Effect Of Negative Pressure In Pharyngo-oral Cavity On Lymphatic Circulation

Background:Lymphatic vessels were first described by GasparoAselli in the 17th century,he named the lymphatic vessels as lacteae venae,or milky veins.As an accessory system of blood vascular system,lymphatic system are essential for maintenance of normal fluid balance,draining extracellular fluid from the tissues to blood circulation,and providing an exclusive environment in which immune cells can encounter and respond to foreign antigen in the peripheral lymphoid tissues.But lymphatic vascular system is traditionally neglected as a topic of scientificstudy,because lack of lymphatic specific markers and knowledge about the molecular regulation of lymphatic development and function.Although more scientific attention was paid to the blood vascular system than the lymphatic vascular system,the lymphatic vascular system has recently received tremendous scientific interest.Some of the mechanisms controlling the normal and pathological development of the lymphatic vasculature are being unraveled by a number of recent discoveries,and several genetic defects were also been identified in patients with lymphedema.Now,along with the findings of some special markers and growth factors,many researchers from different backgrounds recognized the impact of lymphatic research on both basic research and clinical medicine.Although more scientific attention was paid to lymphatic system than before,the treatments for lymphedema and related disorders still very difficulty.And the mechanisms of many diseases were related to lymphatic system.Lymphedema is the swelling of tissues and organs because of lymphatic blockage at the certain location of organism.Lymphedema general contain secondary and primarily.The primary lymphedema is caused by primary disease of the lymphatic system.The secondary lymphedema is caused by the damaged or disease process of the lymphatic system.For example,extensive secondary and primarily malignant diseases,surgery,filariasis repetat inflammation and large dose of radiation therapy can damage lymphatic system and lead to lymphedema.The secondary lymphedema contain surgery lymphedema,malignant tumor causeded lymphedema,filaria causeded lymphedema,inflammatory lymphedema,radioactivity lymphedema.at present,the ratio of surgery lymphedema is high because of iatrogenic damage.Reported by WHO,there is 30 million women with lymphedema on the upper limb after modified radical mastectomy.As the domestic report,the hypodermic product fluid,skin petal necrosis as well as the upper limb lymphedema incidence rate reaches as high as 51%-71%after breast cancer operation.These complications seriously influence operation's quality,patient's survival rate as well as patient's quality of life.At presen,the therapy of lymphedema has no specific treatment,the conventional treatment contain conservative treatment and operative treatment,but the effect of these treatments is not well,moreover,these treatments can cause severe suffering to patients.The results showed that the change of press grads in coelom is the main power of lymph refluence,increasing the pressure difference of internal coelom can accelerate regurgitant lymph.So,it is important for treat lymphedema or the diseases of disorder of lymph recirculation to how to remove the obstruction of lymph refluence and keep lymph system unobstructed and strengthen the power of regurgitant lymph and accelerate the lymph circulation.It is better method for the diseases of disorder of lymph recirculation to increase the press grads of internal coelom,enhance the pressure difference of lymph circulation,keep the lymph circulation on the rails.Waldeyer's ring is the lymphoid tissues that form a ring around the opening of the throat including tonsils laterally, adenoids superiorly,and lingual tonsil at the base.We manufacture a machine to form negative pressure in pharyngo-oral cavity,thus to increase lymphatic circulation in Waldeyer's ring.Using this machine,we improved the symptom of some patients with lymphedema and patients with chyloperitoneum.This treatment is also useful on the cure of haemorrhoids with clinical proof.So,we set up this experiment to observe the effect of negative pressure in pharyngo-oral cavity on lymphatic circulation.From here,we design two parts experiment as follows:Partâ… Making the oral negative press to influence natural lymph circulation of rabbitObjective:We form negative pressure in pharyngo-oral cavity of rabbits,and observe the changes of lymphatic circulation to find a new treatment for lymphedema and related disorders.Methods:This experiment contain two parts:Part one To experiment at venous angle:control group and experimental groupUsing 25 New-Zealand rabbits,divide them to 2 groups,the control group(CG of LJT)which has 10 rabbits,the experimental group(EG of LJT)which has 15 rabbits. the rabbits of control group were anesthetized with 3%Pentobarbital Sodium(30mg/kg),firstly,to expose the left venous angle and left jugular trunk and left subclavian trunk,then to inject 10%Patent Blue V 0.3ml,after that to observe and write down the time of dye from left jugular trunk to left venous angle.Subcutaneous injection 10%Patent Blue V 0.5ml between the second and the third toes of the left upper limb and to observe and record the time of dye from left subclavian trunk to left venous angle.The rabbits of experimental group were anesthetized by the same method,we made negative pressure in pharyngo-oral cavity of rabbits and record the time by the method as the control group.Compare the difference between the experiment groups and the control group.Part two To experiment at left lumbar trunk:control group and experimental groupUsing 25 New-Zealand rabbits,divide them to 2 groups,the control group(CG of LLT)and the experimental group(EG of LLT),the number of rabbits is 10 and 15 respectively.The rabbits of control group were anesthetized with 3%Pentobarbital Sodium(30mg/kg),exposed the overlape of left lumbar trunk and left renal vein. Subcutaneous injection 10%Patent Blue V 1ml between the second and the third toes of the left lower limb.Then to observe and record the time.The rabbits of experimental group were treate as the control group after accepted negative pressure. At last,Compare the difference between the experiment groups and the control group.Results:Part one:The time of the experiment groups is less than that of the control groupsafter the rabbits accepted the treatment of negative pressure.Part two The time of the experiment groups is obviously shortened after the rabbits accepted the treatment of negative pressure.Conclusion:From the experimental result,we find that there is a effect on lymphatic circulation with negative pressure,it can enhance lymphatic return,we still need to find how it can influence lymphatic circulation from microcosmic environment using special instruments and markers.Although more scientific attention was paid to the blood vascular system than the lymphatic vascular system,the lymphatic vascular system has recently received tremendous scientific interest.Some of the mechanisms controlling the normal and pathological development of the lymphatic vasculature are being unraveled by a number of recent discoveries,and several genetic defects were also been identified in patients with lymphedema.The finding of specific markers and growth factors for lymphatic vessels is important in this advance.We hope this experiment in lymphatic research may open the door to the development of new treatments for lymphedema and related disorders.Partâ…¡The experimental study of lymph dropsy's prevention and the therapeutic action after breast cancer improvement radical correction by the establishment of oral cavity negative pressureObjectiveWe study the promotion for lymph circulation by the establishment of oral cavity negative pressure,observe the function of lymph dropsy's prevention and therapeutic action by the establishing the oral cavity negative pressure on the patients who received modified radical mastectomy.Methods:In the Shandong University Qi Lu hospital mammary gland surgical department, we select 80 example patients by random,they are all the female,come to hospital from January,2007 to January,2008 and all been diagnosed to breast cancer,in hospital they accept modified radical mastectomy,they aged 31-72 years old,average age is 47 years old.We divide them into 2 groups by random,each group has 40 examples,the first group is the use group after operation,which use the oral cavity negative pressure attraction machine from the first day after the operation,the second group is a control group,does not use the oral cavity negative pressure attraction machine to cure.In addition,we choose 20 example patients for the third group,which have dropsy occur within three days after accepting modified radical mastectomy,if does not conform to this standard we don't select into this group.The patient who use oral cavity negative pressure attraction machine,aged 29-70 years old,the average age is 45 years old,treat the group as dropsy cure group.These 100 example patient,they all accept modified radical mastectomy,3 groups of patient's age distributions,modus operandi,pathology classification by stages have not obvious difference.Observation item are double drainage tube's drainage time which we set after operation(drainage time is the day numbers before we put out the tube),upper limb lymph dropsy's formation rate(incidence of lymphedema),difference of longitude between upper limb trouble side and healthy side.After surveying the target and obtaining above data,the observation item that the first group(uses group after operation)compares with the control group is that:Drainage time(drainage time) and upper limb lymph dropsy's incidence rate(incidence of lymphedema).the observation item that the third group(dropsy uses group)compares with the control group is that:Curative effect.Results:The analytic result between the use group after operation and the control group: the double drainage tube drainage time(drainage time)is to shorten greatly,the upper limb lymph dropsy's incidence rate(incidence of lymphedema)is to cut down greatly.The comparative analysis result between dropsy uses group and the control group:in the dropsy uses group,the patients' upper limb lymph dropsy is much better than the patients in control group,lymph dropsy resolve obviously,and the therapeutic efficacy is pretty good.Conclusion:The trouble side upper limb dropsy is one of the complications which usually happen after breast cancer operation,it influences the patient's quality of life badly, and its reason is mainly because of the lymphatic return barrier.We choose these cases in order to research influence to the lymph circulation by the establishment of oral cavity negative pressure,and has made the satisfactory progress.This experiment confirms that for the patients who accept breast cancer improvement radical correction,the establishment negative pressure in their oral cavity can greatly shorten drainage time of the tube,greatly reduce the incidence rate of the patients' upper limb lymphedema,and shorten the recover time for the patient who have occur upper limb lymphedema after operation,and also have good prevention and therapeutical effect for traumatic lymphedema.Meanwhile we can confirm that the establishment negative pressure in oral cavity can greatly promote lymph circulation of upper limb,and to accelerate the absorption and recirculation of lymph fluid.