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Objective:To investigate the correlations between expression of long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), nuclear-enriched abundant transcript 1 (NEAT1) and their functions on exosome secretion, proliferation and invasion in hepatocellular carcinoma (HCC).Methods:We used small interfering RNA of MALAT1 (si-MALAT1) to knockdown MALAT1 in HuH-7. At the meanwhile, cells which were transfected with si-NC were used as the negative control group. Expression of NEAT1, cell proliferation and invasion function were detected these two groups. HuH-7 cells were transfected with lentivirus NEAT1 over expressing vector (lv-NEAT1) or negative control (lv-control). Expression of exosomes secretion related genes were analyzed between lv-NEAT1 and lv-control groups. Cells of lv-NEAT1 were knockdown MALAT1 expression using si-MALAT1, which could be si-MALAT1+ lv-NEAT1 group. exosomes secretion was detected in si-NC, si-MALAT1 and si-MALAT1+ lv-NEAT1 group. We treated cells (si-MALAT1 group) with exosomes from cells with lv-NEAT1 or lv-control to divide cells as si-MALAT1+ exosomes of lv-NEAT1 cells and si-MALAT1+ exosomes of lv-control groups. Cell proliferation and invasion of cells were detected in two groups.Results:Low expression of NEAT1 were found in MALAT1 knockdown cells compared with si-NC group [(0.72±0.02) vs. (0.98±0.01), P<0.05]. Cells with MALAT1 knockdown shown diminished proliferation [(0.66±0.03) vs. (0.98±0.04), P<0.05)] and invasion [(88.33±7.26) vs. (147.70±13.62), P<0.05)]. Compared with si-NC group, CD9 and CD63 expression were decreased in exosomes of si-MALAT1 group. Compared with si-MALAT1 group, CD9 and CD63 expression was increased in exosomes of si-MALAT1+ lv-NEAT1 group. Compared with si-MALAT1+ exosomes of lv-control group, proliferation [(0.97±0.03) vs. (0.74±0.05), P<0.05)] and invasion [ (132.70±7.36) vs. (98.33±6.01), P<0.05) ] were increased in si-MALAT1+ exosomes of lv-NEAT1 group. Exosomes related genes expression including HSPA8 (5.53±0.31), SLC3A2 (0.32±0.07) and SLC7A5 (0.77±0.45) were changed in lv-NEAT1 group compared with lv-control group [(0.98±0.15), P<0.05]. Conclusion:MALAT1 induced exosomes secretion by NEAT1 and exosomes related genes regulation. This regulation might be related with increased proliferation and invasion function in HCC cells with MALAT1 and NEAT1 abnormal expression.
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Objective:To investigate the related risk factors for biliary anastomotic stenosis after liver transplantation (LT) from donation after cardiac death(DCD) and therapeutic strategies.Methods:The data of 192 patients who received LT from DCD in First Hospital of Kunming from Jan 2010 to Jun 2018 were retrospectively analyzed. A total of 145 patients were enrolled, 85 males and 60 females, with average age 45 years. There was a biliary anastomotic stenosis in 8 cases and no stenosis in 137 cases. Their Chinese criterion for biliary anatomic stenosis, age, body mass index, liver fat, cold/warm ischemia time, unschedule cardiac arrest time, usage of vasopressors, high sodium in the donor were compared, and stenosis related factors were analysed by Spearman correlation analysis.Results:The stenosis was positively correlated with age ( r=0.229), body mass index ( r=0.204), lipoidosis ( r=0.239), duration of hot ischemia ( r=0.214), total duration of unplanned cardiac arrest ( r=0.401), use of booster drugs ( r=0.237), and preoperative donor hypernatremia ( r=0.557) (all P<0.05). Endoscopic biliary stent implantation is effective in the treatment of biliary anastomotic stenosis and has a high success rate. Conclusions:There are many factors related to biliary anastomotic stenosis after DCD liver transplantation, but the better donor maintenance, shorten cold/ warm ischemia time, improved anastomosis will be helpful to reduce biliary complications.As the same time, endoscopic biliary stent placement is the preferred way to treat biliary anastomotic stenosis.
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Objective To explore the skills and summarize the experience in the establishment of orthotopic liver transplantation rat models from donation after cardiac death (DCD). Methods According to the time of warm ischemia, 120 rats were divided into 3 groups: group A (warm ischemia for 0 min, n=40 pairs), group B (warm ischemia for 10 min, n=40 pairs) and group C (warm ischemia for 20 min, n=40 pairs). Orthotopic liver transplantation was performed by the modified two-cuff technique in 3 groups. The time of each stage of surgery was recorded in 3 groups. The survival rate at the end of surgery, 24 h, 72 h and 7 d after surgery was recorded in 3 groups. The dead rats were immediately subject to anatomical examination to identify the cause of death. Results The cold ischemia time of donor liver, anhepatic phase and operation time of the recipients did not significantly differ among three groups (all P>0.05). In groups A, B and C, the survival rate at the end of surgery was 97%, 97%, and 100% respectively. The survival rate at postoperative 24 h was 92%, 90% and 92% respectively. The survival rate at postoperative 72 h was 90%, 80% and 77% respectively. The survival rate at postoperative 7 d was 85%, 70% and 57% respectively. The survival rate at the end of surgery, postoperative 24 h and 72 h did not significantly differ among 3 groups (all P>0.05). At postoperative 7 d, the survival rate in group C was significantly lower than that in group A (P<0.05). Surgical operation was the major cause of intraoperative and postoperative 24 h death. Bile leakage and ischemic hepatic failure were the causes of death at postoperative 72 h. Biliary duct complications were the main causes of death at postoperative 7 d. The quantity of rats developing with biliary duct complications was increased along with the prolongation of warm ischemic time. Conclusions The success of stable establishment of rat models with orthotopic liver transplantation from DCD depends upon the protection of the liver and biliary function. The difficulty lies in the anastomosis of the suprahepatic inferior vena cava and the shortening of anhepatic phase.
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Objective To investigate the effect of CaMK Ⅱ expression on apoptosis of rat hepatocytes BRL-3A.Methods Rat BRL-3A cells were stable passage were cultured.The CaMK Ⅱ γ protein (LV-CaMK Ⅱ γ group) and CaMK Ⅱ γshRNA (shRNA group) lentiviral expression systems were constructed.The corresponding blank vectors (LV-NC group and shRNA-NC group) and normal saline (CON group) were perfused into the control groups.The expression levels of CaMK Ⅱ,Cyt C and MF proteins were detected by Western blotting,and the apoptosis rate of BRL-3A cells was measured by Tunel method.Results The protein expression of CaMK Ⅱ,Cyt C and AIF in LV-CaMK Ⅱ γ group was significantly higher than that in CON group (P＜0.05).The protein expression of CaMK Ⅱ,Cyt C and AIF in shRNA group was significantly lower than that in CON group (P＜ 0.05).There was no significant difference among CON group,LV-NC group and shRNA-NC group (P＞0.05).At the same time point,the apoptosis rate of hepatocytes in LV-CaMK Ⅱ γ group was significantly higher than that in CON group (P＜0.05).At the same time point,the apoptosis rate of hepatocytes in shRNA group was significantly higher than in CON group (P＜0.05).There was no significant difference in the apoptosis of hepatocytes among CON group,LV-NC group and shRNA-NC group (P＞0.05).Conclusion The specific CaMK Ⅱ signaling pathway can inhibit the apoptosis of BRL-3A cells,while the enhanced CaMK Ⅱ signaling pathway promotes the apoptosis of BRL-3A cells.
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Objective To discuss the differential expression of hepatic stress proteins after reduced-size liver transplantation in rats.Methods The specimens of liver tissues were procured on 1 d,3 d and 7 d after the improved model of reduced-size liver transplantation in rats.Then,the two-dimensional electrophoresis of these specimens was compared with that of the original liver tissues of normal donors and recipients.The differentially expressed protein spots were selected with the standard of change times greater than 10 or less than 1 /10 and then were analyzed and identified by mass-spectrometric technique and data bases.Results Seventy-two differentially expressed protein spots were found in total.And the 32 kinds of proteins were identified with definite function through mass spectrometry and a series of identifications.The expression difference of heat shock protein-8 and hypertrophy agonist reactive protein was larger,amounting 7% (5 /72)of all differential proteins.Conclusions This study provides fundamental research data for studying the relation between liver ischemia-reperfusion injury after liver transplant and the above differential proteins of stress reaction in transplant liver which are found after reduced-size liver transplantation in rats.
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BACKGROUND:At present, the proteome is a mature technology that has been applied in basic research fields related to liver transplantation. But, it has been not reported in research related to reduced-size liver transplantation. OBJECTIVE:To explore the expression of differential proteins related to hepatic energy metabolism fol owing reduce-size liver transplantation in rats by using by proteomic technology. METHODS:The improved model of reduced-size liver transplantation was used in this experiment. The donor was health female Lewis rats and the recipient was male Wistar rats for liver transplantation. The difference between the donor and the recipient was about 20 g. The weight of donor liver/the weight of recipient donor was approximately equal to 50%. The donor liver tissue was harvested and trimmed to the required size. The portal vein and infrahepatic vena cava were cannulated, and the biliary tract was implanted into the donor bile duct for transplantation. Then the donor was transplanted into the recipient after the removal of original liver tissue. Hepatic specimens were harvested by 1, 3 and 7 days after reduced-size liver transplantation. Then, the harvested specimens were compared with the normal donor and recipient liver tissue that were previously harvested and frozen, to generate two-dimensional gel electrophoresis profile using proteome technology. Then tandem mass spectrometry and databases analysis were performed after two-dimensional electrophoresis for identifying differential protein stains. RESULTS AND CONCLUSION:In this experiment, 72 differential protein stains with over lo-fold changes were selected. After identification, 32 proteins showed clear functions, and among them three differential proteins (ATP synthase beta subunit, electron-transferring flavoprotein beta peptide and proton-transferring ATP synthase) were involved in the process of cel energy metabolism. The proteins were distributed on 1 and 7 days after reduce-size liver transplantation, accounting for 6%.
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Abstract BACKGROUND: Looking for the early diagnosis of acute rejection indicators after liver transplantation can assess the risk after liver transplantation quickly and effectively, and T lymphocytes play the significant role in acute rejection. OBJECTIVE:To observe the relationship between acute rejection and variation of expression of T cel subset in blood after liver transplantation in rhesus monkey. METHODS: The sixteen liver transplant models in rhesus monkey which were constructed successfuly by the method of “double-cuff and one support tube” were divided into two groups randomly: experiment group (no treated by immunosuppressant in perioperative period) and control group (treated by immunosuppressant in perioperative period). Then the blood specimen and liver tissue respectively were colected at 6, 12, 24 and 72 hours after operation. The levels of alanine transferase, aspartate aminotransferase, and total bilirubin were detected with the fuly automatic biochemical analyser. The levels of CD4+/CD8+were tested by flow cytometry. The liver tissue in rhesus monkey after liver transplantation was detected by hematoxylin-eosin staining. The degree of acute rejection was evaluated by Banff Score System. RESULTS AND CONCLUSION: Acute rejection appeared in the experiment group at 12, 24, and 72 hours after liver transplantation. Levels of alanine transferase, aspartate aminotransferase, and total bilirubin were significantly higher in the experimental group than in the control group at 24 and 72 hours after transplantation (P < 0.05). The expression of CD4+/CD8+of the experiment group and control group began to rise at 6 hours after surgery, but the experiment group increased the most obvious. CD4+/CD8+ expression was significantly greater in the experimental group than in the control group at 24 and 72 hours after transplantation (P < 0.05). Morphological pathology was severer, and Banff score was higher in the experiment group than in the control group at 72 hours (P < 0.05). These data suggested that the variation of expression of CD4+/CD8+was earlier than the change of liver tissue pathology and the change of liver function in the early acute rejection after liver transplantation. The rise of level of CD4+/CD8+ after liver transplantation indicated the increase of celular immunity in body, which had an important role in the early diagnosis of acute rejection after liver transplantation.
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BACKGROUND:The proteome is a highlight technology in medical research fields lately, and has been reported to be applied in basic research fields related to liver transplantation. However, it has not been heard that the proteome has been used in research related to reduced-size liver transplantation. OBJECTIVE: To study expression of hepatic differential proteins related to signal transduction using proteomics after reduced-size liver transplantation in rats. METHODS:On the basis of successful establishment of rat models of reduced-size liver transplantation, transplanted liver tissues were obtained at 1, 3 and 7 days after transplantation. Postoperative liver tissue and normal donor, receptor liver tissues were subjected to solid pH gradient two-dimensional gel electrophoresis. Two-dimensional gel electrophoresis patterns were set up. Differentialy expressed protein spots were identified using tandem mass spectrometry analysis and database. RESULTS AND CONCLUSION:Seventy-two differential protein stains were found taking 10 times measure. Finaly, 32 proteins with clear functions were identified. Of them, four proteins participated in signal transduction, and they distributed at 3 and 7 days after liver transplantation, accounting for 6%. Results verified that on the basis of successful and stable establishment of rat models of reduced-size liver transplantation, proteomics technology was utilized to study differential proteins involving in signal transduction after reduced-size liver transplantation, and this study provides data for further deep investigation of regulating MicroRNA of these proteins.
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BACKGROUND:Tumor necrosis factor-αis an inflammatory cytokine involved in the immune response and increasing graft antigen expression. OBJECTIVE:To investigate the relationship between tumor necrosis factor-αin the liver tissue and acute rejection after liver transplantation in a rhesus monkey. METHODS:Liver transplant models in rhesus monkey were constructed by the improved vascular dual cuff, supporting tube of biliary tract and artery anastomosis method. The successful models were randomly divided into experimental group (no immunosuppressant treatment in perioperative period) and control group (treated by immunosuppressant in perioperative period). Then the blood samples and liver tissue were col ected at 6, 12, 24, and 72 hours after surgery. Al ograft rejections of liver transplantation were monitored by liver function tests, hematoxylin-eosin staining and Banff score. Final y, the expression level of tumor necrosis factor-αwas detected by western blot analysis and immunohistochemistry technique. RESULTS AND CONCLUSION:The expression of tumor necrosis factor-αin the experimental group and control group began to increase at 6 hours, reached the peak at 12 hours, and then decreased at 24-72 hours. The changes of expression level were the most obvious in the experimental group. At 6, 12, 24 and 72 hours, the expression of tumor necrosis factor-αin the experimental group was significantly higher than that in the control group (P<0.05). This change appeared earlier than pathological changes in the liver and liver function. Variations in the expression of tumor necrosis factor-αafter liver transplantation have important implications for early diagnosis of acute rejection after liver transplantation.
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BACKGROUND:Interleukin-6 is an important cytokine in the immune inflammatory response, strongly links with graft rejection reaction, and plays an important role in diagnosis of graft rejection and evaluation of anti-rejection. OBJECTIVE:To measure the expression of interleukin-6 in acute rejection of the liver transplantation in the rhesus monkey, and to evaluate the value as an early diagnosis of acute rejection after liver transplantation. METHODS:A total of 16 rhesus monkeys were used as the object and randomly divided into experimental group (no treated by immunosuppressant in perioperative period), and control group (treated by immunosuppressant in perioperative period). The al ograft orthotopic liver transplantation models were established in those monkeys. Then serum and liver tissue were col ected at 6, 12, 24, and 72 hours after surgery. Al ograft rejection was monitored by liver function tests, and hematoxylin-eosin staining of liver and Banff score. Final y, the expression levels of interleukin-6 were detected by enzyme linked immunosorbent assay and immunohistochemistry.RESULTS AND CONCLUSION:Acute graft rejection reaction appeared at 12, 24 and 72 hours after liver transplantation in the experimental group. The expressions of alanine aminotransferase, aspartate aminotransferase and total bilirubin were significantly higher in the experimental group than in the control group at 24 and 72 hours (P<0.05). Histological manifestations were severer and Banff score was higher in the experimental group at 72 hours than in the control group (P<0.05). Interleukin-6 levels were significantly higher in the serum and liver tissue of experimental group than in the control group at 12, 24 and 72 hours after liver transplantation (P<0.05), especial y at 72 hours. Results suggested that interleukin-6 possibly participated in rejection after liver transplantation. The expression of interleukin-6 was probably of significance in the early diagnosis of acute rejection after orthotopic liver transplantation in rhesus monkeys.
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BACKGROUND:Nuclear factor-κB as an important nuclear transcription factor, is a converge point for various signal transduction pathways, and participate in the regulation of reactive substances gene expression such as the immune cel proliferation, differentiation and apoptosis. The nuclear factor-κB plays an important role in humoral and cel ular immune. OBJECTIVE:To investigate the relationship between the nuclear factor-κB p65 protein expression and acute rejection in transplanted liver tissue of rhesus monkey. METHODS:The rhesus monkey recipients were randomly divided into two groups:acute rejection group and control group. The acute rejection group did not received anti-rejection treatment after liver transplantation, and the control group was given anti-rejection treatment during and after liver transplantation. The blood samples were col ected at 6, 12, 24 and 72 hours after transplantation, and the automatic biochemical analyzer was used to detect the levels of alanine aminotransferase and total bilirubin. Hematoxylin-eosin staining of transplanted liver tissue was performed to observe the morphological structure and rejection. The degree of rejection was evaluated according to the Banff scoring system, and the expression of nuclear factor-κB p65 in the liver tissue was detected with Western blot. RESULTS AND CONCLUSION:When the acute rejection occurred after liver transplantation, the liver function change was observed after liver histopathological examination, the expression of nuclear factor-κB p65 in the liver tissue was up-regulated, and the degree of acute rejection was increased. In the early stage of acute rejection, the liver function and pathology were changed slightly, while the expression of nuclear factor-κB p65 was significantly increased. The results indicate that the detection of nuclear factor-κB p65 in the transplanted liver tissue has great significance for the early diagnosis of acute rejection after liver transplantation, and the nuclear factor-κB may be the new target for control ing the acute rejection.
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Objective To explore the indication and feasibility of laparoscopic hepatectomy. Methods Clinical data of 6 patients undergoing laparoscopic hepatectomy(LH) were collected and retrospectively anallyzed,5 of them with lesions located in surface or edge of Ⅱ -Ⅵ segment,one of them with lesion in Ⅷ segment. These lesions were 5 - 9.6 cm, the average diameter was (6.64 ± 2.60) cm. There were 4 cases of liver cavernous hemangioma, and 2 case of hepatic focal nodular hyperplasia. The liver functions of 6 cases w ere in Child Pugh A . Results All 6 patients were applied laparoscopic hepatetomy successfully, 5 cases were performed partial resection, 1 case underwent laparoscopic hepatic left lateral lobectomy. The average operation time was( 105.17 ± 27.97 )minutes, and the intraoperative average hemorrhage was (247. 50 ± 90.91 ) mL. All of the lesions were completely removed. There were no postoperative complications such as bile leakage or hemorrhage. All patients recovered well. The average postoperative hospitalization was (4.16 ± 1.60)days: Conclusions Laparoscopic hepatectomy is safe and feasible for lesion located in the edge or sur face of liver and left liver.
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BACKGROUND: Various factors contribute to the establishment of liver transplantation models in rhesus monkey, the rate of successful operation and long-term survival are very low. OBJECTIVE: To analyze the cause of early death following liver transplantation in rhesus monkey. METHODS: Liver transplantation models were fabricated with the classical and modified methods in rhesus monkeys. Operation of donor was performed quickly by a big crucial incision of abdomen. The improved double-cuff of the portal vein and inferior vena cava were finished, in addition to stay pipe of biliary tract in the process of repairing donor liver. Operation of the receptor was performed by classical orthotopic liver transplantation. RESULTS AND CONCLUSION: A total of 25 pairs of rhesus monkeys were successfully for establishing liver transplantation models. Seven rhesus monkeys died within early stage of post-operation, including six out of nine monkeys died by using the classical approach and one out of sixteen monkeys died by using the improved approach. There were five of seven monkeys died of intra-abdominal hemorrhage, one died of primary graft nonfunction and one died of respiratory failure. Results indicated that, the major death cause after classical orthotopic liver transplantation in rhesus monkey is abdominal hemorrhage. The improved methods of liver transplantation apparently reduce the hemorrhage and raise early survival rate following liver transplantation.
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BACKGROUND: There are few studies on liver regeneration following living liver transplantation. Improvement of operation methods and techniques and successful rate are the basis for rat liver transplantation study and data acquisition. OBJECTIVE: To investigate the efficacy of improved model of reduced-size liver transplantation in the rat. METHODS: Healthy SD rats were selected. 70 pairs of rats were subjected to reduced-size liver transplantation before modification, and 100 pairs subjected to reduced-size liver transplantation after modification. The donors were female and the recipients were male, and the body mass of donors was 10 g less than the recipients. Operation of donor was performed by only one person with the naked eye, and reduced-size donor liver was performed in the donor operation. The handle of self-made cannula was placed in the front of portal vein and inferior vena cava, respectively, and the tied ligature of pyloric veins was turned inside out of the self-made cannula. Furthermore, the tied ligature was placed in the left of the self-made cannula; the same to inferior vena cava except that the tied ligature of right renal vein was placed in the right of the self-made cannula; the portal vein and inferior vena cava were washed with self-made perfusate respectively. Operation of the receptor was performed by two persons with the naked eye, with improved dual-cuff technique of Kamada and stay pipe of biliary tract, the fixed points of left and right were connected by anastomosis of "8" type with turning inside out while inosculating inferior vena cava. RESULTS AND CONCLUSION: The average modified operation time of the donor and the donor liver preparation time was (32±2) minutes and (6±2) minutes, respectively. The average operation time of the recipient and the anhepatic time was (40±3) minutes and (14±3) minutes, respectively. The general successful rate was 92%; three-day survival rate was 85% and two-week survival rate was 83%. The postoperative complications reduced significantly (P< 0.05), and cold conservation time of donor was shortened (P < 0.05). The modified model of reduced-size liver transplantation was more safe and reliable, with high success rate of liver transplantation and survival rate of recipient. Moreover, the postoperative complications of receptor decreased significantly. It provide an effective method of investigating liver graft regeneration following reduced-size liver transplantation.
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BACKGROUND: It was reported from home and abroad that the effect of nucleoside anti-hepatitis B medicine and anti-hepatitis B immunoglobulin for prevention and cure of hepatitis B virus recurrence after liver transplantation with hepatopathy correlation with hepatitis B was good for patients. But the reported dosage of anti-hepatitis B immunoglobulin in and after liver transplantation was different. OBJECTIVE: To verify and investigate the effect of nucleoside anti-hepatitis B medicine combined with anti-hepatitis B immunoglobulin on prevention and cure of hepatitis B virus recurrence after liver transplantation, METHODS: A retrospective analysis was performed on 59 patients with liver transplantation of hepatopathy correlated with hepatitis B who were selected from Liver Transplantation Center, the Ganmay Affiliated Hospital of Kunming Medical College between May 2006 and February 2009. A total of 50 out of 59 cases were diagnosed with posthepatitic cirrhosis in decompensatio stage before transplantation, including 15 cases having positive hepatitis B DNA. Before liver transplantation, 5 cases accepted Lamivudine, 1 case accepted Adefovir dipivoxil, and 1 case accepted Entecavir. Treatment time ranged from two weeks to one year. All the patients accepted intramascular injection of anti-hepatitis B irnrnunoglobulin, 200 U/d; which were adjusted in the light of hepatitis B surface antibody titer. A total of 55 out of 59 cases accepted Lamivudine, 3 cases accepted Adefovir dipivoxil, and 1 case accepted Eetecavir after liver transplantation. RESULTS AND CONCLUSION: Two patients underwent hepatitis b virus reinfection, but HBV variants (YMDD) reinfection was not determined, one of which occurred in one year after liver transplantation with positive pre-OLT serum hepatitis b virus DNA, another after one year with negative pre-OLT serum hepatitis b virus DNA. The reinfection rate of group with negative or positive pre-OLT serum HBV DNA was 2% and 7%, respectively, it was maybe well prevention and cure of hepatitis B after liver transplantation that patients accepted nucleoside anti-hepatitis B medicine combined with low close anti-hepatitis B immunoglobulin (200 U/d).
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Objective To explore improvement of orthotopic liver transplantation model in rhesus monkey.Methods Healthy rhesus monkeys were chosen to perform orthotopic liver transplantation for 10 cases.The model was established by drawing on a variety of animal model methods,and the portal vein cuff method was used to establish stable model of orthotopic liver transplantation in rhesus monkeys.Results Ten orthotopic liver transplantation models in rhesus were performed,and the achievement ratio of operation was 10/10.The time of donor hepatectomy and donor preparation was (20?5) min and (30?7) min,respectively.The operation time of recipient and anhepatic phase were (180?35) min and (17?4) min,respectively.After 24 h of operation 9 cases survived,one case died of intra-abdominal hemorrhage after 9 h of operation.After 72 h of operation 8 cases survived,and one case died of upper gastrointestinal bleeding after 38 h of operation.After one week of operation 5 cases survived,and 3 cases died of rejection after 9,11,and 11 d of operation,respectively.The longest survival time was 32 d,but all of them also died of rejection.No portal vein thrombosis and biliary complications were found in all recipients.Conclusion The improved rhesus monkey model of orthotopic liver transplantation is easy to perform with high achievement ratio of operation.It is an ideal animal model for pre-clinical studies of liver transplantation.
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Objective To explore the influential factor and management of biliary tract complica-tions after liver transplantation. Method Clinical data of 57 patients who underwent liver transplantation between May 2006 and November 2007 were studied retrospectively. Results Among the 57 patients, 8patients (14.04%) developed postoperative bililary tract complications,4 patients with biliary leakage, 2patients with anastomosis stricture, 1 patient with intrahepatic biloma, all above eases were fully recover, 1patient with anastomosis stricture and intrahepatie biliary tract casting mould received liver retransplantation.Conclusions The management of biliary tract complications after liver transplantation are difficult. To at-tach importance to influential factor and prevention, timely diagnosis and treatment will improve patients' sur-vival time and quality of life.
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Objective To study the mechanism of immune hyporesponsiveness of allograft rejection induced by transfusion nonpufsed allopeptide syngeneic immature dendritic cell(imDC) generated from recipient bone marrow progenitors and to explore a possible strategy for liver allograft protection in clinic.Methods Forty experimental rats were randomly divided into 4 group: control group,cyclosporine A(CsA) group,mature DC(mDC) group and imDC group.In control group,Wistar rats only received liver transplantation.In CsA group,Wistar rats underwent liver transplantation plus CsA treatment(10 mg/(kg?d)).In mDC group,recipient-derived mDC 1?106 were infused intravenously through the penile vein to Wistar rats.In imDC group,ImDC with the dose of 1?106 were injected into Wistar rats via the dorsum vein of penile.In each group,five recipients were killed on the 10th day after transplantation,the other five recipients were left to observe survival time.The levels of ALT,AST,TBIL,IL-2,IFN-?,IL-4 and IL-10 were detected.The acute rejection and the expression of FasL/Fas in the grafts were detected by HE and immunohistochemical staining.Western blot was used to detect Scurfin protein expression of CD4+ CD25+ T cells.Results The median survival time of the liver allografts in CsA group and imDC group were significantly longer than that in control group and mDC group(P
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Objective To investigate the joint effects of selective digestive decontamination (SDD) and glutamine (Gln) on preventing intestinal bacterial translocation of orthotopic piggyback liver transplantation and to observe the incidence of postoperative pneumonia in rabbit. Methods Thirty rabbits received orthotopic piggyback liver transplantation and were randomly divided into three groups (SDD group, SDD+Gln group and control group). Mixed emulsion of tobramycin, polymyxin E and nystatin were given to the rabbits in SDD group. Same dosage of the above components plus Gln were given to the rabbits in SDD+Gln group. Samples of portal vein blood, ileum tissue and lung tissue were obtained in each group at different phases during and after operation, the pathological changes of ileum tissue, the bacterial translocation in blood of portal vein and the incidence of postoperative pneumonia were detected. Results The mixing section area of intestinal blood capillaries in SDD+Gln group was smaller compared with control group (P
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Objective To study the therapeutic effects of combined use of laparoscopic cholecystetomy and endoscopic sphincterotomy for cholecystolithiasis with secondary choledocholithiasis.Methods Thirty-five patients were diagnosed as cholecystolithiasis with secondary choledocholithiasis by B-ultrasonography and magnetic resonance cholangiopancreatography.Of them,in 28 cases,laparoscopic cholecystetomy was performed first,and ERCP and endoscopic sphincterotomy were done one week later;in 7 cases,endoscopic sphincterotomy were performed before laparoscopic cholecystectomy.Results The outcome of all the thirty-five cases was satisfactory without severe complications or conversion into open procedure.Conclusions The method of combined laparoscopic cholecystomy and endoscopic sphincterotomy,for cholecystolithiasis with secondy choledocholithiasis,especially for cases in whom the diameter of the common bile duct stone is ≤1cm,can give good therapeutic results and has advantages of minimal invasiveness,few complications and quick recovery.