Establishment of bioartificial pancreas using PTD-FNK protein

采用^<99m>Tc-tetrofosmin （TF）灌注显像目视和定量分析方法，探讨自体骨髓单核细胞加血小板（包括内皮祖细胞（EPCs））植入治疗难治性慢性外周动脉疾病（PAD）的疗效和安全性，并对各项定量评价进行客观评价。我们在本试验中连续治疗了12例和19例四肢和手部重度慢性PAD，几乎是Fontaine IV级（11/12例，约92%）。这种治疗对于缓解严重的PAD疼痛非常有效，特别是对于伯格氏病。采用视觉模拟量表（VAS）测量疼痛程度。种植前最大疼痛水平为66.5±5.0(mm)，种植后最大疼痛水平为12.1±2.2(mm) （p<0.001）。11例（11/12例，92%）腿部和手指静息性疼痛得到缓解。所有患者在跑步机上无痛行走时间均有显著改善（植入前140±53秒，植入后451±74秒，p=0.034）。骨髓单核细胞植入后的下肢静息踝肱压指数（ABI）也明显改善（植入前为0.65±0.08，植入后为0.73±0.07,p=0.055）。^<99m>Tc-TF灌注显像显示，近端（膝关节至踝关节）植入前为1.32±0.10，植入后为1.56±0.11,p=0.007。^<99m>Tc-TF灌注显像，远端区（踝关节至趾端或腕关节至指端），植入前为0.79±0.06，植入后为0.83±0.06,p=0.29。缺血的腿和手注射后灌注血流量增加。^<99m>Tc-TF灌注显像可有效估计新生血管中侧支血管的视觉和定量分析。因此，我们成功地为目前任何治疗方法都无法治愈的大多数严重慢性PAD提供了新的治疗方法，这种治疗性血管生成将成为拯救严重缺血肢体和手部的新策略。少

We investigated efficacy and safety of autologous bone marrow-mononuclear cells plus platelets including endothelial progenitor cells (EPCs) implantation for recovering refractory chronic peripheral arterial disease (PAD) using visual and quantitative analyses by ^<99m>Tc-tetrofosmin (TF) perfusion scintigraphy, and also investigated various quantitative assessments objectively. We performed consecutive twelve cases and 19 limbs and hands with severe chronic PAD that almost Fontaine class IV(11/12 cases, about 92%) in this trial. This treatment was very effective to relieve severe pain of PAD, especially for Buerger's disease. We used visual analog scale (VAS) for measurement of pain level. The maximum pain level before implantation was 66.5±5.0(mm), and decreased to 12.1±2.2(mm) after implantation (p<0.001). Rest pain in legs and fingers were resolved eleven cases (11/12 cases, 92%). All patients could measure pain-free walking time on treadmill were improved remarkably (before implan … More tation 140±53 sec versus after implantation 451±74 sec, p=0.034). And resting ankle-brachial pressure index (ABI) in legs implanted with bone marrow-mononuclear cells was also improved (before implantation was 0.65±0.08 versus after implantation was 0.73±0.07, p=0.055).According to ^<99m>Tc-TF perfusion scintigraphy, in proximal area (region from knee to ankle) before implantation was 1.32±0.10 versus after implantation was 1.56±0.11, p=0.007). ^<99m>Tc-TF perfusion scintigraphy, in distal area (region from ankle to end of toes, or from wrist to end of fingers) before implantation was 0.79±0.06 versus after implantation was 0.83±0.06, p=0.29). Ischemic legs and hands that were injected were increased perfusion blood flow. ^<99m>Tc-TF perfusion scintigraphy was effective to estimate visual and quantitative analysis of collateral vessels in neovascularization. Thus we successed to this new treatment for most severe chronic PAD unable to cure by present any treatments, this therapeutic angiogenesis would be a new strategy for saving severe ischemic limbs and hands. Less