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Liver transplantation is an effective treatment for the end-stage liver disease. However, hepatic ischemia-reperfusion injury (HIRI) will inevitably occur during liver transplantation, which might lead to early graft dysfunction or aggravate rejection. The underlying protective mechanism remains to be further elucidated. Programmed cell death is an important mechanism of HIRI, and multiple novel types of programmed cell death participate in the pathological process of HIRI. In-depth study of programmed cell death is expected to further improve the therapeutic effect of liver transplantation. In this article, research progresses on apoptosis, autophagy and autophagy-dependent cell death, ferroptosis, necroptosis, pyroptosis, pathanatos and other common programmed cell death patterns in HIRI were reviewed, aiming to provide reference for enhancing the success rate of liver transplantation and improving clinical prognosis of the recipients.
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Objective:To develop an ex vivo normothermic mechanical perfusion(NMP)and compare the effect of different portal perfusion pressures on attenuating hepatic injury from donor after cardiac death(DCD).Methods:All rat livers were subjected to in situ warm ischemia for 30 min after cardiac attest and thereafter stored for 8 h under cold preservation. Six livers were harvested and regarded as static cold storage(group CS, n=6). In experimental group, liver received an ex vivo dual NMP with oxygenated perfusion via hepatic artery for 2 h after cold storage. Hepatic injury was assessed and compared from perfused livers with full portal vein pressure(group M1, n=6)and low portal vein pressure(group M2, n=6). The evaluation parameters included perfusion flow, liver enzymes of perfusate, pathological changes by hematoxylin-eosin staining, Suzuki histological criteria, expression of activation markers of polymorphonuclear neutrophils and macrophages, myeloperoxidase (MPO)and CD68 by immunohistochemistry, level of malondialdehyde(MDA)and activity of superoxide dismutase(SOD). Results:In experimental group during NMP, perfusion flows tended to increase when portal pressures were stabilized in groups M1 and M2.Perfusion flow during NMP 60~120 min was significantly higher than during NMP 0~20 min.After NMP with full portal pressure, hepatic sinusoidal congestion, hepatocyte necrosis, steatosis and Suzuki criteria were lower in group M1 than those in group CS( P<0.05). Compared with group M1, lower hepatic injury was characterized with a lower change of liver enzymes in perfusate( P<0.05), a better histological evaluation( P<0.05), a lower level of MDA and a higher activity of SOD( P<0.05), lower expressions of CD68 and MPO ( P<0.05)and lower levels of TNF-α and IL-6( P<0.05)in perfused liver. Conclusions:The ex vivo dual NMP with oxygenated perfusion via hepatic artery mimics liver perfusion under the physiological conditions.NMP with a lower portal pressure can attenuate hepatic ischemia-reperfusion injury and confer a better protection against liver damage from DCD.
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Objective:To assess the future risk of bleeding events and ischemic events in a two-year follow-up of elderly patients with acute coronary syndromes(ACS)who experienced upper gastrointestinal bleeding during hospitalization, and to analyze the related factors for the recurrence.Methods:This was a retrospective case-control study.Elderly ACS patients who underwent percutaneous coronary intervention(PCI)in Beijing Hospital from January 1, 2015 to December 31, 2018 were continuously included.According to whether upper gastrointestinal bleeding occurred during hospitalization, they were divided into the bleeding group(n=51)and the control group(n=2 834). Baseline data were compared between the two groups.The incidence of major adverse cardiovascular events(MACE)and the recurrence of bleeding defined by the Bleeding Academic Research Consortium(BARC)consensus classification were monitored during the 2-year followed-up.Related factors for clinically significant bleeding events(BARC type 2, 3 and 5)were analyzed.Results:The median bleeding time in the bleeding group was 3.3 days after PCI, and the main cause was gastroduodenal ulcer(43 cases, 84.3%). Compared with the control group, patients in the bleeding group had a lower body mass index, a higher proportion of patients with a history of atrial fibrillation, chronic kidney disease, peptic ulcer, ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, higher usage rates of ticagrelor and oral anticoagulants, a lower usage rate of proton pump inhibitor(PPI), a higher proportion of patients with coronary artery disease involving ≥ 2 vessels, higher GRACE scores, higher usage rates of tirofiban and aspiration catheters and a lower complete revascularization rate( P<0.05). Patients were followed up for(22.4±1.5)months.Compared with the control group, the incidence of MACE(19 cases or 37.3% vs.698 cases or 24.6%, HR=1.655, 95% CI: 1.026-2.673, χ 2=4.513, P<0.05)and the recurrence of clinically significant bleeding(BARC type 2, 3 and 5)(10 cases or 19.6% vs.283 cases or 10.0%, HR=2.242, 95% CI: 1.209-4.157, χ2=5.083, P<0.05)increased in the bleeding group.Logistic multivariate regression analysis showed that age ≥70 years( RR=1.813, 95% CI: 1.021-3.219), chronic kidney disease ≥ stage 2( RR=1.623, 95% CI: 1.196-2.202), history of peptic ulcer( RR=2.152, 95% CI: 1.156-4.006), ticagrelor( RR=2.014, 95% CI: 1.253-3.237), and oral anticoagulants( RR=1.352, 95% CI: 1.032-1.771)were independent risk factors for clinically significant bleeding(BARC type 2, 3 and 5), and PPI was a protective factor( RR=0.573, 95% CI: 0.345-0.952). Conclusions:A history of upper gastrointestinal bleeding in elderly patients with ACS during hospitalization can increase the recurrence risk of clinically significant bleeding and MACE events in subsequent two years.Advanced age, chronic kidney disease ≥stage 2, a history of peptic ulcer, and preoperative use of ticagrelor and oral anticoagulants are independent risk factors for the recurrence risk of clinically significant bleeding, and PPI can decrease the recurrence risk of bleeding.
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Objective:To evaluate the outcome of endoscopic submucosal dissection (ESD) of colorectal tumors, and to analyze the factors affecting the therapeutic efficacy of ESD.Methods:Clinical data of patients with colorectal tumors who were treated with ESD in Department of Gastroenterology in Beijing Hospital from November 2016 to December 2019 were reviewed. A total of 82 patients with pathologically confirmed colorectal adenoma or carcinoma of diameter ≥20 mm were included. The clinical features, ESD and pathological outcomes of the patients were analyzed.Results:All 82 lesions were single, with the mean diameter of 29.72±10.74 mm. Lesions were divided into the laterally spreading tumors (LST), mainly located in the ascending colon and ileocecal region (47.8%, 22 / 46) and the protruding colorectal tumors, mainly located in the left colon, 52.8% (19 / 36) of which were located in the sigmoid colon. The overall resection rate was 81.7%(67/82) and the curative resection rate was 72.0%(59/82). The incidences of bleeding and perforation were 2.4%(2/82) and 1.2%(1/82), respectively. The curative resection rates [91.4%(32/35), 63.6%(7/11) and 55.6%(20/36), P=0.003] and surgical operation rates [8.6%(3/35), 18.2%(2/11) and 36.1%(13/36), P=0.010] of LST-G, LST-NG and protruding colorectal tumors were significantly different. Multivariate regression analysis showed that protruding colorectal tumor ( OR=3.396, 95% CI: 1.014-11.374, P=0.047) and submucosal severe fibrosis (F2 type) ( OR=5.508, 95% CI: 2.216-13.692, P=0.001) were independent risk factors for non-curative ESD resection of colorectal tumors. Conclusion:ESD is effective and safe for colorectal tumors of diameter ≥ 20 mm. However, there are some differences in the rate of submucosal invasion and treatment outcome among different types of lesions. The risk factors for non-curative resection are protruding tumors and severe submucosal fibrosis.
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Background: Endoscopic submucosal dissection (ESD) is the first choice for treating laterally spreading colorectal tumor. However, the effect of ESD on large protruding colorectal tumor is not ideal. Aims: To evaluate the features of large protruding colorectal tumor and the clinical outcome of ESD. Methods: The clinical data of 36 patients with protruding colorectal tumor with diameter ≥20 mm that undergone ESD from November 2016 to December 2019 at Beijing Hospital were retrospectively analyzed. The clinical, endoscopic, surgical and pathological features were summarized, and the risk factors of ESD were analyzed. Results: The average diameter of 36 lesions was (25.44±5.57) mm. All lesions were located in left hemicolon. The percentage of en bloc resection was 75.0%, and the percentage of R0 resection was 72.2%. ESD procedure was discontinued in 5 patients (13.9%) and were converted to surgery. The rate of curative resection was 55.6%. Non-curative resection was found in 11 patients, and of them 7 patients accepted surgery later. The overall rate of surgery was 33.3%. The en bloc resection rate (0 vs. 87.1%, P=0.003) and R0 resection rate (20.0% vs. 80.6%, P=0.008) were significantly decreased in muscle-retracting sign group than in non-muscle-retracting sign group. There were significant differences in en bloc resection rate, R0 resection rate and curative resection rate among the non-submucosal fibrosis (F0), mild fibrosis (F1) and severe fibrosis (F2) groups (P<0.001, P=0.000, P=0.010). Conclusions: The ESD procedure of large protruding colorectal tumors ≥20 mm is technically difficult. The rates of the en bloc resection and R0 resection are low, and the curative resection rate is even more lower. Muscle-retracting sign, severe submucosal fibrosis are the important factors that affecting the outcome of ESD operation.
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Objective To evaluate the safety of Propofol combined with Fentanyl in intravenous anesthesia for endoscopic retrograde cholangiopancreatography(ERCP)in elderly patients.Methods The clinical data of 63 elderly patients aged ≥80 years with common bile duct stones who underwent ERCP in digestive endoscopy center of our hospital were retrospectively analyzed.All the patients were divided into Propofol combined with Fentanyl anesthesia group(group A,n =41)and midazolam combined with Fentanyl anesthesia group(group B,n=22).The changes of blood pressure,heart rate and blood oxygen saturation(SpO2),and postoperative complications were compared between the two groups.Results The incidence of hypotension was higher in Propofol combined with Fentanyl anesthesia group than in midazolam combined with Fentanyl anesthesia group(24.4 ％ vs.0.0％,x2=4.683,P =0.030),but the incidence of SpO2 ＜ 90 ％ in midazolam combined with fentanyl anesthesia group was significantly increased(22.7％ vs.0.0％,x2 =7.250,P =0.007).There was no statistically significant difference in the incidence of anesthesia-related complications (39.0％ vs.36.4％,x2 =0.043,P =0.836) and postoperative complications (4.9 ％ vs.4.5 ％,x2 =0.003,P =0.953) between the two groups.Conclusions For elderly patients with common bile duct stones,intravenous anesthesia with Propofol and Fentanyl during ERCP is safe,and blood pressure changes need to be closely monitored.
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Objective To explore the correlation between main indicators of donor liver and early prognosis after liver transplantation.Methods The clinical data of 166 donors and recipients of post-mortem organ donation (DD) from June 2017 to June 2018 were retrospectively analyzed.The effects of donor age,sex,body mass index,serum sodium level,total bilirubin,prothrombin time and international standardized ratio on early allograft dysfunction (EAD) in liver transplant recipients were investigated.According to the culture results of donor liver preservation solution,the results were divided into positive group and negative group.Combined with the culture results of blood,sputum and drainage fluid after liver transplantation,the early infection rate of recipients in the two groups was observed.Results Univariate analysis showed that preoperative donor bilirubin total ＞17.1 mmol/L and donor cold ischemia time ＞8 h were risk factors for postoperative EAD in transplant recipients.Multivariate analysis showed that donor cold ischemia time ＞8 h was an independent risk factor for postoperative EAD in liver transplant recipients;the incidence of EAD in the group with cold ischemia time ＞8 h was significantly higher than that in the group with cold ischemia time ≤8 h (26.3％ vs.7.0％;P =0.003).The positive rate of postoperative sputum culture and drainage fluid culture in the donors with positive donor culture was 43.9％ and 48.8％,respectively,which was significantly higher than that in the negative group (10.7％ and 13.1％).The difference was statistically significant (P =0.000,P =0.000).The positive rate of postoperative blood culture in the positive group and the negative group was 12.2％ and 6.0％ with the difference being not statistically significant (P =0.161).Conclusion Cold ischemia time of the donor ＞8 h is an independent risk factor for EAD in recipients after liver transplantation.Shortening the cold ischemia time of donor liver can reduce the incidence of postoperative EAD in recipients.The culture results of preservation solution have a certain guiding effect on the postoperative anti-infective treatment of the recipients.
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PURPOSE: Kallikrein (KLK) proteases are hormone-like signaling molecules with critical functions in different cancers. This study investigated the expression of KLK6 in gastric cancer and its potential role in the growth, migration, and invasion of gastric cancer cells. MATERIALS AND METHODS: In this study, we compared protein levels of KLK6, vascular endothelial growth factor (VEGF), and matrix metallopeptidase (MMP) 9 in normal gastric epithelial and gastric cancer cell lines by western blot. Fluorescence-activated cell sorting was employed to sort 2 clones of SGC-7901 cells with distinct KLK6 expression, namely, KLK6-high (KLK6high) and KLK6-low (KLK6low), which were then expanded. Lastly, immunohistochemical analysis was performed to investigate KLK6 expression in gastric cancer patients. RESULTS: The expression levels of KLK6, VEGF, and MMP 9, were significantly higher in the gastric cancer cell lines SGC-7901, BGC-823, MKN-28, and MGC-803 than in the normal gastric epithelial cell line GES-1. Compared to KLK6low cells, KLK6high cells showed enhanced viability, colony-forming ability, migration, and invasion potential in vitro. Importantly, immunohistochemical analysis of a human gastric cancer tissue cohort revealed that the staining for KLK6, VEGF, and MMP9 was markedly stronger in the cancerous tissues than in the adjacent normal tissues. KLK6 expression also correlated with that of VEGF and MMP9 expression, as well as several key clinicopathological parameters. CONCLUSIONS: Together, these results suggest an important role for KLK6 in human gastric cancer progression.
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Humans , Blotting, Western , Cell Line , Clone Cells , Cohort Studies , Epithelial Cells , Flow Cytometry , In Vitro Techniques , Kallikreins , Peptide Hydrolases , Stomach Neoplasms , Vascular Endothelial Growth Factor AABSTRACT
Objective To observe the effects of percutaneous endoscopic gastrostomy (PEG)on mortality and complications in patients with persistent dysphagia after stroke using a points scoring system for selecting PEG indication.Methods A total of 75 patients were divided into low score group without PEG,high score group without PEG and low score group with PEG (n=25 each).The follow-up period was 18 months,and the differences in complications,mortalities and survival periods among groups were compared.Results The number of times of aspiration pneumonia was (1.36± 1.44) in low score group,(1.96±2.28) in high score group,(0.36±0.64) in low score group with PEG,with statistically significant differences among three groups (H=7.148,P=0.028).No difference in the morbidity of aspiration pneumonia was found between low score group and high score group (P=0.189).The number of times of aspiration pneumonia was decreased in low score groups after PEG versus in low score group without PEG (P=0.030) and in high score group (P＜0.01).The numberof times of gastrointestinal hemorrhage was (0.48± 0.77)in low score group,(0.64± 0.91) in high score group,(0.12±0.33) in low score group with PEG,with statistically significant differences among three groups (H=5.532,P =0.063).No statistically significant difference in gastrointestinal hemorrhage was found between low score groups and low score group after PEG (P=0.430),as well as between low score group and low score group with PEG (P=0.079).The morbidity of gastrointestinal hemorrhage was lower in low score group than in high score group (P=0.012).The survival rate at the observation end was 88.0％ (22/25),52.0％ (13/25) and 92.0％ (23/25) in low score group,high score group and low score group with PEG,respectively,with statistically significant difference among the three groups (x2 =7.906,P =0.001).Kaplan-Meier survival curve showed that the survival period were longer in the low score group with or without PEG than in high score group (P＜0.01),but no statistically significant difference was found between low score groups with or without PEG (P=0.626).Conclusions The reasonable evaluation using a points-scoring system before PEG might predict the prognosis of such patients:the higher score would indicate higher mortality.PEG operation for low score group with better condition could decrease the aspiration pneumonia and decrease gastrointestinal hemorrhage significantly,but could not prolong general survival time and decrease general mortality.
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Objective To evaluate the colon cleaning efficacy and safety of prucalopride combined with polyethylene glycol electrollytes powder in bowel preparation for colonoscopy examination and treatment under colonoscopy in elderly patients.Methods Elderly patients who prepared for colonoscopy were enrolled from October 2014 to January 2015.They were divided into group A,B and C.Patients of group A only took polyethylene glycol electrolyte powder (137.12 g dissolved in 2 000 mL warm water,stired until completely dissolved),patients of group B took polyethylene glycol electrolyte powder (same usage as group A) combined with prucalopride 2 mg/d for one day,patients of group C took polyethylene glycol electrolyte powder (same usage as group A) combined with prucalopride 2 mg/d for three days.The bowel preparation effects,especially ascending colon and ileocecal junction and cardiovascular adverse effects in all the patients and constipation patients of three groups were compared.Student t test,chisquare test and analysis of variance were performed for statistical analysis.Results A total of 124 elderly patients were divided into group A (64 cases),group B (23 cases) and group C (37 cases).Bowel preparation scores of total colon and ascending colon-ileocecal junction of group A,B,C were 8.34±0.90 and 2.56±0.56,8.96±0.21 and 2.96±0.21,8.86±0.35 and 2.86±0.35,respectively.The cleaning effects in total colon and ascending colon-ileocecal junction of group B were better than those of group A (t=5.52 and 5.15,both P＜0.05).The cleaning effects in total colon and ascending colon-ileocecal junction of groupCwere better than those of group A (t=4.69,3.65,both P＜0.05).There was no statistically significant difference between group B and group C in cleaning effects in total colon and ascending colon-ileocecal junction (both P＞0.05).There were 33,11 and 29 constipation cases in group A,B and C,respectively.The bowel preparation scores for total colon and ascending colon and ileocecal junction of group A,B,C were 7.85±0.94 and 2.24±0.56,8.91±0.30 and 2.91±0.30,8.83±0.38 and 2.83 ± 0.38,respectively.The cleaning effects in total colon and ascending colon-ileocecal junction of group B were better than those of group A (t=6.72 and 5.49,both P＜0.05).The cleaning effects in total colon and ascending colon-ileocecal junction of group C were better than those of group A (t=104.04 and 59.65,both P＜0.05).There was no significant difference between group B and group C in cleaning effects in total colon and ascending colon ileocecal junction (both P＞ 0.05).No obvious cardiovascular adverse events were observed in the patients of three groups.Conclusions The cleaning effects of prucalopride combined with polyethylene glycol electrolytes powder are good for colonoscopy examination in elderly patients,including elderly patients with constipation,especially in ascending colon and ilecocecal junction.No obvious cardiovascular adverse events are observed.
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Objective To observe how brain death affects the hepatic morphology and function of pigs and explore the roles of NF-κB. Methods Under general anaesthesia twelve healthy pigs were allocated randomly to two groups:control group(6 pigs),with non-inflacted Foley balloon catheter placed in the cerebral ventricle for 24 h,and brain death group,6 pigs,with estabhshment of brain death for 24 h.The serum and hepatic tissues in the same locus were taken at 6 h,12 h,and 24 h after the initial conformation of brain death.AST and ALT were determined by automatic biochemistry analyzer.IL-1βwas determined by ELISA.The NF-κB mRNA was determined by Real-time PCR and the NF-κB p65 by immunohistochemistry. Results The AST,ALT,IL-1β in serum,the NF-κB mRNA and the NF-κB p65 in hepatic tissues in brain death group were higher than those in control group and they all increased with the time(P<0.05).In brain death group,hepatocytes were edematous lightly after 12 hours,and the swelling progressively deteriorated after 24 hours,but there were no necrosis. Conclusion The activated NF-κB by brain death promoted the synthesis and release of inflammatory mediators,resulting in the hepatic dysfunction.
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Objective To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD). Methods Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss,diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniquks were compared. The proportions of patients with positive findings using each examination were compared. Results Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66. 00% ), the remaining 17 (34.0%)were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85. 29% ); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30% ); SBF was performed in 39 patients and 26 of small bowel lesion were detected (66. 67% ). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0. 006 ). The combinded positive rates of two methods were: CE + CTE 92. 86% (13/14), SBFT + CTE 90. 91% (20/22), CE + ileocolonoscopy 95. 65% (22/23), CE + SBFT100% (17/17), ileocolonoscopy + CTE 89. 66% ( 26/29 ), ileocolonoscopy + SBFT 77.78% ( 28/36 ), but there were no significant differences between each two examinations. Conclusion CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease,whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFF have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.
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Objective To analysis the features of Montreal classification,serum markers,treatment and prognosis of Chinese patients with Crohn's disease(CD),and to estimate the relationships between clinical classification and anti-sarccharomyces cerevisiae antibody(ASCA),treatment and prognosis.Methods A retrospective study of 102 consecutive definite CD eases were performed and all subjects were classified into subtypes according to Montreal classification.The results of ASCA,extra-intestinal manifestation,treatment and disease behavior at follow-up were recorded and compared among different subtypes.Results The A2 subtype(52.9%)was dominated in Chinese CD patients.Ileocolon location(40.2%)and stricture lesion (53.9%)were common.The complication rate was dependent on disease course(P＜0.05),and intestinal fistula was associated with disease location(P=0.074).B1 subtype had higher progressive rate than B2 subtype(P=0.018).ASCA was not associated with disease loeation,disease behavior,treatment and disease progression(P＞0.05).Conclusions Crohn's disease mainly attack young people with male predominance.Early-onset CD patients have higher ASCA positive rate and disease progressive rate.The disease behavior progresses associated with disease course,and the rate of complication and the increase of surgery.The penetrating behavior is the main cause for surgery.Montreal classification is useful to predict the disease course,the need for surgery as well as the prognosis.
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Objective To investigate the effects of breviscapine on the renal structure, function and PKC-?mRNA and its protein expression in brain-dead BA-Ma mini pigs. Methods Fifteen BA-Ma mini pigs were randomly divided into 3 groups: brain-dead group (group A), breviscapine pretreatment group (group B), and control group (group C), 5 pigs in each group. The brain-dead models were established by increasing intracranial pressure in a modified, slow and intermittent way. At 3, 6, 12, 18 and 24 h after the initial brain death, serum BUN, Cr, TNF-?, IL-1?, and IL-6 were determined. At 3, 6, 12, and 24 h, the changes of renal tissues were observed by HE staining, and the expression of PKC-?mRNA and protein was detected by RT-PCR and immnohistochemistry respectively. The ultrastructural changes of hepatic cells were observed under electron microscopy. Results (1) At 3rd h after the initial brain death, IL-1?, IL-6, and TNF-?in group A and group B began to increase. Serum BUN and Cr in group A and group B began to increase at 12 th after brain death and were higher at each time point (P
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Objective To evaluate the protection effects of glycine on the brain dead donor liver. Methods 42 male Wistar rats were randomized into 3 groups of liver transplantation: brain dead donor (BDD) group (group B), glycine pretreatment group with BDD (group G), strychnine pretreatment group with BDD (group S). For groups B, G and S, the brain death model was established in the donor rats and then liver transplantation was performed utilizing microsurgical techniques. After establishment of brain death state, and during liver cold rinse of donors or liver reperfusion of the recipients, rats in group B were treated with glycine at a dose of 0.6 mmol, 25 ?mol and 25 ?mol in group G, and rats in group S were given the same dose of glycine and strychnine ( 1 000 ∶1), and rats in group B were not treated. Before the cold rinse, at 2 h and 6 h after the portal vein (PV) reperfusion, blood samples were taken from IHVC to determine the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor alpha (TNF ?) and hyaluronic acid (HA). At 6 h after PV reperfusion, graft samples were fixed for morphological observation and the apoptosis of hepatocytes was detected by using TUNEL method. Results At the time points before liver cold rinse or at 2 h and 6 h after PV reperfusion, serum levels of ALT, AST, TNF ?, HA and apoptosis index (AI) in groups B and S were significantly higher than those in group G ( P 0.05 ). Electron microscopy showed that Kupffer cells were activated and hepatic cells injured more obviously in groups B and S than in group G. Conclusion Glycine may alleviate the injury of the graft from the brain dead rats.