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Superworm (larve of Zophobas atratus) could consume foams of expanded polystyrene plastics. However, there is no sufficient understanding of the impact of microplastics on superworms and the degradation pathways of polystyrene. Herein, we explored the weight and survival change of superworms while fed with polystyrene microplastics, and found that survival rate and mean weight would reduce. In terms of gut microbial community structure of surperworms, significant shifts were detected with the relative abundance of Hafnia-Obesumbacterium sp. increasing. In addition, we domesticated two microbiota from the gut of superworms, and confirmed their ability to degrade PS in vitro. The last but most important, 1291 metabolites were identified by HPLC-TOF-MS/MS, and six metabolites related to polystyrene degradation were identified through comparative metabolomic analysis. According to the content and pathways of these metabolites, three metabolic pathways of polystyrene were (a) styrene-phenylacetyl-CoA-L-2-aminoadipic acid; (b) styrene-phenylacetyl-CoA-benzaldehyde; (c) styrene-2-hydroxyacetophenone. These results would help to further screen bacteria of PS degradation and investigate PS metabolic pathways in invertebrates.
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Objective: To establish a simple and practical model for super-microsurgery training using the middle caudal arteries of Kunming mice. Methods: A â-shaped incision was made approximately 1 cm from the root of the tail in the mouse, and the skin, together with the subcutaneous tissue, was turned up into a rectangular shape to the opposite side with exposure of the mouse middle caudal artery and the accompanying veins. The artery was freed for approximately 1 cm in length. The middle caudal artery was cut transversely at the site, and then the severed middle caudal artery was anastomosed end-to-end using 12-0 microsutures in the order of 6, 12, 3, and 9 o'clock with four stitches. Results: The mouse caudal artery had a constant anatomical location accompanied by a vein. The immediate postoperative patency after vascular anastomosis was 100% (15/15) in all mouse models, the postoperative patency was 100% (5/5), 80% (4/5), and 75% (3/4) at 24 h, 3 days, and 1 week postoperatively, respectively. The outer diameter of the mouse middle caudal artery was 0.2 ~ 0.3 (0.22 ± 0.03) mm. The vascular anastomosis time was 6.5 ~ 15 (11.0 ± 2.5) min. Conclusion: The mouse middle caudal artery was superficially located and anatomically constant, making it easy to be located and exposed. The small size of the opening made it suitable for establishing a useful model for training in super-microsurgery vascular anastomoses.
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OBJECTIVE: To report our experience in the reconstruction of soft tissue defects in the hand with a free anterolateral thigh deep fascia flap and describe the clinical outcomes. METHODS: This study was a retrospective trial. From November 2016 to January 2020, six patients (four men and two women) with soft tissue defects in the hand were included in this study. The average age of the patients was 33.7 ± 12.7 years (range, 20 to 50 years). All patients underwent reconstructions with free anterolateral thigh deep fascia flaps. Relevant clinical characteristics were recorded prior to surgery. The size and thickness of the deep fascia flap and the thickness of the skin were measured intraoperatively. The survival of the flaps and skin grafts and the occurrence of infection were recorded after the operation. At follow-up, donor site complications and postoperative effects were evaluated according to the outcome satisfaction scale. The pain in the injured hand was assessed using the visual analog scale. RESULTS: The average body mass index (BMI) was 26.6 ± 1.7 kg/m2 (range, 23.9 to 28.7 kg/m2 ). The defect sizes ranged from 5 cm × 5 cm to 13 cm × 8 cm (average, 53.1 ± 27.9 cm2 ). The six anterolateral thigh deep fascia flaps ranged from 7 cm × 6 cm to 14 cm × 9 cm in size (average, 71.8 ± 29.1 cm2 ). The thicknesses of skin ranged from 25 mm to 40 mm (average, 32.5 ± 4.8 mm), and the thicknesses of the deep fascia flaps ranged from 2 mm to 3 mm (average, 2.5 ± 0.5 mm). After the operation, the blood supply of the deep fascia flap was normal in all cases. The second-stage skin grafts of most patients survived completely. The skin graft in one case was partially necrotic and healed after a dressing change. No infection occurred. At follow-up (average, 16.3 ± 6.9 months), there was only a linear scar and no loss of sensation at the donor site of each patient. According to the outcome satisfaction scale, the outcome satisfaction score ranged from 6 to 8 (average, 7.2 ± 0.9), all of which were satisfactory. Apart from one patient who reported mild pain, all the other patients reported no pain. Three typical cases are presented in this article. CONCLUSIONS: The free anterolateral thigh deep fascia flap, which is suitable for reconstruction of soft tissue defects in the hand, can provide very good outcomes both functionally and aesthetically.
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Fascia/trasplante , Colgajos Tisulares Libres/trasplante , Traumatismos de la Mano/cirugía , Procedimientos de Cirugía Plástica/métodos , Traumatismos de los Tejidos Blandos/cirugía , Muslo/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Satisfacción del Paciente , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To investigate the effectiveness of tissue transplantation combined with bone transmission in treatment of large defects of tibial bone and soft tissue. METHODS: Between February 2006 and February 2011, 15 cases of traumatic tibia bone and soft tissue defects were treated. There were 12 males and 3 females, aged from 16 to 54 years (mean, 32 years). After internal and external fixations of fracture, 11 patients with open fracture (Gustilo type III) had skin necrosis, bone exposure, and infection; after open reduction and internal fixation, 2 patients with closed fracture had skin necrosis and infection; and after limb replantation, 2 patients had skin necrosis and bone exposure. The area of soft tissue defect ranged from 5 cm x 5 cm to 22 cm x 17 cm. Eight cases had limb shortening with an average of 3.5 cm (range, 2-5 cm) and angular deformity. The lenghth of bone defect ranged from 4 to 18 cm (mean, 8 cm). The flap transplantation and skin graft were used in 9 and 6 cases, respectively; bone transmission and limb lengthening orthomorphia were performed in all cases at 3 months after wound healing; of them, 2 cases received double osteotomy bone transmission, and 14 cases received autologous bone graft and reset after apposition of fracture ends. RESULTS: All flaps and skin grafts survived; the wound healed at 3.5 months on average (range, 3 weeks-18 months). The length of bone lengthening was 6-22 cm (mean, 8 cm). The time of bone healing and removal of external fixation was 9.5-39.0 months (mean, 15 months). The healing index was 40-65 days/cm (mean, 55 days/cm). All patients were followed up 1-5 years (mean, 4 years). The wounds of all the cases healed well without infection or ulceration. The functions of weight-bearing and walking were recovered; 6 cases had normal gait and 9 cases had claudication. The knee range of motion was 0 degrees in extention, 120-160 degrees in flexion (mean, 150 degrees). According to the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system for ankle function, the results were excellent in 7 cases, good in 4 cases, and fair in 4 cases, with an excellent and good rate of 73.3%. CONCLUSION: Tissue transplantation combined with bone transmission is an effective method to treat large defects of soft tissue and tibial bone, which can increase strength of bone connection and reduce damage to the donor site.
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Trasplante Óseo/métodos , Trasplante de Piel , Traumatismos de los Tejidos Blandos/cirugía , Tibia/lesiones , Fracturas de la Tibia/cirugía , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Fijación de Fractura/instrumentación , Fijación de Fractura/métodos , Fracturas Óseas/cirugía , Humanos , Pierna/cirugía , Masculino , Persona de Mediana Edad , Necrosis , Recuperación de la Función , Piel/patología , Colgajos Quirúrgicos , Tibia/cirugía , Resultado del Tratamiento , Cicatrización de Heridas , Adulto JovenRESUMEN
Clear cell renal cell carcinomas (RCC), the major histologic subtype of RCC accounting for more than 80% of cases, are typified by biallelic inactivation of the von Hippel-Lindau (VHL) tumor suppressor gene. Although accumulation of hypoxia-inducible factor alpha (HIF-α) is the most well-studied effect of VHL inactivation, direct inhibition of HIFα or restoration of wild-type pVHL protein expression has not proved readily feasible, given the limitations associated with pharmacologic targeting of transcription factors (i.e., HIF-α) and gene replacement therapy of tumor suppressor genes (i.e., VHL). Here, we have established that phosphorylated c-Jun, a substrate of the c-Jun-NH(2)-kinase (JNK), is selectively activated in clear cell RCC patient specimens. Using multiple isogenic cell lines, we show that HIF-α-independent JNK hyperactivation is unique to the pVHL-deficient state. Importantly, pVHL-deficient RCCs are dependent upon JNK activity for in vitro and in vivo growth. A multistep signaling pathway that links pVHL loss to JNK activation involves the formation of a CARD9/BCL10/TRAF6 complex as a proximal signal to sequentially stimulate TAK1 (MAPKKK), MKK4 (MAPKK), and JNK (MAPK). JNK stimulates c-Jun phosphorylation, activation, and dimerization with c-Fos to form a transcriptionally competent AP1 complex that drives transcription of the Twist gene and induces epithelial-mesenchymal transition. Thus, JNK represents a novel molecular target that is selectively activated in and drives the growth of pVHL-deficient clear cell RCCs. These findings can serve as the preclinical foundation for directed efforts to characterize potent pharmacologic inhibitors of the JNK pathway for clinical translation.
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Carcinoma de Células Renales/metabolismo , Proteínas Quinasas JNK Activadas por Mitógenos/metabolismo , Neoplasias Renales/metabolismo , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Antracenos/farmacología , Proteína 10 de la LLC-Linfoma de Células B , Western Blotting , Proteínas Adaptadoras de Señalización CARD/genética , Proteínas Adaptadoras de Señalización CARD/metabolismo , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/patología , Línea Celular Tumoral , Activación Enzimática , Femenino , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Proteínas Quinasas JNK Activadas por Mitógenos/antagonistas & inhibidores , Proteínas Quinasas JNK Activadas por Mitógenos/genética , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , MAP Quinasa Quinasa 4/genética , MAP Quinasa Quinasa 4/metabolismo , Quinasas Quinasa Quinasa PAM/antagonistas & inhibidores , Quinasas Quinasa Quinasa PAM/genética , Quinasas Quinasa Quinasa PAM/metabolismo , Ratones , Ratones Desnudos , Fosforilación/efectos de los fármacos , Proteínas Proto-Oncogénicas c-fos/metabolismo , Proteínas Proto-Oncogénicas c-jun/metabolismo , Interferencia de ARN , Factor 6 Asociado a Receptor de TNF/genética , Factor 6 Asociado a Receptor de TNF/metabolismo , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/genética , Ensayos Antitumor por Modelo de Xenoinjerto , Zearalenona/análogos & derivados , Zearalenona/farmacologíaRESUMEN
OBJECTIVE: To investigate the therapeutic effect of free tissue flap anastomosed with reverse descendant branch of lateral femoral circumflex artery for severe soft tissue defect at leg. METHODS: The severe soft tissue defect at leg, without any vessels for anastomosis of free tissue flap, was reconstructed with free tissue flap, which was anastomosed with proximal end of descendant branch of lateral femoral circumflex artery and great saphenous vein. From Oct. 2004 to Dec. 2009, 36 cases were treated with 15 cases of latissimus dorsi musculocutaneous flaps, 12 cases of anterolateral femoral flaps, and 9 cases of thoracoumbilicus flaps. RESULTS: All the 36 free flaps survived completely. The patients were followed up for 6 months to 2.5 years with good cosmetic results. CONCLUSIONS: It is effective and practical to repair the severe soft tissue defects at legs with the reverse descendant branch of lateral femoral circumflex artery to carry the free flaps.
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Colgajos Tisulares Libres , Traumatismos de la Pierna/cirugía , Traumatismos de los Tejidos Blandos/cirugía , Adulto , Femenino , Arteria Femoral/cirugía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Trasplante de Piel/métodos , Muslo/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
The critical downstream signaling consequences contributing to renal cancer as a result of loss of the tumor suppressor gene von Hippel-Lindau (VHL) have yet to be fully elucidated. Here, we report that VHL loss results in an epithelial to mesenchymal transition (EMT). In studies of paired isogenic cell lines, VHL silencing increased the levels of N-cadherin and vimentin and reduced the levels of E-cadherin relative to the parental VHL(+) cell line, which displayed the opposite profile. VHL(+) cells grew as clusters of cuboidal and rhomboid cells, whereas VHL-silenced cells took on an elongated, fibroblastoid morphology associated with a more highly invasive character in Matrigel chamber assays. Based on earlier evidence that VHL loss can activate NF-kappaB, a known mediator of EMT, we tested whether NF-kappaB contributed to VHL-mediated effects on EMT. On pharmacologic or molecular inhibition of NF-kappaB, VHL-silenced cells regained expression of E-cadherin, lost expression of N-cadherin, and reversed their highly invasive phenotype. Introducing a pVHL-resistant hypoxia-inducible factor 1alpha (HIF1alpha) mutant (HIFalpha(M)) into VHL(+) cells heightened NF-kappaB activity, phenocopying EMT effects produced by VHL silencing. Conversely, inhibiting the heightened NF-kappaB activity in this setting reversed the EMT phenotype. Taken together, these results suggest that VHL loss induces an EMT that is largely dependent on HIFalpha-induced NF-kappaB. Our findings rationalize targeting the NF-kappaB pathway as a therapeutic strategy to treat renal tumors characterized by biallelic VHL inactivation.
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Carcinoma de Células Renales/patología , Neoplasias Renales/patología , FN-kappa B/metabolismo , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/genética , Carcinoma de Células Renales/genética , Carcinoma de Células Renales/metabolismo , Células Epiteliales/patología , Regulación Neoplásica de la Expresión Génica , Silenciador del Gen , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/biosíntesis , Neoplasias Renales/genética , Neoplasias Renales/metabolismo , Mesodermo/patología , FN-kappa B/antagonistas & inhibidores , Proteínas Nucleares/biosíntesis , Factores de Transcripción de la Familia Snail , Factores de Transcripción/biosíntesis , Proteína 1 Relacionada con Twist/biosíntesis , Regulación hacia Arriba , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau/metabolismoRESUMEN
The biochemical mechanisms that underlie hypoxia-induced NF-kappaB activity have remained largely undefined. Here, we find that prolonged hypoxia-induced NF-kappaB activation is restricted to cancer cell lines infected with high-risk human papillomavirus (HPV) serotypes. The HPV-encoded E6 protein is necessary and sufficient for prolonged hypoxia-induced NF-kappaB activation in these systems. The molecular target of E6 in the NF-kappaB pathway is the CYLD lysine 63 (K63) deubiquitinase, a negative regulator of the NF-kappaB pathway. Specifically, hypoxia stimulates E6-mediated ubiquitination and proteasomal degradation of CYLD. Given the established role of NF-kappaB in human carcinogenesis, these findings provide a potential molecular/viral link between hypoxia and the adverse clinical outcomes observed in HPV-associated malignancies.
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Hipoxia de la Célula , FN-kappa B/metabolismo , Proteínas Oncogénicas Virales/metabolismo , Infecciones por Papillomavirus/metabolismo , Proteínas Represoras/metabolismo , Proteínas Supresoras de Tumor/fisiología , Animales , Adhesión Celular , Células Cultivadas , Enzima Desubiquitinante CYLD , Ensayo de Cambio de Movilidad Electroforética , Células Epidérmicas , Epidermis/metabolismo , Epidermis/virología , Femenino , Humanos , Queratinocitos/citología , Queratinocitos/metabolismo , Queratinocitos/virología , Luciferasas/metabolismo , Ratones , Ratones Desnudos , FN-kappa B/genética , Proteínas Oncogénicas Virales/genética , Oxígeno/metabolismo , Papillomaviridae/genética , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Proteínas Represoras/genética , Factor 6 Asociado a Receptor de TNF/metabolismo , Proteínas Supresoras de Tumor/antagonistas & inhibidores , Ubiquitina/metabolismo , UbiquitinaciónRESUMEN
Constitutive nuclear factor-kappaB (NF-kappaB) activation is observed in androgen-independent prostate cancer and represents a predictor for biochemical recurrence after radical prostatectomy. Dietary agents such as pomegranate extract (PE) have received increasing attention as potential agents to prevent the onset or progression of many malignancies, including prostate cancer. Here, we show that PE inhibited NF-kappaB and cell viability of prostate cancer cell lines in a dose-dependent fashion in vitro. Importantly, maximal PE-induced apoptosis was dependent on PE-mediated NF-kappaB blockade. In the LAPC4 xenograft model, PE delayed the emergence of LAPC4 androgen-independent xenografts in castrated mice through an inhibition of proliferation and induction of apoptosis. Moreover, the observed increase in NF-kappaB activity during the transition from androgen dependence to androgen independence in the LAPC4 xenograft model was abrogated by PE. Our study represents the first description of PE as a promising dietary agent for the prevention of the emergence of androgen independence that is driven in part by heightened NF-kappaB activity.
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Lythraceae/metabolismo , FN-kappa B/metabolismo , Fitoterapia , Extractos Vegetales/uso terapéutico , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/patología , Andrógenos/metabolismo , Animales , Ciclo Celular/efectos de los fármacos , Muerte Celular/efectos de los fármacos , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Humanos , Masculino , Ratones , FN-kappa B/antagonistas & inhibidores , Factor de Necrosis Tumoral alfa/farmacología , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Twenty-eight patients who suffered traumatic obsolete incomplete paralysis were treated with intradural lysis and peripheral nerve implantation by a microsurgery technique. The endorachis was opened and the fibrous bands adhering to the spinal cord from the arachnoid, pia mater spinalis, ligamenta denticulatum, and the initial part of the nerve root were completely relieved. The abnormal spinal cord was then opened by three to six incisions, which were each 0.1 mm to 0.2 mm deep and longer than the abnormal portion. A cyst found in the back or side of the spinal cord was opened and the liquid in it was drained. After that, the denuded spineurium and perineurium of the autogenous sural nerve were grafted, which makes the character and aspect of the nerve like the cauda equine. The nerve was longitudinally implanted into the incised spinal cord, and the cyst was waded with grafted nerve and at least one of them is ectropion sutured with the pia mater with 9-0 scatheless wire as a drain. Finally, the endorachis was covered by sacrospinal muscle flap. These patients were followed for 2 years to 8 years (average 3.5 years), and the sensibility and motion of each increased at least one grade. The strength of the main muscle was increased two grades and reached four grades in 11 patients, and the capability to walk was recovered. Relieving of the adhesion in the endorhachis, carving the cicatricial spinal cord, and implanting the autogenous peripheral nerve yields good results by initial clinical observation for traumatic obsolete and incomplete paralysis.
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Microcirugia/métodos , Procedimientos Neuroquirúrgicos/métodos , Paresia/cirugía , Traumatismos de la Médula Espinal/cirugía , Nervio Sural/trasplante , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paresia/etiología , Traumatismos de la Médula Espinal/complicaciones , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate a method of improving design of the skin flap pedicled with descending branch of lateral femoral circumflex artery, in order to increase the accuracy of preoperative Doppler location. METHODS: Firstly, the interspace between rectus femoris and vastus lateralis was regarded as line A, and the point of intersection between line A and the vertical line through the midpoint of the line between anterior superior iliac spine and lateral margin of patella was point A. And then the line between the midpoint of groin and point A was regarded as line B. Based on this , the perforating point of cutaneous branch could be located by Doppler along the line B. From November 2001 to October 2004, this method was used in 38 skin flaps of 37 cases, being all males and 16-48 years old. The area of the flap ranged from 7 cm x 6 cm to 24 cm x 16 cm. RESULTS: All the perforating point of cutaneous branch were located outward the line A. The rate that the preoperative Doppler location was consistent with the utility point of formatting skin flap was 97.4%. All the cases were followed up postoperatively 1-20 months. Among the cases, 36 skin flaps of 35 cases was successful and only 2 skin flaps partially necrosed, which healed after changing dressings or skin graft. Out of 35 cases, the sensation restoration of the skin flap was S2-S3 in 6 cases owing to the anastomosis of lateral femoral cutaneous nerve and a skin nerve of the recipient site, while that of the other cases was S0-S1. CONCLUSION: Preoperative Doppler location and improving design of line B can be a useful instruction for the design of skin flap pedicled with descending branch of lateral femoral circumflex artery.
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Músculo Cuádriceps/cirugía , Trasplante de Piel/métodos , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Adolescente , Adulto , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Colgajos Quirúrgicos/inervaciónRESUMEN
OBJECTIVE: To explore the clinical effect of different types of free tissue transplantation on repairing tissue defects and reconstructing functions. METHODS: From November 2001 to September 2004, 14 types of free tissue transplantation and 78 free tissue flaps were applied to repairing tissue defects and reconstructing functions in extremities and maxillofacial region in 69 cases. Of the 69 cases, there were 53 males and 16 females (their ages ranged from 18 to 56, 31 on average). Five cases were repaired because of skin defects in foot, 22 cases were repaired because of skin defects in leg, 36 cases were repaired as the result of skin defects in hand or forearm and finger reconstruction, 3 cases were restored by virtue of ulna or radius defects, and 3 cases were repaired in maxillofacial region. There were 55 cases of open wound, in which 16 cases were infectious wound, 6 cases were osteomyelitis or pyogenic arthritis. There were 14 cases of non-infectious wound. The area of these tissue flaps ranged from 2.0 cm x 1.5 cm to 43.0 cm x 12.0 cm. The length of bone transplantation ranged from 10 cm to 15 cm. RESULTS: Arterial crisis occurred in 2 cases, venous crisis occurred in 2 cases. Seventy-six flaps survived completely and 2 flaps survived partially which were later healed. Fifty-two cases were healed at stage I, 13 cases were healed at stage I (healing time ranged from 20 to 30 days), purulent infection occurred to 4 cases(healing time ranged from 3 to 11 months). Bone healing time ranged from 6 to 8 weeks in finger reconstruction. Bone healing time ranged from 4 to 6 months in fibula transplantation. The function reconstruction and appearance were satisfying. The functions of all regions, where free tissues were supplied, were not disturbed. CONCLUSION: Tissue transplantation and composite tissue transplantation are effective in repairing tissue defects and reconstructing functions.
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Procedimientos de Cirugía Plástica , Traumatismos de los Tejidos Blandos/cirugía , Trasplante de Tejidos , Adolescente , Adulto , Traumatismos del Brazo/cirugía , Traumatismos Faciales/cirugía , Femenino , Traumatismos de los Pies/cirugía , Humanos , Traumatismos de la Pierna/cirugía , Masculino , Microcirugia , Persona de Mediana Edad , Colgajos QuirúrgicosRESUMEN
OBJECTIVE: To repair defects at both ends of the blood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities by phleboplasty of branched and double autogenous veins. METHODS: Three kinds of phleboplasty: funnel-shaped, raincape-shaped and transposed Y-shaped were designed. Experiments in fresh blood vessels in vitro were completed successfully. These methods were used clinically to repair injured external iliac veins, femoral arteries and veins, and popliteal arteries and veins, to replant severed fingers and to transplant toenail flaps on thumbs by harvesting autogenous great saphenous veins, small saphenous veins and forearm veins in 36 cases, including 35 cases in emergency operation and 1 case in selective operation. The length of The phleboplasty of funnel-shaped could enlarge the grafted blood vessels ranged from 1.0 cm to 15.0 cm. RESULTS: The phleboplasty of funnel-shaped could enlarge the diameter by 1.0-1.25 times in anastomotic stomas. The phleboplasty of raincape-shaped could enlarge the diameter large enough to meet the demands for various blood vessels in extremities. The phleboplasty of transposed Y-shaped could provide large vein transplants. In 36 grafted veins, 35 were in patency. The blood supply in extremities was normal. CONCLUSION: The funnel-shaped and raincape-shaped phleboplasty of branched veins can enlarge the anastomotic stomas of grafted veins. The transposed Y-shaped phleboplasty of double femoral veins is an ideal way to repair injured primary blood vessels with a considerable disparity in the diameter of the both sides or with a large diameter in extremities.