Method of transfection of STOP gene lentiviral vector into oligodendrocyte precursor cells of BTBR mouse model of autism / 解剖学报

Objective To investigate the effect of microtubule binding protein STOP on myelin formation of oligodendrocyte in BTBR mice spectrum disorder in vitro, a highly purified primary culture method of oligodendrocyte precursor cells from cerebral cortex of BTBR mice was established. Establishment of a highly efficient transfection method for overexpression of STOP gene in oligodendrocyte precursor cells of BTBR mice cerebral cortex using lentiviral vector. Methods BTBR mice were used as experimental objects, 6-10 suckling mice were taken each time, repeat 3 times independently. The single cell suspension was prepared by trypsin digestion, and the primary oligodendrocyte precursor cells were obtained by immunomagnetic bead cell sorting method . After 5 days of culture, the cell purity was identified by oligodendrocyte precursor cell marker staining. The primary cultured oligodendrocyte precursor cells were transfected with STOP gene vector constructed in the early stage of the project group. 72-96 hours after transfection, the fluorescence staining of oligodendrocyte precursor cells was observed under fluorescence microscope, and the transfection rate and cell survival rate were calculated. Results The oligodendrocyte precursor cells of BTBR mice extracted by immunomagnetic beads sorting method basically adhered to the wall completely after 48 hours, and the cells had strong ability of proliferation. On the fifth da)' of culture, the purity of the cells was more than 95% identified by immunofluorescence. A lentivirus transfection method for primary oligodendrocyte precursor cells of BTBR mice with high transfection efficiency was established. The fluorescence expression of the cells was obvious after being photographed by high connotation microscope, the lentivirus transfection rate of oligodendrocyte precursor cells was increased to 60%-70%. Conclusion The primaiy oligodendrocyte precursor cells of BTBR mouse cerebral cortex with high purity were successfull)' isolated and cultured. A method for lentivirus infection of primaiy oligodendrocyte precursor cells in the cerebral cortex of BTBR mice is successfully established.

Professor Yu Hai-bo's clinical experience in treating acute attack of hemorrhoids with acupuncture-moxibustion / 针灸推拿医学（英文版）

Hemorrhoid refers to soft vein mass formed by varicosity of submucosal veins around the end of the rectum and subcutanceous veins of the anal canal. It is the most common anorectal disease. This article summarized the regular patterns, features and advantages of Professor Yu Hai-Bo's acupuncture-moxibustion therapy for hemorrhoids, in order to guide the acupuncture treatment for hemorrhoids.

TLR3 gene polymorphisms in cancer: a systematic review and meta-analysis / 癌症

<p><b>INTRODUCTION</b>Recent studies examining the association of Toll-like receptor 3 (TLR3) gene polymorphisms with the risk of developing various types of cancer have reported conflicting results. Clarifying this association could advance our knowledge of the influence of TLR3 single nucleotide polymorphisms (SNPs) on cancer risk.</p><p><b>METHODS</b>We systematically reviewed studies that focused on a collection of 12 SNPs located in the TLR3 gene and the details by which these SNPs influenced cancer risk. Additionally, 14 case-control studies comprising a total of 7997 cases of cancer and 8699 controls were included in a meta-analysis of 4 highly studied SNPs (rs3775290, rs3775291, rs3775292, and rs5743312).</p><p><b>RESULTS</b>The variant TLR3 genotype rs5743312 (C9948T, intron 3, C>T) was significantly associated with an increased cancer risk as compared with the wild-type allele (odds ratio [OR]=1.11, 95% confidence interval [CI]=1.00-1.24, P=0.047). No such association was observed with other TLR3 SNPs. In the stratified analysis, the rs3775290 (C13766T, C>T) variant genotype was found to be significantly associated with an increased cancer risk in Asian populations. Additionally, the rs3775291 (G13909A, G>A) variant genotype was significantly associated with an increased cancer risk in Asians, subgroup with hospital-based controls, and subgroup with a small sample size.</p><p><b>CONCLUSION</b>After data integration, our findings suggest that the TLR3 rs5743312 polymorphism may contribute to an increased cancer risk.</p>

RIN1 expression in hepatocellular cancer and the affection on prognosis and tumor invasion ability / 中华外科杂志

<p><b>OBJECTIVE</b>To test the expression of RIN1 in hepatocellular cancer (HCC) and study its clinicopathological significance and mechanism.</p><p><b>METHODS</b>RIN1 mRNA in 36 HCC tissues was analyzed using real-time PCR (RT-PCR). The expression of RIN1 was examined by immunohistochemistry (IHC) in 110 HCC specimens. The relationship between the protein expression and prognosis was analyzed. Transwell was used to test invasion ability of HCC cell lines which were transfected with the expression vector pEGFP-N1-RIN1.</p><p><b>RESULTS</b>RIN1 mRNA expression levels was much lower in tumor tissues than that in their corresponding non-cancerous tissues (χ(2) = 7.430, P = 0.026). RIN1 protein was lowly expressed in liver cancer samples (69.1%) and correlated with poor survival (6.46%) (χ(2) = 13.808, P < 0.05). Transwell assays show that RIN1 overexpression can inhibit invasion ability of HepG2 cells (t = 8.975 and 9.522, both P < 0.05). RIN1 expression and ABL2 and E calcium protein were positively correlated (r = 0.898 and 0.912, P < 0.05), and negatively correlated with MMP-9 (r = -0.933, P = 0.002).</p><p><b>CONCLUSIONS</b>RIN1 expression was down-regulated in HCC and low expression of RIN1 foreshows poor prognosis of HCC patients. RIN1 overexpression can inhibit invasion ability of HepG2 cells.</p>

Correlations between MELD score and left ventricular function in patients with end-stage liver disease / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the correlations between MELD score and left ventricular function in patients with end-stage liver disease.</p><p><b>METHODS</b>A total of 92 patients who prepared for orthotopic liver transplantation from January 2002 to May 2008 were enrolled in this study. Of these Patients, 75 were males and 17 were females, and the mean age was 50.3+/-9.5 years; 85 were cirrhosis, 7 were cirrhosis with primary liver cancer. Preoperative information, including biochemical parameters, coagulation parameters, indicators of hepatitis virology, two-dimensional echocardiography and electrocardiogram were collected. According to MELD (the Model for End-stage Liver Disease) scoring system, these subjects were categorized into three groups: MELD score is less than or equal to 9 points (31 cases, 33.7%); 10 is less than or equal to MELD score is less than or equal to 19 points (45 cases, 48.9%); MELD score is more than or equal to 20 points (16 cases, 17.4%). The relationships between MELD score and classification and cardiac function were determined by chi-square test, analysis of variance, rank sum test and correlation analysis, et al.</p><p><b>RESULTS</b>MELD score was significantly correlated with left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular end-diastolic diameter (LVEDD), aortic flow (AF), cardiac output (CO), QRS interval (QRSI) and corrected QT interval (QTc) (r = 0.317, 0.341, 0.228, 0.387, 0.325, 0.209 and 0.347, respectively; P value less than 0.01, respectively); except QRSI, these variables and left ventricular posterior wall thickness (LVPWT) were also correlated with INR (a MELD component) (r = 0.282, 0.319, 0.322, 0.435, 0.275, 0.320 and 0.237, respectively; P value less than 0.01, respectively); LAD, LVEDD, AF, CO and QTc were correlated with serum total bilirubin (r = 0.241, 0.219, 0.357, 0.246 and 0.253, respectively; P value less than 0.05, respectively); IVST and E/A ratio (A blood flow [from left atrium to left ventricular] velocity ratio between early diastole [E wave] and late diastole[A wave] ) were correlated with serum creatinine (r = 0.216 and -0.343; P value less than 0.05 and 0.01); the proportion of E/A is less than or equal to 1 in all subjects was 46.7% (43/92), and 48.4% (15/31), 35.6% (16/45) and 75.0% (12/16) in each group, besides, there was statistically significant difference between 10 is less than or equal to MELD score is less than or equal to 19 points group and MELD score is more than or equal to 20 points group (X2 = 7.359, P = 0.009).</p><p><b>CONCLUSIONS</b>There are different degrees of left ventricular structure, function and electrophysiological changes in patients with end-stage liver disease, these anomalies also will be increased with the MELD score increasing.</p>

Clinical analysis of autoimmune pancreatitis: a single center study of 14 consecutive cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristic findings of autoimmune pancreatitis (AIP) to increase the recognition of AIP.</p><p><b>METHODS</b>From February 2002 to April 2008, a total of 14 cases of AIP were reviewed by clinical, imaging, serologic, histopathologic features and treatment response. There were 13 male and 1 female, with a mean age of 53 years. The main clinical manifestations included progressive obstructive jaundice in 11 cases, upper abdomen pain in 3 cases.</p><p><b>RESULTS</b>Diffuse enlargement of pancreas and diffuse narrowing of the main pancreatic duct (MPD) were observed in 11 cases, while 3 patients showed localized pancreatic head enlargement and focal narrowing of the MPD. Distal common bile duct stenosis was found in all cases. Increased expression of serum immunoglobulin G was found in 7 patients. Autoantibody test was positive in 5 of 12 patients. Nine of 14 patients with AIP had extrapancreatic organ involvement. Massive lymphocytes and plasma cells infiltration in pancreatic tissues were showed on pathology, as well as parenchymal fibrosis. Seven earlier patients were treated initially with surgical laparotomy or resection for suspected malignancy. Steroid therapy was given to the other patients and was responsive. There were 4 recurrences after initial treatment.</p><p><b>CONCLUSION</b>AIP should be a differential diagnosis in pancreatic head mass in order to avoid unnecessary resection.</p>

The effect of iNOS gene expression inhibited by RNA inference on the pancreas islet apoptosis and function in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of iNOS gene on cell apoptosis and insulin secretion of pancreas islet in rats by RNA inference (RNAi).</p><p><b>METHODS</b>Islets obtained from thirty Wistar rats were randomly divided into five groups, and siRNA oligo was purchased from Genepharma in Shanghai. The cultured islets were transfected with iNOS siRNA, and then were divided into five groups. Islet cultured only was taken as blank control group, and cultured with TNF-alpha + IL-1 beta as cytokine group. Islet transfected with negative or iNOS siRNA were taken as negative transfection control group or RNAi group, while that transfected with iNOS siRNA and cultured with TNF-alpha + IL-1 beta as RNAi + cytokine group. Expression of iNOS mRNA was evaluated by RT-PCR and iNOS protein was evaluated by Western blot to detect the effect of RNAi. The expression of apoptosis correlated gene, Bax, Fas were analyzed, and the apoptotic cells were identified by TUNEL method meanwhile. Insulin secretion index assay the function of the islets.</p><p><b>RESULTS</b>500 - 600 IEQ islets could be extracted from every rat. RNAi attenuated the expression of iNOS and restrained the synthesis of iNOS protein.With treatment of cytokines IL-1 beta and TNF-alpha, the level of iNOS increased remarkably, the expression of Bax and Fas ascended distinctly, and insulin secretion index decreased strikingly. While, the expression of apoptosis gene and amount of apoptotic cells descended in group of RNAi + cytokine, and insulin secretion index were satisfying.</p><p><b>CONCLUSION</b>The apoptosis from cytokines to islets mediated by iNOS could be suppressed by RNAi, which leaded to favorable function and survival of islets.</p>

Liver transplantation in end-stage liver disease with portal vein thrombosis / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience in the managements of portal vein thrombosis (PVT) and to evaluate the impact of PVT on intraoperative course and postoperative outcome in liver transplantation.</p><p><b>METHODS</b>Between May 1995 and September 2007, 194 orthotopic liver transplantations were performed, of which 24 cases presented portal vein thrombosis. There were 12 patients with grade I, 9 with grade II, 2 with grade III and 1 with grade IV. The management of PVT depended mainly on its extent. Ligation of the collateral circulation, especially spontaneous or surgical splenorenal shunt, was made as approaches to improve portal flow.Heparin or low-molecule-weight heparin as a prophylactic anticoagulation therapy was maintained during and after operation if prothrombin time is less than eighteen seconds. Follow-up Doppler ultrasonography was used daily in the early postoperative period. Risk factors and variables associated with the transplant and the post-transplant period were analyzed and compared with 170 patients transplanted without PVT.</p><p><b>RESULTS</b>Surgical techniques were eversion thromboendovenectomy in 21 patients with PVT grades I and II, extra-anatomic mesenteric graft in 2 with grade III, and anastomosis to a collateral vein in 1 with grade IV. The study demonstrated more RBC transfusions [(15.2 +/- 11.8) U vs. (8.6 +/- 6.6) U, P = 0.006], longer surgery procedures [(492 +/- 89) min vs. (403 +/- 105) min, P = 0.001] and hospital stay [(32.4 +/- 13.5) d vs. (22.1 +/- 9.1) d, P = 0.001] in the PVT group. However, there were no differences in overall morbidity (58.3% vs. 50.6%, P = 0.478), hospital mortality (8.3% vs.6.5%, P = 0.73) and 1-year survival (87.5% vs. 89.4%, P = 0.778). The incidence of rethrombosis was higher in the PVT group (8.3% vs.1.2%, P = 0.021). Two cases rethrombosis were successfully cured by percutaneous thrombolysis, balloon angioplasty, and stent placement.</p><p><b>CONCLUSION</b>Portal thrombosis is associated with greater operative complexity and rethrombosis, but has no influence on overall morbidity and mortality in liver transplantation.</p>

Prevention and treatment of biliary complications following orthotopic liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To study the prevention and treatment of biliary complications after orthotopic liver transplantation.</p><p><b>METHODS</b>Clinical data of 183 recipients who had received liver transplantation between May 1995 and December 2006 were retrospectively analyzed.</p><p><b>RESULTS</b>Biliary complications occurred in 15 patients (15/183, 8.2%). The incidence for short-term and long-term complication were 6.0% (11/183) and 2.2% (4/183) respectively. No biliary complications was due to hepatic artery thrombosis(HAT). Four cases who received PTC(percutaneous transhepatic cholangiography) with stent insertion,8 cases who received ERCP( endoscopic retrograde cholangiopancreatography) with stent insertion and 1 who received Roux-en-Y choledochojejunostomy for anastomotic stricture were successfully cured. Two cases required relaparotomy died for fungus infection eventually. The mortality due to biliary complications was 1.1%.</p><p><b>CONCLUSIONS</b>The rapid combined abdominal organ harvesting technique could shorten the ischemia time and ameliorate the injury due to vascular and bile duct variances, which could reduce the incidence of biliary complication. PTC and (or) ERCP combined with stent insertion were main procedure for biliary complications not related to HAT after liver transplantation.</p>

Surgical treatment of asymptomatic primary hyperparathyroidism / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and management of asymptomatic primary hyperparathyroidism (PHPT).</p><p><b>METHODS</b>Clinical data of 46 cases of primary hyperparathyroidism from January 1990 to December 2006 were retrospectively analyzed. There were 5 cases of asymptomatic PHPT. Three out of the 5 cases obtained the diagnosis by routine health examination and 1 case was misdiagnosed as thyroid tumor before surgery, but was conformed as parathyroid adenoma by intraoperative biopsy. Remaining 1 case was diagnosed because of weakness. The serum calcium and the parathyroid hormone (PTH) levels were elevated in 4 cases, while only 1 being normal range. Unilateral neck exploration was performed in all 5 cases.</p><p><b>RESULTS</b>There were no operational death, recurrent nerve injury or other complications. All patients had the same pathological diagnosis as parathyroid adenomas. Three cases showed gentle circumoral paresthesia after surgery with normal serum level of calcium, but the symptoms were relieved with oral use of calcium gluconate. Only 1 patient had tetany with the lowest level of serum calcemia at 1.96 mmol/L in 24 h postoperatively. The signs and symptoms were all relieved by intravenous use of calcium gluconate for 3 d after surgery. Remaining 1 case has normal level of serum calcemia after surgery. Time range of following-up for 4 cases was from 2 months to 2 years. The level of serum calcemia was normal for them. One lost following-up.</p><p><b>CONCLUSIONS</b>Asymptomatic primary hyperparathyroidism could be diagnosed according to co-elevated serum calcemia and PTH without typical symptoms. Unilateral neck exploration was the best choice for the patients with accurate imaging localization. Conservative management including adequate hydration, dietary calcium intake and pharmacological approaches could be used for the patients who were unfit for surgery.</p>

Effects of blocking the CXC chemokine receptor 3 pathway on acute rejection of islet allograft / 中华外科杂志

<p><b>OBJECTIVE</b>To identify the effect of PNA CXCR3 on acute rejection of islet allograft.</p><p><b>METHODS</b>The mice islet transplant models were used. The mice were divided into three groups including saline group, PNA CXCR3 group and mismatch PNA group. In vitro the proliferation capability of T cell was assessed by proliferative responses. RT-PCR and western blot were used to detect the expression of mRNA and protein. Flow cytometry was applied to determine the expression level of CXCR3 in spleen CD3(+) T cells.</p><p><b>RESULTS</b>Compared with saline [(6.72 +/- 1.48) d] and PNA mismatch-treated recipients [(6.54 +/- 0.86) d], PNA CXCR3-treated recipients demonstrated statistically significant prolongation [(9.70 +/- 1.57) d] in functional allograft survival. The CXCR3 mRNA expression level of PNA CXCR3 group (1.06 +/- 0.07) was significantly down-regulated compared with saline (1.98 +/- 0.22) and PNA mismatch (1.87 +/- 0.10) group at the 7th day after transplant. The date showed that CXCR3 protein and lymphocytes proliferation capability was significantly down-regulated in PNA CXCR3 group compared with saline and PNA mismatch group (P<0.01).</p><p><b>CONCLUSIONS</b>The present study indicates that PNA CXCR3 can inhibit T cell activating and prolonging the survival time of islet allograft and has a substantial therapeutic effect on inhibiting acute allograft rejection.</p>

Effects and possible mechanism of cocaine on the neurons of lateral habenular nucleus / 中国应用生理学杂志

<p><b>AIM</b>To investigate the effects and the possible mechanism of cocaine on the neurons of lateral habenular nucleus (LHb).</p><p><b>METHODS</b>We observed the effects on c-Fos protein expression in lateral habenular nucleus and medial habenular nucleus after injecting cocaine into a belly cavity and spontaneous and evoked discharge of pain-correlative unit through iontophoresis of cocaine into LHb. The delayed rectifier K+ current was recorded in the acute isolated LHb neuron in whole-cell mode.</p><p><b>RESULTS</b>(1) The c-Fos protein expression was increased by cocaine treatment in LHb, but little effect in MHb. (2) Iontophoresis of cocaine into LHb increased the discharges of pain excitation unit and enhanced excitation response to noxious stimulation, but it decreased the discharges of pain inhibition unit and its responses to noxious stimulation in LHb. Cocaine inhibited the delayed rectifier K+ current.</p><p><b>CONCLUSION</b>Cocaine can excite the LHb and increase its sensitivity. The probable mechanism is that cocaine inhibits the delayed rectifier K+ channels.</p>

Influence of hepatitis B and hepatitis C virus infection on the outcome of kidney transplantation / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the impact of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection on the long-term survival of renal transplantation recipients.</p><p><b>METHODS</b>A total of 443 patients who received renal allografts from 1992 to 2002 were analyzed. Outcome and survival were compared among four groups retrospectively.</p><p><b>RESULTS</b>Twelve patients were positive for both hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) (group 1), 18 were HBsAg-positive and anti-HCV-negative (group 2), 26 were HBsAg-negative and anti-HCV-positive (group 3) and 387 were negative for both markers (group 4). The mean follow-up period was 6.1 +/- 2.8 years (range, 0.5-10 years) for all patients. Group 2 had significantly higher liver-related complications (38.9%) and liver-related death (16.7%) than did group 4 (0%, P < 0.01). Among all patients, 4 HBsAg-positive patients had fulminant hepatitis and died within two years of transplantation. Three patients (group 2) who died were seropositive for HBeAg and/or HBV DNA and none had a history of or positive serologic marker to indicate hepatitis of other etiologies. One (group 1), two (group 2), and one patient (group 3) developed liver cirrhosis respectively, and hepatocellular carcinoma occurred in two patients (group 2) and one patient (group 3). Despite high liver-related mortality in HBV-infected patients, no significant differences among the four groups in the long-term graft and patient survivals were demonstrated. The presence of HBsAg or anti-HCV was not associated with poor prognosis as determined by Cox regression analysis.</p><p><b>CONCLUSION</b>HBV or HCV infection is not a contraindiction to kidney transplantation in Chinese patients. However, it should be noted that serious liver-related complications may occur and limit survival in patients infected with HBV and/or HCV after kidney transplantation.</p>

Effects of nitric oxide on reperfusion injury following pancreaticoduodenal transplantation in rats / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of nitric oxide (NO) on reperfusion injury following pancreaticoduodenal transplantation in rats.</p><p><b>METHODS</b>The homologous male Wistar rat model of heterotopic total pancreaticoduodenal transplantation was used. The L-arginine (L-Arg) group received intravenous injection of L-Arg 5 minutes before and after reperfusion at a dose of 200 mg/kg while the N-Nitro-L-Arginine methyl ester (L-NAME) group received intravenous injection of L-NAME at a dose of 10 mg/kg, and control group received saline. The amount of NO in the pancreas graft was measured. Serum concentration of cytokine-induced neutrophil chemoattractant (CINC) determined by enzyme-linked immunosorbant assay, expression of CINC mRNA detected by Northern blot assay, and myeloperoxidase (MPO) activity in the pancreas graft were measured. Histological observation was performed.</p><p><b>RESULTS</b>The amount of NO in the L-Arg group was higher than in the control group, while in the L-NAME group was lower than in the control group (P < 0.05). The peak of serum CINC concentration occurred 3 hours after reperfusion with significant difference among groups. Expression peak of CINC mRNA in the pancreas graft occurred 3 hours after reperfusion. The expression level in the L-Arg group was lower than in the control group, the L-NAME group was higher than control group (P < 0.05). MPO activity in the L-Arg group obviously decreasd compared with other groups. The pancreas inflammation was ameliorated in L-Arg group, and pancreas damage was aggravated in L-NAME group.</p><p><b>CONCLUSIONS</b>L-Arg can increase the amount of NO and inhibit the elevation of CINC, CINC mRNA expression, and early neutrophil accumulation in the transplanted pancreas. NO has protective effects on the ischemia/reperfusion injury of pancreaticoduodenal transplantation.</p>

Prevention and treatment of rejection after simultaneous pancreas-kidney transplantation / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney (SPK) transplantation.</p><p><b>METHODS</b>Seventeen patients underwent SPK transplantation from September 1999 to September 2003 were reviewed retrospectively. Immunosuppression was achieved by a triple drug regimen consisting of cyclosporine, mycophenolate mofteil (MMF), and steroids. Three patients were treated with anti-CD3 monoclone antibody (OKT3, 5 mg x d(-1)) for induction therapy for a mean period of 5-7 days. One patients received IL-2 receptor antibodies (daclizumab) in a dose of 1 mg x kg(-1) on the day of transplant and the 5th day posttransplant. One patient was treated with both OKT3 and daclizumab for induction.</p><p><b>RESULTS</b>No primary non-functionality of either kidney or pancreas occurred in this series of transplantations. Function of all the kidney grafts recovered within 2 to 4 days after transplantation. The level of serum creatinine was 94 +/- 11 micromol/L on the 7th day posttransplant. One patient experienced the accelerated rejection, resulting in the resection of the pancreas and kidney grafts because of the failure of conservative therapy. The incidence of the first rejection episodes at 3 months was 47.1% (8/17). Only the kidney was involved in 35.3% (6/17); and both the pancreas and kidney were involved in 11.8% (2/17). All these patients received a high-dose pulse of methylprednisone (0.5 g x d(-1)) for 3 days. OKT3 (0.5 mg x d(-1)) was administered for 7-10 days in two patients with both renal and pancreas rejection. All the grafts were successfully rescued.</p><p><b>CONCLUSION</b>Rejection, particularly acute rejection, is the major cause influencing graft function in SPK transplantation. Monitoring renal function and pancreas exocrine secretion, and reasonable application of immunosuppressants play important roles in the diagnosis and treatment of rejection.</p>

Analysis of rejection after simultaneous pancreas-kidney transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney transplantation (SPK).</p><p><b>METHODS</b>Seventeen patients performed SPK operation from Sep, 1999 to Sep, 2003 were reviewed retrospectively. Immunosuppression was achieved by triple regimen consisting of cyclosporine, mycophenolate mofetil (MMF)/azathioprine and steroid. 2 patients were treated with Dalizumab, the other three patients used OKT3 as immune induction.</p><p><b>RESULTS</b>1 patient experienced the accelerated rejection, the pancreas and kidney grafts were resected because of failure of conservative therapy. 8 patients experienced renal acute rejection, 2 cases suffered from pancreas acute rejection at the same time. All these patients received daily high dose pulse steroid for 3 days. OKT3 was administered in 2 patients with steroid resistance rejection. All the grafts were successfully rescued.</p><p><b>CONCLUSIONS</b>Reasonable application of immunosuppression after SPK operation and adoption of systemic measures which can reduce sensitivity of high risk receptor before SPK operation are the effective methods of preventing and treating rejection.</p>

The changes of Oddi sphincter motility after canine pancreas transplantation with bladder drainage / 中华外科杂志

<p><b>OBJECTIVE</b>To study the changes of canine Oddi sphincter (SO) function after pancreas transplantation with bladder drainage and the effect on the graft function.</p><p><b>METHODS</b>Normal canine SO, transplant canine SO and canine SO in vitro manometry were performed by triple lumen catheter. At the same time, pancreas endocrine and exocrine function after transplantation were determined. After transplantation, anti-reflux function of graft SO was also measured.</p><p><b>RESULTS</b>Endocrine and exocrine function of all the transplanted dogs showed that pancreas graft function was good. Basal pressure of SO in control group was (18.5 +/- 2.8) mm Hg (1 mm Hg = 0.133 kPa). The contraction frequency was (9.7 +/- 1.5) per min, the contraction amplitude was (47.1 +/- 5.5) mm Hg, the motility index was (236 +/- 56). After transplantation, basal pressure increased to (27.8 +/- 2.8) mm Hg, frequency increased to (13.1 +/- 1.9) per min, amplitude decreased significantly to (8.3 +/- 1.8) mm Hg. There was no significant difference of motility index. Basal pressure of SO in vitro increased significantly to (37.2 +/- 5.1) mm Hg. Phasic contraction was not absent. After transplantation, the pressure in the bile duct residual did not increase in accordance with the increase of bladder pressure.</p><p><b>CONCLUSIONS</b>After pancreas transplantation with bladder drainage, Basal pressure and frequency of canine SO could increase while amplitude could decrease, which provide the anti-reflux function of graft SO and may serve as an obstacle to pancreatic juice flow.</p>

Risk factors of postoperative acute lung injury of liver transplantation / 中华器官移植杂志

Objective To study the risk factor of postoperative acute lung injury(ALI)after liver transplantation.Methods The clinical data of I00 patients with end-stage liver diseases who re- ceived liver transplantations were retrospectively reviewed.The risk factors of postoperative ALI after liver transplantation were analyzed by using single variance analysis and multiple variance regression analysis.Results Thirteen patients(13 %,13/11t0)altogether were diagnosed as ALI after liver transplantation.Binary logistic analysis revealed that massive transfusion during operation(more than 5000 ml)and severity of reperfusion injury(ALT above 600 U/L)were two independent risk factors of postoperative ALI following liver transplantation.Massive transfusion significantly increased the risk of ALI by 12.7 times,whereas the severe reperfusion significantly increased the risk of ALI by 7.0 times.Conclusions ALl is a serious multifactoral complication after liver transplantation with high mortality and fatality.Massive transfusion and the severe reperfusion injury are two independent risk factors with high morbidity and mortality.

Experimental study on effect of Astragalus extractum on canine isolated kidney during hypothermia perfusion and preservation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of Astragalus Extractum on canine isolated kidney during hypothermia perfusion and preservation.</p><p><b>METHODS</b>Isolated kidneys in the control group were hypothermia perfused and preserved using conventional hypertonic adenine citrate solution (HC-A), and for those in the experimental group, using HC-A plus Astragalus extract instead. The changes of renal tissue construction were observed with light microscopy and electron microscopy. Moreover, the kidney transplantation model of dog was established to determine the changes of biochemical parameters before and after transplantation. Data were analysed synthetically.</p><p><b>RESULTS</b>The ultrastructural injury in preserved kidney of the experimental group was significantly milder than that in the control group. Parameters determined in the early stage of transplantation showed that the blood creatinine level was significantly lower and the endogenous creatinine clearing value was higher in the experimental group than that in the control group, the difference was significant (P < 0.05).</p><p><b>CONCLUSION</b>When Astragalus extractum is used in preserving kidney with hypothermia perfusion, it shows definite protective effect on the ischemic reperfusion injured kidney.</p>