ABSTRACT
ObjectiveTo evaluate the role of nitric oxide (NO) in ischemia reperfusion injury (IRI) and acute rejection (AR) of intestinal transplantation in rats.MethodsThe rat orthotopic intestinal transplantation was performed. Animals were assigned to the following 4 groups with random methods:transplant control group,L-arginine (L-Arg) group,NG-Nitro-L-arginine methyl ester (L-NAME) Ⅰ group (group Ⅰ ) and L-NAME Ⅱ group (group Ⅱ ).The rats in different group were given saline,L-Arg (150 mg· kg-1 · d-1 ),L-NAME (4 and 8 mg· kg-1 · d-1 ) injection respectively from the operative day.The recipient survival time was observed.The pathologic changes were observed by HE staining.The activity of nitric oxide synthases (NOS) was measured by using immunohistochemistry.The abilities of glucose absorption and serum NO levels were tested.Results The recipient survival timein transplant control group,L-Arg group,group Ⅰ and group Ⅱ were (11.7 ± 1.2),(10.2 ± 1.0),( 12.3 ± 1.5) and ( 17.3 ± 1.9) days respectively,and the survival in group Ⅱ was prolonged significantly (P＜0.01).As compared with control group,the Park scores in L-Arg group and group Ⅰ were reduced,and IRI were attenuated; the Park score in group Ⅱ was increased (P＜0.01),the IRI was aggravated,but the AR was attenuated.As compared with control group,during the IRI period,the iNOS staining in group Ⅰ was decreased,and both iNOS and nNOS staining in group Ⅱ was decreased; during the AR period,the iNOS staining in group Ⅱ was decreased obviously.The serum NO levels were increased gradually in all groups.As compared with control group,the increase of serum NO level in group Ⅱ was delayed.As compared with control group,the glucose absorption levels in L-Arg group were increased significantly from 30 min after reperfusion to POD-3 (P＜0.01),and the postoperative glucose absorption levels in groups Ⅰ and Ⅱ maintained the low levels.ConclusionNO may play a dual role as both cytotoxic and cytoprotective effects in IRI,and aggravate mucosal damage in AR in rats intestinal transplantation.The glucose absorptive capacity of graft is promoted by supplementation of LArg at early postoperative period.
ABSTRACT
Objective To explore the influence of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence's reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 min, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotic stoma. The hemoglobin, total protein, body weight and food-intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence's reconstuction procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.
ABSTRACT
The experiment was conducted between February 2004 and May 2006 at The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang province, China. Forty hybrid pigs were used in the experiment, 20 were used as donors and the other 20 were used as recipients. Donor operation: Abdominal aorta was lavaged in situ with 500 mL 4℃ heparinized saline (lavage pressure 7.8-9.8 kPa), intestinal canal cut from donor was conserved in 4℃ physiological saline.Recipient operation: Orthotopic small intestine transplantation and heterotopic small intestine transplantation were conducted according to exploring results, and abdominal cavity was washed with 40-45℃ physiological saline until the flush out liquid became warm.Periprocedural management: Preoperative discussion and postoperative discussion were done, and body temperature of pigs was monitoring and controlled. Early-stage feeding was used, 4 pigs could drink water freely after transplantation and took food normally at the second day, while other 16 pigs began to drink water 2 days after transplantation. Evaluation after the operation: No experimental animal had anastomotic leakage after taking food. Sixteen pigs survived over 7 days, average 9 days, the longest over 14 days. The success rate of the small intestine transplantation is 80% (16/20). Failure reasons: One with phlebothrombesis, one with blood loss and two with unknown reasons. Results showed that experience of periprocedural management had got relatively satisfactory effects through a great quantity of small intestine transplantation practices.