The Relevance Research Gene Expression Of HIF1-α, P-selectin And TNF-α In Lower Limb Venous Skin Ulcer Formation

Objective:To explore the role of P-selectin, hypoxia induced factor 1-a (HIF1-α) and tumor necrosis factor alpha (TNF-a) in the process of lower limb vein skin ulcers via observed the content of the lower limb vein patients,and to find the novel treatment of lower limb vein skin ulcers.Methods:(1)select 12 causes involving 12 legs with venous ulcer in lower extremity patients from The Forth Affliated hospital of Kunming Medical college. All patients are from 2009.4 to 2011.1,among them 7 are male,5 are female.Gathered information on patients. The patients are done double lower limbs vascular doppler inspection to comparate arterial patency and superficial vein, deep vein unobstructed, venous valve function and blood backward situation of double lower limbs.To clear the operation area,the traffic vein ulcer and the degree varicose vein, patients are done limb percutaneous selective retrograde vein angiogram.(2) 5ml dorsal vein blood of the patients are freeze-stored in the-80℃before the surgery and after operation 120 day later;during operation,take 1-2cm tissue of around ulcer as ulcer group,20cm operation around ulcer as control group.The tissue samples are fixed and kept in refrigerator. (3)The content of TNF-a, P-selectin, HIF-1 a from the blood specimens, ulcer tissue and normal tissues was detected via retrovirus, fluorescence quantitative polymerase chain reaction (PCR).after operation the expression levels of the HIF-1α, P-selectin and TNF-a of the blood group is down. Results:(1)Double lower limbs vascular doppler detection:double lower limbs artery flow sound are normal.All of patients the limb saphenous vein venous reflux,small saphenous vein have reflux.8 Deep vein, and the popliteal venous valve function of 8 patients are nomal; The three patients'deep venous appeared reflux,but no thrombosis, blood flow unobstructed; 1 patient have deep vein thrombosis or recanalization.9 patients'healthy limbs with superficial veins and deep veins are normal,3 patients healthy limbs have varicose vein.(2)The ulcer base of 11 patients'limbs are found the venous valve function obstacle and varicose vines in the calf and foot boots section by the percutaneous selective retrograde deep vein imaging.3 patients'deep vein appear reflux(3)The expression of HIF-la, P-selectin and TNF-a in blood and ulcer of the patient's venous skin ulcer lower limb and the relationships of information:In 12 cases with venous skin ulcers lower limb in patient blood, ulcer tissues and normal tissue,The results of variance analysis showe three indexes (HIF-la. P-selectin and TNF-a) groups are statistically significant difference (P<0.01); both Multiple comparison results show that the control group and the blood group, ulcer group and blood group are statistically significant (P< 0.05).The blood group is the highest, ulcer is second, and control group is the lowest.in all, the three factors expression be concerned with ulceration.(4)HIF-la, P-selectin and TNF-a in lower limb venous skin ulcer relationship: through the RT-PCR experimental results show that between three indexes related a statistically significant (P<0.05).A positive correlation between all the weak, including TNF-a and P-selectin element correlation coefficient is the largest, r= 0.60. From table 2 can see. no matter the blood group, ulcer group and control group, the mean is: HIF-1α> P-selectin> TNF-a. Further speculation ulcer formation maybe relationship with these factors expression,and these factors are from the blood stream.(5)After the percutem transillumiated with Negative Pressured,the expression levels of the HIF-la, P-selectin and TNF-a of the blood group is reduced (P<0.05).healing the ulcer.Conclusion:(1) HIF-1α, P-selectin and TNF-a are related to the formation of ulcer,which all expressed highly in the lower limb venous skin ulcer patients.(2) In our study,HIF-1α,P-selectin and TNF-a expression levels are high.HIF-1αand P-selectin expression levels is higher than TNF-a expression level.HIF-la and P-selectin are more important than TNF-a in the venous skin ulcer.(3)Percutem Transilluminated with Negative Pressured on The Potaried Technique on Treatment of Venous Ulcer in Lower Extremity,healing is getting better and better.