| The repairment of congenital and acquired tissue deficiency is the difficulties and keypoint of plastic and reconstructive surgery. The tissue types of defects are various, but the important part is the subcutaneous fat. Various tissue transplantation and augmentation have been utilizied to repair soft tissue defects. Clinically the most common materials for soft tissue augmentation is two kinds:autologeous and synthetic materials. Due to the poor biocompatibility of synthetic artificial materials, the defects of the contour are obvious, and the non permanent implants, which limit its wider application.Adipose tissue is one of the commonly used soft tissue repair materials. Free tissue transplantation is one of the common methods for tissue repairment in Plastic Surgery. It holds the advantages of abundant resources, easy taken, concealed scar, simple operation, good histocompatibility and no foreign body rejection reaction. However, the inherent shortcomings are high and un-predictable absorption rate. Although a series new technique and method have been widely recongnized and used to improve the survival rate of free fat transplantation. But the survival rate of fat transplantation is still not satisfactory, and the effect of treatment can not be determined. The wide application is mostly restricted in clinically usage.The fat cell itself manifests the characteristics of high energy consumption and low tolerance to ischemia and hypoxia, and it needs to get enough nutrition from the recipient site after free transplantation. The nutrition supply of the adipose tissue can only be maintained by the infiltration of the tissue fluid of surrounding tissue, and the distance of the supply is very limited. More than this distance, the nutrition should be provided by neo-generated vessels. But the growing of the spontaneous blood vessels is more than a dozen microns per day, the ingrowth may last 5 days after transplantation and new blood vessels can only invade the surrounding areas of the graft. At this time, the central part of the adipose tissue manifests cell necrosis, fat liquefaction. This demonstrates that the key to solve the problem is to establish the sufficient blood supply so as to promote the re-vascularization of free transplanted adipose tissue.In order to re-establish the blood supply, so as to increase the blood supply of grafted tissue and shorten the ischemia cycle of adipose cell, scholars have done a lot of research among which the most representative of the research methods are:ASC, SVF, BRAVA, etc.. Although they have achieved encouraging results, the limitation is obvious with the existence of in vitro culture, complicated manipulation, easy contamination, consumption of a large number of adipose tissue can be filled and poor patients compliance. And the survival rate of large amount fat transplantation is not satisfactory.This research, through animal experiments and clinical studies, observes the gross and histological changes of free autologous adipose tissue transplantation, the tendency of number and density of blood capillary in the adipose tissue, so as to evaluate the effect of Chinese herbal medicine on the survival rate of fat particles. To explore new ways of improving the survival rate of transplanted adipose tissue.Objective1. Investigate the effect of Astragalus injection and Salvia miltiorrhiza Injection on the survival rate of autologous fat transplantation2 Screening of Chinese herbal medicine for improving the survival rate of autologous fat transplantation3. Clinical study of the efficacy and safety of application of Salvia miltiorrhiza injection in autologous fat transplantation for breast augmentationMethod1. autologous fat transplantation was divided into the experimental and the control group in rabbit model, which were treated with intraperitoneal injection of Astragalus and Salvia miltiorrhiza injection, (1) Serum VEGF expression level was measured at different time points by ELISA method; (2) postoperative 2,4 and 12 weeks were harvested, through precision balance measurement of graft residual mass to calculate the survival rate; (3) Histological morphology and semi quantitative analysis was observed by H & E staining under optical microscope; (4) the growth of capillaries were observed by endothelial cell factor CD31 through immunohistochemical staining; (5) the celluar activity of transplanted adipose cell was observed by perilipin immunohistochemical staining.2 breast augmentation with autologous fat transplantation was divided into experimental and control group. Salvia miltiorrhiza injection was applied for 4 weeks in experimental group. (1)the breast volumemeasured by three-dimensional (3D) scanning (Knonica Minota, Vivid 910), with calculation of fat survival rate, breast volume enlargement amount and breast volume enlargement rate were calculated. (2) the activity of fat cell transplantation was observed by Hochest33342 and perilipin immunofluorescence staining. (3) the distribution of blood vessels in the transplanted adipose tissue was observed by vWF immunofluorescence staining. (4) the blood vessels of vWF by immunofluorescence staining was extracted by Analyzer BZ-X software, and the microvessel density was calculated at height magnification mirror.ResultAnimal model:(1) twelfth weeks after autologous fat transplantation, the volume difference between the control and the experimental group was statistically significant; (2) ELISA results manifested that the serum VEGF expression level in each time point was significantly higher than that in the control group (3) H&E staining manifested that the number of fat cells, morphology were significantly better than the control group with less complications. (4). CD31 immunohistochemical staining in endothelial cells manifested that neo-capillary is more in experimental group than that in group group. Comparing with two experimental groups, more vessels found in Astragalus group. (5) perilipin immunohistochemical staining manifested that the transplanted adipose cell activity in experimental group was higher than that in the control group. Chinese medicine two experimental group is more, but also to Salvia miltiorrhiza group.Research in breast augmentation with autologous fat transplantation:(1) Salvia miltiorrhiza group higher than that of the control group.in the increased breast volume, adipose cell survival rate and breast volume increase rate, (2) transplanted adipose cell morphology and degree of satiation is higher in Salvia miltiorrhiza group than that in control group,determined.by Hoechst 33342 and perilipin immunofluorescence staining observation (3) the distribution of the microvessels in vWF immunofluorescence staining was higher than that in the control group. (4) the number and density of microvessels stained by vWF calculated in BZ-X analyzer were higher in experimental group than that in the control group.Conclusion1 Salvia miltiorrhiza injection can improve the number and density of the blood vessels in the autologous fat transplantation.2 Salvia miltiorrhiza injection can improve the survival rate of autologous fat transplantation. |
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