Research On The Relationship Between Diabetes Mellitus And In-Situ Saphenous Vein Disease

OBJECTIVE:To confirm that diabetes has an influence on in-situ Saphenous Vein, and to explore specific mechanism through comprehensive analysis of vascular physical properties、biological stability、microscopic structure and expression、distribution of Inflammatory proteins. Then to judge quality of great Saphenous Vein taken from patient, to evaluate prognosis of Vascular graft, and make an initial study of improving long-term patency rates of great saphenous vein.METHODS:The residual fresh great saphenous veins specimen were getting from the patients who were divided into experimental group (with type2diabetes mellitus, DG) and control group (without type2diabetes mellitus, NG) during CABG surgery. Each specimen was4cm long for further experiments as follows.1. Physical properties detection of vascular specimenIn the test the physical properties were detected on every vessel specimen from every groups, including water content、vascular heat shrink temperature and vascular rupture strength. Physical property was evaluated according to the differential expression of every testing results The influence of diabetes on physical properties of in situ saphenous vein was assessed.2. Histological features detection on vascular wallThe routine HE stain and connective tissue Masson stain for vascular wall were conduced on each specimen of two groups. Stability of vascular biology and the microstructural components were evaluated based on RE、RC、C/E and CC/MC, and then to observe the diabetes’impact on cell and histological features of in-situ saphenous vein groups.3. Immunohistochemistry detection on the degree of expression and location of TNFAIP8and TIPE2in the in-situ saphenous veinStreptavidin Peroxydase Conjugated Method was conducted to determines the degree of expression and location of TNFAIP8and TIPE2, then to observe the differential expression of TNFAIP8and TIPE2, and to discuss the diabetes’impact on inflammation disease of in-situ Saphenous Vein.RESULTS:1. Water content in groups of NG＞groups of DG (P>0.05);2. Vascular heat shrink temperature in groups of NG> groups of DG (0.01<P<0.05);3. Vascular rupture strength in groups of NG＞groups of DG (P<0.01);4. Vascular Biology stability index, groups of NG>groups of DG,(P<0.01);5. Elastic fiber content (RE), groups of NG> groups of DG,(0.01<P<0.05)6. Collagenous fiber content (RC), groups of DG>groups of NG,(P<0.05);7. Tube-wall stiffness (C/E), groups of DG>groups of NG,(P< 0.01);8. Connective tissue stroma’s volume density in circular smooth muscle (CC/MC), groups of DG＞groups of NG,(P<0.01);9. Expression and location of TNFAIP8in the in-situ Saphenous Vein.In groups of NG:TNFAIP8is moderately expressed in tunica intima and tunica media; There is no expression in tunica adventitia.In groups of DG:TNFAIP8is mild expressed in tunica adventitia, moderately expressed in tunica media, and highly expressed in tunica intima, which shows an increasing trend from tunica adventitia to tunica intima.TNFAIP8is expressed in every group and every vessel. Groups of DG> Groups of NG; TNFAIP8is no expressed in tunica adventitia of NG. However, which is expressed in all vascular layers of DG, and shows an increasing trend from tunica adventitia to tunica intima.10. Expression and location of TIPE2in the in-situ Saphenous VeinIn groups of NG TIPE2is mild expressed in tunica media and moderately expressed in tunica intima, and there is no expressed in tunica adventitia.In groups of DG TIPE2is moderately expressed in tunica media and highly expressed in tunica intima, and there is also no expressed in tunica adventitia.TIPE2is expressed in every group and every vessel. Groups of DG>Groups of NG. Both groups are quite similar, TIPE2is distributed in tunica intima and tunica media, and there is no distribution in tunica adventitia.CONCLUSIONS:To confirm that diabetes has an influence on in-situ saphenous vein, and to explore the specific mechanism through the comprehensive analysis of vascular physical properties, biological stability, microscopic structure and expression and distribution of Inflammatory proteins. Then to judge the quality of great saphenous vein taken from patient, to evaluate the prognosis of Vascular grafts, and make an initial study of improving long term patency rate of great saphenous vein. The conclusion of the study is as follows:1. There is significant difference in vascular heat shrink temperature and vascular rupture strength between two groups. Groups of NG have an advantage over the groups of DG2. Groups of NG show a better vascular biology stability than the groups of DG.3. Groups of NG are higher than groups of DG, but on the other hand, Groups of DG are higher in RC C/E and CC/MC. In groups of DG, both systolic function of vascular smooth muscle and vascular wall’s elasticity are reducing, the vein is prone to expansion.4. Inflammatory protein is expressed in every group, and groups of DG are obviously higher than groups of NG. To in-situ saphenous vein disease, both TNFAIP8and TIPE2can make a difference, and groups of DG are particularly evident.