In vivo microvascular regeneration in the various conditions and molecular expressions and regulations

肥胖、高血压、动脉硬化闭塞症(ASO)和糖尿病(DM)在接受游离皮瓣手术和断指再植的患者中的并存率增加。在这些并存的血管中，血管内皮细胞受到了显著的损伤，从而导致缺氧，氧化应激和缺血再灌注损伤备受关注。即使大体上再吻合成功，也可能导致术后血栓形成。在微血管模型中，结扎股血管，切断隐神经后，以腹壁浅动静脉为营养血管的上腹筋膜瓣，对结扎的血管和切断的神经进行包裹。将人骨髓间充质干细胞与碱性成纤维细胞生长因子一起通过滋养动脉(腹壁浅动脉)注入，将包裹的筋膜瓣贴附于缺损区后，夹闭孵育10min。对神经传导速度和组织血流量进行时间分析。此外，临床上头颈部手术和肢体微血管重建有时也是困难的，因为经常会出现痉挛和血管直径的差异。含细胞因子的人工真皮作为一种替代性的重建方式，尤其是在老年人小腿严重受损的情况下，在创面覆盖方面是有效的。在创面质量分析中，碱性成纤维细胞生长因子处理的创面从伤后即刻开始即可获得较好的瘢痕质量，且缩短了创面愈合时间。

Obesity, hypertension, atherosclerosis obliterans (ASO)and diabetes mellitus (DM) are increasing as co-morbidities increasing among those who are undertaking free flap surgeries and digital re-plantations. In these co-morbidities, there are remarkable damages in the endothelial cells of these blood vessels and thus induced hypoxia and the oxidized stresses and ischemic-reperfusion injury are highly concerned. Even macroscopically successful re-anastomoses may lead to thrombosis afterward. Thus, the optimal microvascular environment was investigated with low-sensory and low-blood flow models.In the microvascular models, after ligating the femoral vessels and severing the saphenous nerves, the epigastric fascial flap of which the nutrient vessels are the superficial epigastric artery and veins, covered the ligated-vessels and severed-nerves by wrapping. The human derived mesenchymal stem cells, together with basic fibroblast growth factor (bFGF)were injected through the nutrient artery (the superficial epigastric artery)and then incubated for 10 minutes by clamping after the wrapped fascial flap was attached to the defects. The analysis of the nerve conduction velocity and tissue blood flows was temporally investigated. The ipsi-lateral 4-mm full-thickness paw skin defect was also compared among groups temporally.Also, clinically the head-and-neck surgery and extremities are sometimes difficult for microvascular surgical reconstructions, because spaspms and the differences of the diameters of the vessels are often experienced. As an alternative reconstructive modalities, especially severely damaged lower legs in the elderly population, the artificial dermis with cytokine (bFGF)were effective in wound coverage. In the analysis of quality of wounds, there is much better scar quality in bFGF-treated wounds from the immediately post-wounding as well as shortening the wound healing time.