1。胎盘的制备<ol><li>收购胎盘应尽快从产房分娩后，以尽量减少血凝块形成，干燥和组织的整体恶化。 </li><li>应谨慎，以确保胎盘是不暴露于福尔马林或其他固定液。 </li><li>标准BSL2应注意保持人体组织和​​人员应戴上口罩，隔离衣，手套和鞋套。 </li><li>放置在一个大的塑料或金属碗，预切孔，以便引流液的胎盘。此碗应放在一个较大的不锈钢碗，以防止泄漏。 </li><li>用温生理盐水冲洗胎盘。 </li><li>对于更好胎盘的可视化，消费的跨双羊水膜，确保不损害胎盘本身使用梅岑鲍姆剪刀。留下到位的跨双膜0.5厘米袖口。 （图1A）。 </li></ol> 2。胎盘血管插管<ol><li>确定各自的双胞胎线。产科医生通常每双标识放置在每个线的夹具。请务必确认线提供了展示双（双）。 </li><li>一时间，保持跟踪线，断面每个线正下方的夹子（图1B）。轻轻乳凝块从船只（图1C）。在电源线的切割边缘会有一个静脉和至少一个，通常有两种，动脉。动脉确定其直径相对较小（比静脉）和周围的肌肉袖口（图1D）。 </li><li>使用一个标准的桡动脉行导丝，直径为0.46毫米和80厘米长（箭头，读美国宾夕法尼亚州），用软技巧获得双A的线（图1E）切缘的动脉孔。 </li><li>导丝应放入船只至少3厘米。温和上线使用凯利钳切割边缘的非血管部分柜台紧张，极大地方便了线的进步。线小转向理顺曲折的血管可能有助于用铁丝进步。应谨慎，以避免虚假的段落。 </li><li>一个直言斜面在电线的末端动脉（图1F）使用Seldinger技术，线程20厘米长0.6-1.19毫米内径聚乙烯导管（Intramedic，巴达维亚IL，美国）。必须小心不赶走线同时推进的导管。取下导管后坐在船至少有3厘米的钢丝。 </li><li>另外，某些群体有不使用的脐与脐动脉导管血管的导丝和直接插管成功。虽然，这种技术在我们手中使用的导丝，我们才能完成该过程所花费的时间减少。 </li><li>将一个18 G先端钝针（BD公司，Franlik湖区，新泽西州，美国）油管的近端。确保船只注入少量的生理盐水，观察结算远端动脉导管妥善安置。温柔的手指上的血管注射生理盐水的同时扫描可能有助于促进运动的任何残余的血块。 </li><li>仔细重复步骤2.3至2.6，注意避免撞出双人房A静脉动脉导管。 </li><li>扎脐带1厘米的片，远端切缘周围的电线和导管。确保完全密封，以避免回流。 </li><li>重复步骤2.3至2.9双乙线（非呈现双）等，有脐动脉，静脉和脐磁带和两个环流担保每双导管已用生理盐水（图2）注入。 </li></ol> 3。胎盘血管彩色染料注入<ol><li>病理学染料，钡悬浮液，明胶或其他粘性的彩色染料，可用于可视化的胎盘血管。选择四个对比鲜明的色彩与注入的动脉和静脉对双胞胎一个和B，每双动脉和静脉的颜色应该很容易区分。浅表吻合应染料混合，形成不同（混合）不易察觉的色彩检测。 </li><li>使用3毫升注射器注入动脉双在低压与染料的手。轻轻扫过沿染料流动方向的船只，以确保填充整个血管树与一个或两个手指。如果是确定的，表面的血管吻合手册闭塞饲养容器可以允许较高的抗血管床休息，以填补（图3A）。 </li><li>使用一个单独的手3毫升注射器注入双乙动脉（图3B）。 </li><li>重复步骤3.2和3.3静脉注射。 </li><li>如果受伤的船只，维​​修染料泄漏，应进行罚款缝合针驱动程序。小心不要缝合结扎整个VESSEL。 </li><li>使用一个高分辨率的数码相机，每次注射后的图像。所有注射完成后，取出试样的碗，地方对一个中性色彩背景和重形象（图4）。文件的数量和类型的双胞胎“环流之间看到连接。 </li></ol> 4。代表性的成果： 动脉动脉吻合（AAS）已表明要“保护”，因为它们与一个显著下降TTTS风险和相关的两个双胞胎5改进的成果。图4演示了一个注入MC双胎盘。一节AA前瞻性已确定在子宫内多普勒超声。这一发现证实了混合双人房A动脉（黄色）和双乙动脉（蓝色）在交通动脉结构的染料（绿色箭头）。也表明双人房A（黄色）和双B（橙色）静脉与动脉吻合的AV（箭头）。图5和6描绘我们注入其他两个胎盘标本的照片。 <img src="/files/ftp_upload/2837/2837fig1.jpg" alt="图1"/> 图1。 （一）羊膜小心取出从梅岑鲍姆剪刀共享MC胎盘的胎儿面（B）一对双胞胎的脐带清洁的边缘是由近端切断与梅岑鲍姆剪刀暴露（C ）血块挤奶从人工压迫脊髓（D）脐动脉（箭头）和静脉（箭头）的双A的确定。（e）在放置一个上线的切割面缺血性部分凯利钳牵引，导丝置于脐动脉双A和通过曲折的船只轻轻先进。（F）的小导管，然后在导丝入血管先进，使用Seldinger技术的管腔。 <img src="/files/ftp_upload/2837/2837fig2.jpg" alt="图2"/> 图2。导管已被放置在每个双胞胎中的一个脐动脉和脐静脉。这些导管担保围绕整个线的脐带磁带关系的地方。每个导管的正确定位，已被证实已回暖生理盐水注射清除腔内的血块。 <img src="/files/ftp_upload/2837/2837fig3.jpg" alt="图3"/> 图3。 （一）动脉循环的双胞胎，一个是注射用黄色染料。明显的对比（二）双乙动脉循环是用蓝色染料注入到对双胞胎B.动脉流通传递整个血管赤道。掺加的内表现出的AA吻合（箭头），绿色染料黄色染料和蓝色染料的结果。 <img src="/files/ftp_upload/2837/2837fig4.jpg" alt="图4"/> 图4。静脉双A（红色）和静脉双B（橙色）已注入。机管局吻合（箭头）和一个AV吻合，具有流量指示，从双一对双胞胎乙（箭头）划定。 <img src="/files/ftp_upload/2837/2837fig5.jpg" alt="图5"/> 图5。MC双胎盘接受激光治疗后，产后注射的例子。捐助双胞胎的动脉和静脉分别为黄色和绿色。收件人的动脉和静脉分别为蓝色和橙色。无残留的环流之间的连接进行检测。 <img src="/files/ftp_upload/2837/2837fig6.jpg" alt="图6"/> 图6。MC双胎盘注射后的范例。左侧双胞胎的动脉和静脉分别为黄色和红色。右路双胞胎的动脉和静脉分别为蓝色和橙色。一节AA（箭头）和VV（箭头），胎盘表面上可见。

<ol>
	<li>Rand, L., Lee, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complicated+monochorionic+twin+pregnancies:+updates+in+fetal+diagnosis+and+treatment.">Complicated monochorionic twin pregnancies: updates in fetal diagnosis and treatment.</a> Clin Perinatol. 36, 417-430 (2009).</li><li>Sebire, N., Talbert, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Twin-to-twin+transfusion+syndrome+results+from+dynamic+asymmetrical+reduction+in+placental+anastomoses:+a+hypothesis.">Twin-to-twin transfusion syndrome results from dynamic asymmetrical reduction in placental anastomoses: a hypothesis.</a> in Placenta. , (2001).</li><li>Machin, G. A., Keith, L. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> An atlas of multiple pregnancy: biology and pathology. , (1999).</li><li>Machin, G. A., Feldstein, V. A., van Gemert, M. J., Keith, L. G., Hecher, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Doppler+sonographic+demonstration+of+arterio-venous+anastomosis+in+monochorionic+twin+gestation.">Doppler sonographic demonstration of arterio-venous anastomosis in monochorionic twin gestation.</a> Ultrasound Obstet Gynecol. 16, 214-217 (2000).</li><li>Denbow, M. L., Cox, P., Taylor, M., Hammal, D. M., Fisk, N. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Placental+angioarchitecture+in+monochorionic+twin+pregnancies:+Relationship+to+fetal+growth,+fetofetal+transfusion+syndrome,+and+pregnancy+outcome.">Placental angioarchitecture in monochorionic twin pregnancies: Relationship to fetal growth, fetofetal transfusion syndrome, and pregnancy outcome.</a> American Journal of Obstetrics and Gynecology. 182, 417-426 (2000).</li><li>Taylor, M. J. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Doppler+detection+of+arterio-arterial+anastomoses+in+monochorionic+twins:+feasibility+and+clinical+application.">Doppler detection of arterio-arterial anastomoses in monochorionic twins: feasibility and clinical application.</a> Human Reproduction. 15, 1632-1636 (2000).</li><li>Berm&#250;dez, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Placental+types+and+twin-twin+transfusion+syndrome.">Placental types and twin-twin transfusion syndrome.</a> American Journal of Obstetrics and Gynecology. 187, 489-494 (2002).</li><li>Lewi, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intertwin+anastomoses+in+monochorionic+placentas+after+fetoscopic+laser+coagulation+for+twin-to-twin+transfusion+syndrome:+is+there+more+than+meets+the+eye.">Intertwin anastomoses in monochorionic placentas after fetoscopic laser coagulation for twin-to-twin transfusion syndrome: is there more than meets the eye.</a> Am J Obstet Gynecol. 194, 790-795 (2006).</li><li>Wee, L. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Characterisation+of+deep+arterio-venous+anastomoses+within+monochorionic+placentae+by+vascular+casting.">Characterisation of deep arterio-venous anastomoses within monochorionic placentae by vascular casting.</a> Placenta. 26, 19-24 (2005).</li><li>Paepe, M. E. D. e., Burke, S., Luks, F. I., Pinar, H., Singer, D. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Demonstration+of+placental+vascular+anatomy+in+monochorionic+twin+gestations.">Demonstration of placental vascular anatomy in monochorionic twin gestations.</a> Pediatr Dev Pathol. 5, 37-44 (2002).</li></ol>

没有利益冲突的声明。

染料注射MC双胎盘血管的映射是评估复杂，临床治疗的情况下，为进一步加强我们的了解MC的孪生的宝贵的过程。与产科队伍，以确保迅速获得一个完整的胎盘标本的协调是至关重要的。干燥或组织的长期存储在注射之前，可能会导致血管损伤和染料外渗。必须避免胎盘固定，因为交联的血块会阻塞血管染料灌注。在此过程中的关键和困难的一步是脐动脉和静脉插管。这些船只，特别是动脉，是脆...

<table border="1"><tbody><tr><th>试剂名称</th><th>公司</th><th>目录编号</th><th>评论（可选） </th></tr><tr><td>多孔塑料碗</td><td> QuickMedical的医疗设备和用品</td><td> Polarware PA75 </td><td>穿孔，可一钻</td></tr><tr><td>不锈钢碗</td><td>纳朗医药有限公司</td><td> HH517 </td><td></td></tr><tr><td>生理盐水</td><td>费舍尔</td><td> 50983204 </td><td></td></tr><tr><td> 0.6-1.9 mm内径聚乙烯管材</td><td> Intramedic </td><td> 7436 </td><td></td></tr><tr><td>动脉线导丝（0.46毫米） </td><td> arrow国际</td><td> PW - 18080 </td><td>轻柔的笔尖</td></tr><tr><td> 18 G钝性针</td><td> BD公司</td><td> 305180 </td><td></td></tr><tr><td>脐磁带</td><td>质量控制供应</td><td> 140895 </td><td></td></tr><tr><td>梅岑鲍姆剪刀</td><td>科尔 - 帕默</td><td> EW - 10921 - 04 </td><td></td></tr><tr><td>凯利钳</td><td>科尔帕默</td><td> EW - 10918 - 20 </td><td></td></tr><tr><td> 3 ml注射器</td><td> Covidien公司</td><td> 1180300555 </td><td></td></tr><tr><td>病理染料</td><td> Bradley产品</td><td> 7365 - X </td><td></td></tr><tr><td>数码相机</td><td>松下</td><td> LUMIX - TZ50 </td><td></td></tr></tbody></table>

guide wire assisted catheterization and colored dye injection for vascular mapping of monochorionic twin placentas

单绒毛膜双胎妊娠（MC）的是与显着较高的发病率和死亡率比dichorionic双胞胎。大约50％的MC双胎妊娠并发症所产生的共享胎盘及相关血管连接1。严重的双对双胞胎综合征（TTTS）报道，占约20％，这些并发症 2,3 。双胞胎间的血管连接出现在几乎所有的MC胎盘，都涉及到这些高风险的双胎妊娠的预后和结果。 TTTS和其他的MC双条件的发展有牵连的数量，规模和类型的连接。三种类型的双胞胎间的血管连接出现：1）动脉，静脉连接（AVS），其中一个分支动脉在进行无氧血液从胎盘和潜水成胎盘子叶的胎儿面沿双课程。血液流动通过深部脑实质成出现在胎盘的胎儿面，并带来对其他双含氧血的引流静脉的毛细血管网。是从双单向流，提供对接收传出静脉双的入球小动脉; 2）动脉动脉连接（AAS），其中从每双支动脉符合上肤浅胎盘的表面直接导致血管搏动性双向流，3）静脉静脉连接（VVS），在从每双分支静脉符合直接允许低压双向流动的表面上肤浅的胎盘在产科超声检查宫内有针对性的多普勒审讯已被用来识别存在的AV机管局连接4。产前检测产后胎盘注射液的研究已证实的氨基酸都被证明是改善预后相关的两个双胞胎 5 。此外，双胞胎间的血管连接共享胎盘的胎儿面fetoscopic激光烧蚀现在是年初，严重TTTS的首选治疗方法。 产后胎盘注射液的研究提供了有价值的方法，以确认产前多普勒超声检查结果的准确性和胎儿激光治疗的疗效6。单独使用彩色染料手工注入动脉和静脉循环，每双的技术亮点和描绘AVS，AAS，VVS。这个MC的胎盘血管解剖明确的示范，届时可能与多普勒超声检查和新生儿的结果，以提高我们的MC的孪生及其后遗症的病理生理的认识。在这里，我们展示我们的胎盘注射技术。

Watch this Scientific Journal Video about Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas at JoVE.com

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

单绒毛膜（MC）后出生的双胞胎的胎盘血管的映射提供了一个双胞胎“环流之间的血管连接的详细示范的手段。这些连接的不平衡被认为是在MC的孪生并发症，包括双对双胞胎输血症候群的发展发挥了举足轻重的作用。

导丝辅助导管和彩色染料注射的双人单绒毛膜胎盘血管映射

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC ...

guide-wire-assisted-catheterization-colored-dye-injection-for

Research

JoVE Journal

Medicine

14.8K 次观看.  University of California, San Francisco. 单绒毛膜（MC）后出生的双胞胎的胎盘血管的映射提供了一个双胞胎“环流之间的血管连接的详细示范的手段。这些连接的不平衡被认为是在MC的孪生并发症，包括双对双胞胎输血症候群的发展发挥了举足轻重的作用。

视频: Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Mesenteric Artery Contraction and Relaxation Studies Using Automated Wire Myography

Proximal resistance vessels, such as the mesenteric arteries, contribute substantially to the peripheral resistance. These small vessels of between 100-400 &mu;m in diameter function primarily in directing blood flow to various organs according to the overall requirements of the body. The rat mesenteric artery has a diameter greater than 100 &mu;m. The myography technique, first described by Mulvay and Halpern1, was based on the method proposed by Bevan and Osher2. The technique provides information about small vessels under isometric conditions, where substantial shortening of the muscle preparation is prevented. Since force production and sensitivity of vessels to different agonists is dependent on the extent of stretch, according to active tension-length relation, it is essential to conduct contraction studies under isometric conditions to prevent compliance of the mounting wires. Stainless steel wires are preferred to tungsten wires because of oxidation of the latter, which affects recorded responses3.The technique allows for the comparison of agonist-induced contractions of mounted vessels to obtain evidence for normal function of vascular smooth muscle cell receptors.
We have shown in several studies that isolated mesenteric arteries that are contracted with phenylyephrine relax upon addition of cumulative concentrations of extracellular calcium (Ca2+e). The findings led us to conclude that perivascular sensory nerves, which express the G protein-coupled Ca2+-sensing receptor (CaR), mediate this vasorelaxation response. Using an automated wire myography method, we show here that mesenteric arteries from Wistar, Dahl salt-sensitive(DS) and Dahl salt-resistant (DR) rats respond differently to Ca2+e. Tissues from Wistar rats showed higher Ca2+-sensitivity compared to those from DR and DS. Reduced CaR expression in mesenteric arteries from DS rats correlates with reduced Ca2+e-induced relaxation of isolated, pre-contracted arteries. The data suggest that the CaR is required for relaxation of mesenteric arteries under increased adrenergic tone, as occurs in hypertension, and indicate an inherent defect in the CaR signaling pathway in Dahl animals, which is much more severe in DS.
The method is useful in determining vascular reactivity ex vivo in mesenteric resistance arteries and similar small blood vessels and comparisons between different agonists and/or antagonists can be easily and consistently assessed side-by-side6,7,8.

An automated myography method for force measurements in isolated mesenteric arteries is described. It employs a Mulvany-Halpern Auto Dual Wire Myograph 510A to determine responses to phenylephrine and extracellular calcium. The method allows consistent determination of isometric responses to agonists in small vessels of diameters of 60 - 300 &mu;m, independently.

肠系膜动脉收缩和舒张的研究，使用自动线Myography

Proximal resistance vessels, such as the mesenteric arteries, contribute substantially to the peripheral resistance. These small vessels of between ...

科研

医学

Accurate and Simple Evaluation of Vascular Anastomoses in Monochorionic Placenta using Colored Dye

The presence of placental vascular anastomoses is a conditio sine qua non for the development of twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS)1,2. Injection studies of twin placentas have shown that such anastomoses are almost invariably present in monochorionic twins and extremely rare in dichorionic twins1. Three types of anastomoses have been documented: from artery to artery, from vein to vein and from artery to vein. Arterio-venous (AV) anastomoses are unidirectional and are referred to as "deep" anastomoses since they proceed through a shared placental cotyledon, whereas arterio-arterial (AA) and veno-venous (VV) anastomoses are bi-directional and are referred to as "superficial" since they lie on the chorionic plate. Both TTTS and TAPS are caused by net imbalance of blood flow between the twins due to AV anastomoses. Blood from one twin (the donor) is pumped through an artery into the shared placental cotyledon and then drained through a vein into the circulation of the other twin (the recipient). Unless blood is pumped back from the recipient to the donor through oppositely directed deep AV anastomoses or through superficial anastomoses, an imbalance of blood volumes occurs, gradually leading to the development of TTTS or TAPS. The presence of an AA anastomosis has been shown to protect against the development of TTTS and TAPS by compensating for the circulatory imbalance caused by the uni-directional AV anastomoses1,2. 
Injection of monochorionic placentas soon after birth is a useful mean to understand the etiology of various (hematological) complications in monochorionic twins and is a required test to reach the diagnosis of TAPS2. In addition, injection of TTTS placentas treated with fetoscopic laser surgery allows identification of possible residual anastomoses3-5. This additional information is of paramount importance for all perinatologists involved in the management and care of monochorionic twins with TTTS or TAPS. Several placental injection techniques are currently being used. We provide a simple protocol to accurately evaluate the presence of (residual) vascular anastomoses using colored dye injection.

Twin-to-twin transfusion syndrome and twin anemia polycythemia sequence are two potentially devastating problems in perinatal medicine. Both disorders occur only in monochorionic twins and result from unbalanced blood flow through placental vascular anastomoses. We provide a simple protocol to accurately evaluate the presence of vascular anastomoses using colored dye injection of placental vessels after birth.

在单绒毛膜胎盘血管吻合用有色染料的精确和简单的评价

The presence of placental vascular anastomoses is a conditio sine qua non for the development of twin-to-twin transfusion syndrome (TTTS) and twin anemia ...

Accuracy in Dental Medicine, A New Way to Measure Trueness and Precision

Reference scanners are used in dental medicine to verify a lot of procedures. The main interest is to verify impression methods as they serve as a base for dental restorations. The current limitation of many reference scanners is the lack of accuracy scanning large objects like full dental arches, or the limited possibility to assess detailed tooth surfaces. A new reference scanner, based on focus variation scanning technique, was evaluated with regards to highest local and general accuracy. A specific scanning protocol was tested to scan original tooth surface from dental impressions. Also, different model materials were verified. The results showed a high scanning accuracy of the reference scanner with a mean deviation of 5.3 &#177; 1.1 &#181;m for trueness and 1.6 &#177; 0.6 &#181;m for precision in case of full arch scans. Current dental impression methods showed much higher deviations (trueness: 20.4 &#177; 2.2 &#181;m, precision: 12.5 &#177; 2.5 &#181;m) than the internal scanning accuracy of the reference scanner. Smaller objects like single tooth surface can be scanned with an even higher accuracy, enabling the system to assess erosive and abrasive tooth surface loss. The reference scanner can be used to measure differences for a lot of dental research fields. The different magnification levels combined with a high local and general accuracy can be used to assess changes of single teeth or restorations up to full arch changes.

Accuracy is a major demand in dental medicine. To verify accuracy, reference scanners are needed. This article presents a new reference scanner with an adjusted scanning method to acquire a broad variety of dental morphologies with high trueness and precision.

精度在牙科医学，一种新的方法来测量正确度与精密度

Reference scanners are used in dental medicine to verify a lot of procedures. The main interest is to verify impression methods as they serve as a base ...

A Murine Model of Arterial Restenosis: Technical Aspects of Femoral Wire Injury

Cardiovascular disease caused by atherosclerosis is the leading cause of death in the developed world. Narrowing of the vessel lumen, due to atherosclerotic plaque development or the rupturing of established plaques, interrupts normal blood flow leading to various morbidities such as myocardial infarction and stroke. In the clinic endovascular procedures such as angioplasty are commonly performed to reopen the lumen. However, these treatments inevitably damage the vessel wall as well as the vascular endothelium, triggering an excessive healing response and the development of a neointimal plaque that extends into the lumen causing vessel restenosis (re-narrowing). Restenosis remains a major cause of failure of endovascular treatments for atherosclerosis. Thus, preclinical animal models of restenosis are vitally important for investigating the pathophysiological mechanisms as well as translational approaches to vascular interventions. Among several murine experimental models, femoral artery wire injury is widely accepted as the most suitable for studies of post-angioplasty restenosis because it closely resembles the angioplasty procedure that injures both endothelium and vessel wall. However, many researchers have difficulty utilizing this model due to its high degree of technical difficulty. This is primarily because a metal wire needs to be inserted into the femoral artery, which is approximately three times thinner than the wire, to generate sufficient injury to induce prominent neointima. Here, we describe the essential surgical details to effectively overcome the major technical difficulties of this model. By following the presented procedures, performing the mouse femoral artery wire injury becomes easier. Once familiarized, the whole procedure can be completed within 20 min.

The mouse femoral artery wire injury model of restenosis is technically challenging. In this protocol we show the key technical details essential for successfully performing wire injury to induce consistent&#160;neointima for studies of restenosis.

动脉再狭窄小鼠模型：股导线损伤的技术方面

Cardiovascular disease caused by atherosclerosis is the leading cause of death in the developed world. Narrowing of the vessel lumen, due to ...

Induction of Accelerated Atherosclerosis in Mice: The "Wire-Injury" Model

Atherosclerosis is a proliferative fibro-inflammatory disease developing in the arterial wall, inducing a deficient blood flow or a lack of blood flow. Moreover, by rupture of the defective vascular wall, atherosclerosis induces occlusive thrombus formation, which represents the main cause of myocardial infarction or stroke and the most frequent cause of death. Despite the advances in the cardiovascular field, many questions remain unanswered, and additional basic research is essential to improve our understanding of the molecular mechanisms during atherosclerosis and its effects. Due to limited clinical studies, there is a need for representative animal models recreating atherosclerotic conditions such as neointima formation after stent implantation, balloon angioplasty, or endarterectomy. Since the mouse presents many advantages and is the most frequently used model for studying molecular processes, the current study proposes an invasive procedure of endothelial denudation, also known as the wire-injury model, which is representative of the human condition of neointima formation in arteries after revascularization procedures.

Induction of Accelerated Atherosclerosis in Mice: The &quot;Wire-Injury&quot; Model

This study describes an invasive procedure for the induction of accelerated atherosclerosis in mice. In comparison to other methods using electric- or cryo-induced injury, mechanical-induced injury mimics the human condition of restenosis after revascularization therapies and is ideal for the study of the molecular mechanisms involved.

小鼠加速动脉硬化的诱导："电线损伤"模型

Atherosclerosis is a proliferative fibro-inflammatory disease developing in the arterial wall, inducing a deficient blood flow or a lack of blood flow. ...

Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension

In this protocol, PAH is induced by combining a 60 mg/kg monocrotalin (MCT) injection with increased pulmonary blood flow through an aorto-caval shunt (MCT+Flow). The shunt is created by inserting an 18-G needle from the abdominal aorta into the adjacent caval vein. Increased pulmonary flow has been demonstrated as an essential trigger for a severe form of PAH with distinct phases of disease progression, characterized by early medial hypertrophy followed by neointimal lesions and the progressive occlusion of the small pulmonary vessels. To measure the right heart and pulmonary hemodynamics in this model, right heart catheterization is performed by inserting a rigid cannula containing a flexible ball-tip catheter via the right jugular vein into the right ventricle. The catheter is then advanced into the main and the more distal pulmonary arteries. The histopathology of the pulmonary vasculature is assessed qualitatively, by scoring the pre- and intra-acinar vessels on the degree of muscularization and the presence of a neointima, and quantitatively, by measuring the wall thickness, the wall-lumen ratios, and the occlusion score.

This protocol describes a surgical procedure to create a model for flow-induced pulmonary arterial hypertension (PAH) in rats and the procedures to analyze the principle hemodynamic and histological end-points in this model.

分流手术，右心导管，血管形态计量学在大鼠模型中的流量引起的肺动脉高压

In this protocol, PAH is induced by combining a 60 mg/kg monocrotalin (MCT) injection with increased pulmonary blood flow through an aorto-caval shunt ...

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously. Here we describe realistic simulators designed to allow the user familiarity with the equipment and specific steps required in the surgical treatment of TTTS, including fetoscopic handling, approaches to anterior and posterior placenta, recognition of anastomoses, and efficient coagulation of vessels. We describe the skills that are especially important in conducting placental laser coagulation that the surgeon can practice on the model and apply in a clinical case. These models can be adapted easily depending on the availability of materials and require standard fetoscopy equipment. Such training systems are complementary to traditional surgical apprenticeships and can be useful aids for fetal medicine units that provide this clinical service.

Practicing the specific skills required for fetoscopic laser coagulation of monochorionic placental anastomoses on realistic models can aid less experienced surgeons in overcoming the steep learning curve associated with this procedure that is now regarded as the standard of care for twin-twin transfusion syndrome.

模型外科训练: 用逼真模拟器 Fetoscopic 激光光凝单绒毛膜 Diamniotic 双胎胎盘的技能习得

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome ...

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin

Nephrotic syndrome is the most extreme manifestation of proteinuric kidney disease and characterized by heavy proteinuria, hypoalbuminemia, and edema due to sodium retention and hyperlipidemia. To study the pathophysiology of this syndrome, rodent models have been developed based on the injection of toxic substances such as doxorubicin causing podocyte damage. In mice, only few strains are susceptible to this model. In wildtype 129S1/SvImJ mice, the administration of doxorubicin by rapid intravenous injection to the retrobulbar sinus induces experimental nephrotic syndrome that features all the symptoms of human disease including sodium retention and edema. After the onset of proteinuria, mice exhibit increased urinary serine protease activity that leads to the activation of the epithelial sodium channel (ENaC) and sodium retention. Pharmacological inhibition of urinary serine proteases by the treatment with sustained release aprotinin abrogates ENaC activation and prevents sodium retention. This model is ideal to study the pathophysiology of proteasuria, i.e., the excretion of active serine proteases that cause ENaC activation by the proteolysis of its &#947;-subunit. This can be regarded as the primary mechanism of ENaC activation and sodium retention in proteinuric kidney disease.

Here, we describe the induction of experimental nephrotic syndrome in 129S1/SvImJ mice by rapid retrobulbar injection of doxorubicin. We also treat nephrotic mice with sustained release pellets containing aprotinin to inhibit urinary serine protease activity and prevent sodium retention.

球注射阿霉素对小鼠肾病综合征的诱导作用及缓释抑肽酶预防容积保留率的研究

Nephrotic syndrome is the most extreme manifestation of proteinuric kidney disease and characterized by heavy proteinuria, hypoalbuminemia, and edema due ...

Three-Dimensional Printing Guide Template Assisted Percutaneous Vertebroplasty (PVP)

Percutaneous vertebroplasty (PVP) is considered an effective treatment for the back pain caused by osteoporotic vertebral compression fracture. The accuracy of PVP mainly depends on the surgeons&#39; experience and multiple fluoroscopes during a traditional procedure. Puncture related complications were reported all over the world. To make the surgical procedure more precise and decrease the rate of puncture-related complications, our team applied a three-dimensional printing guide template to PVP to modify the traditional procedure. This protocol introduces how to model target vertebrae DICOM imaging data into three-dimensions in the software, how to simulate operation in this 3-D model, and how to use all of the surgical data to reconstruct a patient specific template for application. Using this template, surgeons can identify suitable puncture points accurately to improve the accuracy of the operation. The whole protocol includes: 1) diagnosis of the osteoporotic vertebral compression fracture; 2) acquisition of CT imaging of the target vertebra; 3) simulation of the operation in the software; 4) design and fabrication of the 3-D printing guide template; and 5) application of the template into an operation procedure.

Three-Dimensional Printing Guide Template Assisted Percutaneous Vertebroplasty PVP

Herein, we present a three-dimensional printing guide template for percutaneous vertebraplasty. A patient with a T11 vertebral compression fracture was selected as a case study.

三维打印指南模板辅助皮椎间盘（PVP）

Percutaneous vertebroplasty (PVP) is considered an effective treatment for the back pain caused by osteoporotic vertebral compression fracture. The ...

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery

The use of in vitro maturation (IVM) before gynecological operation (OP-IVM) is an extension of conventional IVM that combines IVM following oocyte retrieval with routine gynecological surgery. OP-IVM is suitable for patients undergoing benign gynecological surgery who have the need for fertility preservation (FP) or infertility treatments such as in vitro fertilization and embryo transfer (IVF-ET). In the operating room, patients undergoing benign gynecological surgery are first anesthetized and receive ultrasound-guided immature follicle aspiration (IMFA) treatment. As the subsequent gynecological surgery is performed, the cumulus-oocyte complexes (COCs) are examined, and the immature COCs are transferred into the IVM medium and cultured for 28-32 hours in the IVF laboratory. After assessment, mature oocytes in the MII stage will be selected and cryopreserved in liquid nitrogen for FP or fertilized by intracytoplasmic sperm injection (ICSI) for IVF-ET. By combining IVM with gynecological surgery, immature oocytes that would have been discarded can be saved and used for assisted reproductive technology (ART). The procedure, significance and critical aspects of OP-IVM are described in this article.

In vitro maturation (IVM) before gynecological operation (OP-IVM) combines IVM following oocyte retrieval with routine gynecological surgery and serves as an extension of conventional IVM applications for fertility preservation.

OP-IVM：将卵母细胞取回后的体外成熟与妇科手术相结合

The use of in vitro maturation (IVM) before gynecological operation (OP-IVM) is an extension of conventional IVM that combines IVM following oocyte ...