达拉奉组和高压氧组显著高于对照组(P <0.05);③联合组炎性细胞浸润程度极低,而对照组炎性细胞浸润程度明显高于高压氧组和依达拉奉组;④RT-PCR和Western Blot检测示细胞间黏附分子1、血管内皮细胞黏附分子1基因和蛋白的表达联合组最低(P <0.05),高压氧组和依达拉奉组显著低于对照组(P <0.05);⑤结果说明,高压氧处理联合联合依达拉奉治疗能够有效促进兔耳撕脱皮瓣成活,其机制与降低兔耳皮瓣损伤过程中细胞间黏附分子1、血管内皮细胞黏附分子1的表达有关。
BACKGROUND: Early application of hyperbaric oxygen adjuvant therapy can relieve blisters, swelling and other symptoms, and thus improves the survival rate of skin flaps. Edaravone can effectively eliminate free radicals in the injured area of skin flaps. OBJECTIVE: To investigate the effect and mechanism of hyperbaric oxygen combined with edaravone on the survival rate of avulsed flap in rabbits. METHODS: Fifty-four healthy New Zealand white rabbits were provided by Laboratory Animal Center of Medical Collage of Soochow University. A 1.5 cm x 8 cm pedicled rectangle flap of the rabbit central artery was made on the middle of the rabbit left ear back, and created crush injury using special device. The 48 model rabbits were randomly divided into four groups(n=12/group), and received no intervention(control group), hyperbaric oxygen therapy, 3 mg/kg·d edaravone injection via tail vein, or hyperbaric oxygen therapy combined with edaravone(combination group), for 3 continuous days. The microcirculation of skin flap was observed at 3 days after treatment. The flap survival area was measured at 7 days after treatment. The survived flap was removed for hematoxylin-eosin staining. The expression levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1 in flap tissue were detected by RT-PCR and western blot assay. RESULTS AND CONCLUSION:(1) Laser doppler and infrared thermal imaging system showed that the blood perfusion reached the distal segment of skin flap in the combination group, reached the middle segment of skin flap in the hyperbaric oxygen and edaravone groups, and reached the proximal segment of skin flap in the control group.(2) The survival rate of flap in the combination group was significantly higher than that in the other three groups(P < 0.05). The survival rate in the edaravone and hyperbaric oxygen groups was significnatly higher than that in the control group(P < 0.05).(3) The degree of inflammatory infiltration in the combination group was significantly low, and the degree of inflammatory infiltration in the control group was significantly higher than that in the hyperbaric oxygen and edaravone groups.(4) The mRNA and protein expression levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1 detected by RT-PCR and western blot assay were lowest in the combination group(P < 0.05), and the levels in the hyperbaric oxygen and edaravone groups were significantly lower than those in the control group(P < 0.05).(5) To conclude, hyperbaric oxygen combined with edaravone can effectively promote the survival of rabbit ear avulsed skin flap, which is related to the decreased expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1.
BACKGROUND: Early application of hyperbaric oxygen adjuvant therapy can relieve blisters, swelling and other symptoms, and thus improves the survival rate of skin flaps. Edaravone can effectively eliminate free radicals in the injured area of skin flaps. OBJECTIVE: To investigate the effect and mechanism of hyperbaric oxygen combined with edaravone on the survival rate of avulsed flap in rabbits. METHODS: Fifty-four healthy New Zealand white rabbits were provided by Laboratory Animal Center of Medical Collage of Soochow University. A 1.5 cm x 8 cm pedicled rectangle flap of the rabbit central artery was made on the middle of the rabbit left ear back, and created crush injury using special device. The 48 model rabbits were randomly divided into four groups(n=12/group), and received no intervention(control group), hyperbaric oxygen therapy, 3 mg/kg·d edaravone injection via tail vein, or hyperbaric oxygen therapy combined with edaravone(combination group), for 3 continuous days. The microcirculation of skin flap was observed at 3 days after treatment. The flap survival area was measured at 7 days after treatment. The survived flap was removed for hematoxylin-eosin staining. The expression levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1 in flap tissue were detected by RT-PCR and western blot assay. RESULTS AND CONCLUSION:(1) Laser doppler and infrared thermal imaging system showed that the blood perfusion reached the distal segment of skin flap in the combination group, reached the middle segment of skin flap in the hyperbaric oxygen and edaravone groups, and reached the proximal segment of skin flap in the control group.(2) The survival rate of flap in the combination group was significantly higher than that in the other three groups(P < 0.05). The survival rate in the edaravone and hyperbaric oxygen groups was significnatly higher than that in the control group(P < 0.05).(3) The degree of inflammatory infiltration in the combination group was significantly low, and the degree of inflammatory infiltration in the control group was significantly higher than that in the hyperbaric oxygen and edaravone groups.(4) The mRNA and protein expression levels of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1 detected by RT-PCR and western blot assay were lowest in the combination group(P < 0.05), and the levels in the hyperbaric oxygen and edaravone groups were significantly lower than those in the control group(P < 0.05).(5) To conclude, hyperbaric oxygen combined with edaravone can effectively promote the survival of rabbit ear avulsed skin flap, which is related to the decreased expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule 1.
引文
[1]Lim H,Han DH,Lee IJ,et al.A Simple Strategy in Avulsion Flap Injury:Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft.Arch Plast Surg.2014;41(2):126-132.
[2]张祥运,廖毅.重组水蛭素对大鼠撕脱皮瓣存活的影响[J].中华医学美学美容杂志,2014,20(2):126-129.
[3]王太平.局部应用重组水蛭素对兔耳静脉淤血皮瓣成活的影响[D].泸州:泸州医学院,2008.
[4]郎继荣.高压氧联合依达拉奉和奥扎格雷治疗进展性脑梗死的疗效观察[J].中国现代医生,2014,52(34):151-153.
[5]刘滨,杨涛,王林,等.依达拉奉治疗急性重型颅脑损伤的疗效探讨[J].临床军医杂志,2013,41(10):1020-1021.
[6]任剑锋,孔宪忠.依达拉奉的实验研究及临床应用进展[J].中国民族民间医药,2012,21(4):33-34.
[7]王海鹏,袁丹,李冬华,等.依达拉奉治疗缺血性卒中后认知功能障碍的随机对照研究[J].川北医学院学报,2015,30(5):649-651.
[8]凡奇,钱腊燕,杨淼,等.依达拉奉联合高压氧治疗急性脑梗死的疗效观察[J].实用心脑肺血管病杂志,2014,22(3):11-12.
[9]Yan D,Shan J,Ze Y,et al.The effects of combined hyperbaric oxygen therapy on patients withpost-stroke depression.J Phys Ther Sci.2015;27(5):1295-1297.
[10]罗世官,陈宏明,谭荣邦,等.高压氧预适应联合依达拉奉对心脏瓣膜置换术后患者神经认知功能、生活质量及炎症因子水平的影响[J].中国医药导报,2016,13(8):29-32.
[11]Kujawski S,Kujawska A,Kozakiewicz M,et al.The effect of hyperbaric oxygen therapy on the nervous system.Systematic review.Polish Hyperbaric Res.2015;53(4).
[12]Peng HS,Liao MB,Zhang MY,et al.Synergistic inhibitory effect of hyperbaric oxygen combined with sorafenib on hepatoma cells.Plos One.2014;9(6):e100814.
[13]陈劲松,张波,潘从泽,等.MCP-3对人脐静脉内皮细胞表达ICAM-1、VCAM-1、TF/TFPI及其凋亡的影响[J].南方医科大学学报,2013,33(1):86-92.
[14]Yang T,Chen ZY,Ren JZ,et al.Effect of hyperbaric oxygen on the scar formation at the rabbit ear.Zhonghua Zheng Xing Wai Ke Za Zhi.2013;29(1):55-58.
[15]Zhiyong W,Fei S,Lianju X,et al.Endostar injection inhibits rabbit ear hypertrophic scar formation.Int J Low Extrem Wounds.2012;11(4):271-276.
[16]Hu X,Wang H,Liu J,et al.The role of ERK and JNK signaling in connective tissue growth factor induced extracellular matrix protein production and scar formation.Arch Dermatol Res.2013;305(5):433-445.
[17]LI HC,Yan L,Wang DL,et al.Imiquimod Inhibit Scar Formation by Regulating the Expression of Th1/Th2 Cell Related Chemokines in Rabbit Ear Hypertrophic Scar Model.Progress in Modern Biomedicine.2014.
[18]Jia S,Xie P,Hong SJ,et al.Intravenous curcumin efficacy on healing and scar formation in rabbit ear wounds under nonischemic,ischemic,and ischemia-reperfusion conditions.Wound Repair Regen.2014;22(6):730-739.
[19]Fang Q,Huang C,You C,et al.Opuntia Extract Reduces Scar Formation in Rabbit Ear Model:A Randomized Controlled Study.Int J Low Extrem Wounds.2015;14(4):343-352.
[20]兰德彬,邹兴军,陈锐.高血压脑出血术后高压氧联合依达拉奉治疗对脑血管功能的影响[J].医学研究杂志,2016,45(1):166-169.
[21]封林森,马建华,印佳,等.早期高压氧联合依达拉奉对颅脑外伤患者血管活性因子的影响及疗效[J].中国血液流变学杂志,2013,23(4):685-687.
[22]赵华,钟丽珍,王剑锋,等.依达拉奉联合高压氧治疗血管性痴呆的疗效观察及对患者血浆一氧化氮合成酶的影响[J].求医问药(学术版),2012,10(6):82-83.
[23]Hou XH,Pei F.Estradiol Inhibits Cytokine-Induced Expression of VCAM-1 and ICAM-1 in Cultured Human Endothelial Cells Via AMPK/PPARαActivation.Cell Biochem Biophys.2015;72(3):709-717.
[24]Ma YR,Ma YH.MIP-1αenhances Jurkat cell transendothelial migration by up-regulating endothelial adhesion molecules VCAM-1and ICAM-1.2014;38(11):1327-1331.
[25]Chang CC,Chu CF,Wang CN,et al.The anti-atherosclerotic effect of tanshinone IIA is associated with the inhibition of VCAM-1-induced VCAM-1,ICAM-1 and CX3CL1 expression.Phytomedicine.2014;21(3):207-216.
[26]Taleb S,Moghaddas P,Rahimi BM,et al.Metformin improves skin flap survival through nitric oxide system.J Surg Res.2014;192(2):686-691.
[27]Bagdas D,Cam EB,Inan OS,et al.Effects of systemic chlorogenic acid on random-pattern dorsal skin flap survival in diabetic rats.Biol Pharm Bull.2014;37(3):361-370..
[28]Xie XG,Zhang M,Dai YK,et al.Combination of vascular endothelial growth factor-loaded microspheres and hyperbaric oxygen on random skin flap survival in rats.Exp Ther Med.2015;10(3):954-958.
[29]Cai L,Huang W,Lin D.Effects of Traditional Chinese Medicine Shuxuetong Injection on Random Skin Flap Survival in Rats.ScientificWorldJournal.2014;2014:816545.
[30]赵国印,刘瑞花.神经节苷脂与依达拉奉联合高压氧治疗一氧化碳中毒迟发脑病疗效分析[J].中国实用神经疾病杂志,2014,17(18):28-29.
[2]张祥运,廖毅.重组水蛭素对大鼠撕脱皮瓣存活的影响[J].中华医学美学美容杂志,2014,20(2):126-129.
[3]王太平.局部应用重组水蛭素对兔耳静脉淤血皮瓣成活的影响[D].泸州:泸州医学院,2008.
[4]郎继荣.高压氧联合依达拉奉和奥扎格雷治疗进展性脑梗死的疗效观察[J].中国现代医生,2014,52(34):151-153.
[5]刘滨,杨涛,王林,等.依达拉奉治疗急性重型颅脑损伤的疗效探讨[J].临床军医杂志,2013,41(10):1020-1021.
[6]任剑锋,孔宪忠.依达拉奉的实验研究及临床应用进展[J].中国民族民间医药,2012,21(4):33-34.
[7]王海鹏,袁丹,李冬华,等.依达拉奉治疗缺血性卒中后认知功能障碍的随机对照研究[J].川北医学院学报,2015,30(5):649-651.
[8]凡奇,钱腊燕,杨淼,等.依达拉奉联合高压氧治疗急性脑梗死的疗效观察[J].实用心脑肺血管病杂志,2014,22(3):11-12.
[9]Yan D,Shan J,Ze Y,et al.The effects of combined hyperbaric oxygen therapy on patients withpost-stroke depression.J Phys Ther Sci.2015;27(5):1295-1297.
[10]罗世官,陈宏明,谭荣邦,等.高压氧预适应联合依达拉奉对心脏瓣膜置换术后患者神经认知功能、生活质量及炎症因子水平的影响[J].中国医药导报,2016,13(8):29-32.
[11]Kujawski S,Kujawska A,Kozakiewicz M,et al.The effect of hyperbaric oxygen therapy on the nervous system.Systematic review.Polish Hyperbaric Res.2015;53(4).
[12]Peng HS,Liao MB,Zhang MY,et al.Synergistic inhibitory effect of hyperbaric oxygen combined with sorafenib on hepatoma cells.Plos One.2014;9(6):e100814.
[13]陈劲松,张波,潘从泽,等.MCP-3对人脐静脉内皮细胞表达ICAM-1、VCAM-1、TF/TFPI及其凋亡的影响[J].南方医科大学学报,2013,33(1):86-92.
[14]Yang T,Chen ZY,Ren JZ,et al.Effect of hyperbaric oxygen on the scar formation at the rabbit ear.Zhonghua Zheng Xing Wai Ke Za Zhi.2013;29(1):55-58.
[15]Zhiyong W,Fei S,Lianju X,et al.Endostar injection inhibits rabbit ear hypertrophic scar formation.Int J Low Extrem Wounds.2012;11(4):271-276.
[16]Hu X,Wang H,Liu J,et al.The role of ERK and JNK signaling in connective tissue growth factor induced extracellular matrix protein production and scar formation.Arch Dermatol Res.2013;305(5):433-445.
[17]LI HC,Yan L,Wang DL,et al.Imiquimod Inhibit Scar Formation by Regulating the Expression of Th1/Th2 Cell Related Chemokines in Rabbit Ear Hypertrophic Scar Model.Progress in Modern Biomedicine.2014.
[18]Jia S,Xie P,Hong SJ,et al.Intravenous curcumin efficacy on healing and scar formation in rabbit ear wounds under nonischemic,ischemic,and ischemia-reperfusion conditions.Wound Repair Regen.2014;22(6):730-739.
[19]Fang Q,Huang C,You C,et al.Opuntia Extract Reduces Scar Formation in Rabbit Ear Model:A Randomized Controlled Study.Int J Low Extrem Wounds.2015;14(4):343-352.
[20]兰德彬,邹兴军,陈锐.高血压脑出血术后高压氧联合依达拉奉治疗对脑血管功能的影响[J].医学研究杂志,2016,45(1):166-169.
[21]封林森,马建华,印佳,等.早期高压氧联合依达拉奉对颅脑外伤患者血管活性因子的影响及疗效[J].中国血液流变学杂志,2013,23(4):685-687.
[22]赵华,钟丽珍,王剑锋,等.依达拉奉联合高压氧治疗血管性痴呆的疗效观察及对患者血浆一氧化氮合成酶的影响[J].求医问药(学术版),2012,10(6):82-83.
[23]Hou XH,Pei F.Estradiol Inhibits Cytokine-Induced Expression of VCAM-1 and ICAM-1 in Cultured Human Endothelial Cells Via AMPK/PPARαActivation.Cell Biochem Biophys.2015;72(3):709-717.
[24]Ma YR,Ma YH.MIP-1αenhances Jurkat cell transendothelial migration by up-regulating endothelial adhesion molecules VCAM-1and ICAM-1.2014;38(11):1327-1331.
[25]Chang CC,Chu CF,Wang CN,et al.The anti-atherosclerotic effect of tanshinone IIA is associated with the inhibition of VCAM-1-induced VCAM-1,ICAM-1 and CX3CL1 expression.Phytomedicine.2014;21(3):207-216.
[26]Taleb S,Moghaddas P,Rahimi BM,et al.Metformin improves skin flap survival through nitric oxide system.J Surg Res.2014;192(2):686-691.
[27]Bagdas D,Cam EB,Inan OS,et al.Effects of systemic chlorogenic acid on random-pattern dorsal skin flap survival in diabetic rats.Biol Pharm Bull.2014;37(3):361-370..
[28]Xie XG,Zhang M,Dai YK,et al.Combination of vascular endothelial growth factor-loaded microspheres and hyperbaric oxygen on random skin flap survival in rats.Exp Ther Med.2015;10(3):954-958.
[29]Cai L,Huang W,Lin D.Effects of Traditional Chinese Medicine Shuxuetong Injection on Random Skin Flap Survival in Rats.ScientificWorldJournal.2014;2014:816545.
[30]赵国印,刘瑞花.神经节苷脂与依达拉奉联合高压氧治疗一氧化碳中毒迟发脑病疗效分析[J].中国实用神经疾病杂志,2014,17(18):28-29.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |