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Objective To analyze the difference and influential factors of clinical prognosis between liver transplantation with autoimmune liver disease (AILD) and viral hepatitis cirrhosis. Methods Clinical data of 75 recipients undergoing liver transplantation from January 2002 to January 2017 were retrospectively analyzed. All recipients were divided into the AILD group (n=25) and viral hepatitis cirrhosis group (n=50). The intraoperative conditions of the recipients were observed including warm ischemia time, cold ischemia time, operation time, anhepatic phase and blood transfusion volume. Postoperative complications were observed including severe acute kidney injury (AKI), infection, acute rejection, biliary tract-related complications, vascular-related complications and post transplantation diabetes mellitus (PTDM). The follow-up status were monitored after discharge. The prognostic factors of liver transplant recipients were analyzed. Results The warm ischemia time, cold ischemia time, operation time and anhepatic phase did not significantly differ between two groups (all P > 0.05). In the AILD group, the incidence of postoperative acute rejection was remarkably higher, whereas the incidence of postoperative severe AKI was significantly lower than those in the viral hepatitis cirrhosis group (both P < 0.05). The postoperative 1-, 3- and 5-year survival rates in the AILD group was 92%, 87%, and 87%, which did not significantly differ from 88%, 88% and 88% in the viral hepatitis cirrhosis group (all P > 0.05). Univariate analysis showed that age, model for end-stage liver disease (MELD) score, severe AKI, infection and biliary tract-related complications were the influencing factors of clinical prognosis of the recipients (all P < 0.05). Conclusions The overall survival prognosis does not significantly differ between the AILD and viral hepatitis cirrhosis groups. Age, MELD score, severe AKI, infection and biliary tract-related complications are the risk factors affecting the clinical prognosis of liver transplantation recipients.
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Objective To investigate the expression and clinical significance of ATAD2 in patients with hilar cholangiocarcinoma (HC) Methods The qRT-PCR,Western blottig and immunohistochemistry were used to detect the expression of ATAD2 in HC and normal bile duct tissues,and the relationship between ATAD2 and the clinicopathological factors,prognosis was analyzed.Results The positive expression rate of ATAD2 in HC tissues was 70％ (57/81),significantly higher than that of normal bile duct tissues 7％ (2/30) (x2 =35.678,P ＜0.01),and ATAD2 expression was associated with lymph node metastasis and TNM staging (respectively x2 =28.619,31.612,all P ＜ 0.01).The 1'-,3'-,and 5-year survival rates of ATAD2 negative HC patients were 87.5％,54.1％,and 33.3％,respectively.The 1'-,3'-,and 5-year survival rates of ATAD2 positive HC patients were 40.3％,14.0％ and 1.7％,respectively (x2 =14.162,P ＜ 0.01).Univariate analysis and multivariate COX regression model analysis showed that microvascular invasion,lymph node metastasis and ATAD2 expression were independent factors influencing the prognosis of patients with HC (respectively F =4.703,4.961,5.013,all P ＜ 0.05).Conclusion The expression of ATAD2 in HC increased,and the overexpression of ATAD2 was closely related to the occurrence,development,invasion,metastasis and poor prognosis of HC.
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Objective To analyze the relative indicators associated with warm ischemia time (WIT).Methods We established the porcine donor after cardiac death (DCD) model and monitored biochemical parameters (glucose,lactate,pyruvate,glycerol,and glutamate) changes of porcine livers at different WIT by microdialysis technique.The pathological changes were also observed during different WIT by HE staining.Results As the extension of WIT,the morphology injury of the graft aggravated:glucose and pyruvate levels slightly declined in the early stage,and then increased with WIT entension;glycerol levels increased with WIT entension;lactate levels and lactate/pyruvate ratio increased significantly after 20 min of WIT.The expression of lactate and lactate/pyruvate ratio were increased with the prolonged WIT.Pearson correlation analysis of all factors with liver ischemia time and liver pathological injury degree (P＜0.05) showed the obvious correlation between lactate,lactate/pyruvic acid ratio with liver ischemia time and liver pathological injury degree,and of positive correlation (P＜0.001,and correlation coefficients were 0.682 and 0.453 respectively).The ROC curve analysis revealed that the area under the curve was 0.950 for lactate,and 0.885 for pyruvate,respectively.When the critical value of lactic acid was 2.3736,the sensitivity was 90％ and specificity was 95％.When the critical value of lactate/pyruvate ratio was 0.0257,the sensitivity was 80％ and specificity was 83％.Conclusion The level of lactic acid and lactate/pyruvate ratio are significantly related to the WIT.These factors may be used as a predictor of donor liver warm ischemia injury.Reference range of these indicators needs further discussion based on larger sample research.
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Objective To explore the influence of abnormal donor hepatic artery on hepatic artery and biliary complications after liver transplanta?tion,and summarize the hepatic artery reconstruction procedures during transplantation. Methods The clinical data of 210 cases of liver transplan?tation conducted in our hospital from May 2005 to April 2015 were retrospectively searched for the study,including 42 with abnormal donor hepatic artery. Results Among the 210 liver transplantation,42 cases exhibited abnormal donor hepatic artery,and the aberration rate was 20.0%. Mean volume of blood flow of abnormal group and normal group was 4.7±95.1 mL/min and 190.9±101.6 mL/min,respectively. There was no statistic differ?ence(P=0.519). Twelve cases had arterial complications,the incidence rate was 5.71%,and there was no statistic difference between each group (χ2=0.72,P>0.05). Twenty five cases got biliary complications,the incidence rate was 11.9%,and there was no statistic differences between each group(χ2=0.05,P>0.05). Conclusion There was no statistic difference of mean volume of blood flow after arterial reconstruction between two groups. Liver transplantation with abnormal arterial reconstruction will not increase the incidence rate of arterial and biliary complications.
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Objective To explore whether polymorphisms in non-coding RNA has potential as biomarkers for predicting the risk of kidney transplantation rejection.Methods A total of 79 patients who had received kidney transplants were recruited from the First Affiliated Hospital of China Medical University and divided into the rejection group (n =26) and non-rejection group (n =53).Four polymorphisms in miRNA and 8 polymorphisms in lncRNA were detected by MALDI-TOF-MS.Results When compared with the wild genotype,the mutation genotype in miR-27a rs895819 and lnc-LRFN2-2 rs61516247 had 11.72 and 4.87 folds increased risk of kidney transplantation rejection (P =0.046,OR=1.04-131.74 and P =0.047,95％ CI =1.02-23.21,respectively).The other three polymorphisms in miRNA and 7 polymorphisms in lncRNA showed no significant associations with transplantation rejection risk (P ＞ 0.05).Conclusion The miR-27a rs895819 and lnc-LRFN2-2 rs61516247 polymorphisms were associated with the risk of kidney transplantation rejection.
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Objective To summarize the clinical characteristics,diagnosis and treatment of autoimmune pancreatitis(AIP).Methods The retrospective descriptive study was adopted.The clinical data of 43 patients with AIP who were admitted to the First Affiliated Hospital of China Medical University between January 2010 and December 2014 were collected.All patients underwent laboratory tests and imaging examinations.For the patients who had the definite diagnosis of AIP,corticosteroid therapy was adopted,and for the patients who had the suspicion of pancreatic cancer,surgical operation was carried out.Observed indexes included clinical manifestations,laboratory findings,imaging findings,treatment,pathological findings and follow-up status.The follow-up of imaging examinations and laboratory tests via outpatient and inpatient examinations was performed on the patients until January 2016.Measurement data with skewed distribution were presented as average (range).Results (1) Clinical manifestations:of the 43 patients,33 demonstrated obstructive jaundice,19 had loss of weight,18 had upper abdominal pain and 5 had acute mild pancreatitis (the same patient with a variety of symptoms).Extrapancreatic organ involvement was detected in 23 of the 43 patients,including focal nephritis in 15 patients,sicca syndrome in 7 patients,pulmonary involvement in 5 patients,autoimmune thyroiditis in 5patients,hilar IgG4-associated cholangitis in 3 patients,retroperitoneal fibrosis in 3 patients and ulcerative colitis in 1 patient (the same patient with a variety of diseases).(2) Results of laboratory tests:17 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 15 patients.(3) Imaging findings:all the 43patients underwent enhanced computed tomography (CT) scan of pancreas.Diffused enlargement of pancreas with appearance of sausage was observed in 34 patients and localized pancreatic head enlargement was observed in 9patients.Twenty patients had peripancreatic vascular involvement including stenosis or occlusion of splenic vein,stricture at the confluence of superior mesenteric vein,portal vein and splenic vein resulting in regional portal hypertension which led to gastric venous varices and splenomegaly.Three patients showed that superior mesenteric artery was surrounded by tissue masses with massive ascites.Five patients had pancreatic pseudocyst with splenic vein involvement and peripancreatic effusion.The abdominal CT examination of 15 patients with renal involvement showed renal cortical wedge or nodular lesions.Pulmonary inflammatory pseudotumor and interstitial pneumonia appeared in 5 patients,CT of whom showed solid pulmonary nodules or diffuse ground-glass opacities and patchy shadows in pulmonary interstitium.Thirty-two patients underwent magnetic resonance cholangiopancreatography and 28 patients underwent endoscopic retrograde cholangiopancreatography.The results showed the focal and diffuse or segmental stenosis of the main pancreatic duct were detected in 28 patients (diffuse stenosis in 23patients,local stenosis in 5 patients),stenosis of the intrapancreatic common bile duct in 32 patients,stenosis of hilar bile duct in 3 patients.Nine patients underwent endoscopic ultrasonography examination.The results showed 3 patients had hypoechoic mass in the head of pancreas and 6 patients had diffuse or heterogeneous hypoechoic of the pancreatic parenchyma.(4) Treatment status:of 43 patients,30 patients received initial steroid treatment.After steroid treatment,the clinical symptoms of 27 patients gradually improved and laboratory and imaging findings were both improved.Eleven patients didn 't receive initial steroid treatment,of whom 2 patients with obstructive jaundice underwent endoscopic biliary stent implantation,7 patients underwent surgical biliary drainage and 2 received neither endoscopic treatment nor surgical treatment.Two patients underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma and were diagnosed as AIP based on postoperative pathological results and treated with steroid after operation.(5) Pathological examination:of the 43 patients,22 underwent pathological examination.Results of pathological examination of superficial lymph nodes showed lymph follicles hyperplasia,and immunohistochemistry staining showed massive IgG4 positive plasmocytes in 5 patients,supporting the diagnosis.Results of fine needle aspiration cytology in 15 patients showed no cytological evidence were detected in 14 patients and epithelial cells of malignant tumors in 1 patient.Results of pathological examination of surgical specimens showed dense infiltration of lymphocyte and immunohistochemistry staining showed massive IgG4 positive plasmocytes.(6) Follow-up status:of 43 patients,41 were followed up for an average time of 28 months (range,12-71 months).Of the 30 patients who received steroid treatment,27 had complete response and 3 had partial response.Of the 27 with complete response,4 patients relapsed during followup and were cured by continuous steroid treatment and extending treatment course,3 patients did not relapse,1 patient relapsed again,and long-term low dose steroid maintenance therapy was needed.The 3 patients with partial response were treated with mycophenolate mofetil for 6,4,4 months and imaging abmormalities disappeaved absolutely.Eleven patients received no steroid for the initial treatment,in whom 2 patients were lost to follow-up,1 patient with common bile duct jejunum anastomosis died in 1 year after surgery.In the other 8 patients,the imaging abnormalities were spontaneous remission or clinical and imaging manifestations were improved after steroid treatment and no recurrence was found.Two patients who underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma received steroid treatment after operation and no recurrence was observed.Conclusion Clinicians should combine clinical manifestations,serological examination,imaging findings and pathological examination to make definite diagnosis of AIP and make differential diagnosis of pancreatic cancer to avoid unnecessary surgical treatment by misdiagnosis.
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Objective To modified doxorubicin liposome with transferrin(TF),and to investigate its inhibition efficacy on the proliferation of human breast cancer cells.Methods The liposome was prepared by thin film ultrasonic,and doxorubicin liposomal was prepared by sulfuric acid gradient.The TF-doxorubicin lipo-some was prepared by the post insertion method.The uptake of TF-liposomal doxorubicin on breast cancer cells MCF-7 and MDA-MB-231 were detected by confocal microscopy.The killing ability of TF-doxorubicin liposomal targeting for MCF-7 and MDA-MB-231 were detected by MTT assay.Inhibitory effect of TF-doxorubicin lipo-some on the growth of MCF-7 and MDA-MB-231 were detected by soft agar colony assay.Results Confocal microscopy result showed that the uptake of TF-liposomal doxorubicin on MCF-7 and MDA-MB-231 were signifi-cantly higher than doxorubicin liposomal.Cell-killing ability on MCF-7 and MDA-MB-231 showed that the IC50 in TF-liposomal doxorubicin [MCF-7 cells:(20.8 ±3.2)μmol/L;MDA-MB-231 cells:(20.1 ±3.0)μmol/L)] were significantly lower than the liposomal [(1 58.6 ±24.6)μmol/L;(1 60.1 ±25.1 )μmol/L)]and free doxorubicin [(1 61 .7 ±26.2)μmol/L;(1 66.9 ±27.0)μmol/L)],with significant differences(F =1 1 6.03, P <0.001 ;F =75.29,P <0.001 ).Soft agar colony assay showed that the inhibition of TF-doxorubicin lipo-some on colony growth were significantly higher than doxorubicin liposome,free doxorubicin and control [dia-meter of MDA-MB-231 cells:(60.5 ±10.4)μm,(94.3 ±16.8)μm,(1 31 .8 ±22.6)μm,(162.8 ±30.3)μm;diameter of MCF-7 cells:(31 .8 ±5.5)μm,(62.1 ±11 .1 )μm,(108.6 ±1 8.6)μm,157.4 ±29.3)μm],with significant differences (F =87.17,P <0.000 1 ;F =178.23,P <0.000 1 ).Conclusion TF-doxorubicin lipo-some has a significant inhibitory effect on the proliferation of breast cancer cells in vitro,and can effectively and specifically kill the breast cancer cells,which provides theoretical basis for the treatment of breast cancer in vivo.
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Objective To observe the clinical efficacy of Tiao Ren Tong Du (regulating the Conception Vessel and unblocking the Governor Vessel) needling method plus bloodletting at the Jing-well points in treating post-stroke spastic state. Method Sixty-seven eligible patients were randomized into a group to receive Tiao Ren Tong Du needling plus bloodletting at the Jing-well points (treatment group) and a rehabilitation group (control group). For the two groups, the treatment was given once a day, 6 times as a treatment course, for 4 courses in total. The Modified Ashworth Scale was used to evaluate the spasticity intensity, and the Patient Reported Outcome (PRO) for post-stroke spastic hemiplegia was used to measure the patients from the following four aspects:subjective symptoms, objective symptoms, mental state, and social function. Result After intervention, the scores of spasticity, and physiological, mental, social, and environmental factors were significantly improved in both groups (P<0.01,P<0.05). Compared to rehabilitation, Tiao Ren Tong Du needling plus bloodletting at Jing-well points can more significantly release the muscular spasticity and reduce the PRO score (P<0.01). The recovery plus markedly-effective rate was 70.6% in the treatment group versus 42.4% in the control group. Conclusion Tiao Ren Tong Du needling plus bloodletting at Jing-well points can effectively improve post-stroke spastic state and the quality of life.
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Objective:To observe the spleen-strengthening and mind-regulating acupuncture method on the quality of life of children with cerebral palsy (CP) and their parents. Methods:A total of 76 CP children were randomly allocated into a treatment group (n=38) and a control group (n=38) according to their visit sequence. The CP children and their parents in both groups received the same psychological counselling. The CP children in the treatment group were intervened with spleen-strengthening and mind-regulating acupuncture method, versus routine acupuncture method in the control group. The parents of CP children in the treatment group were intervened with three mind-regulating points, versus placebo in the control group. The developmental quotients were evaluated using the Gesell scale before and after treatment. The anxieties of parents were assessed using the self-rating anxiety scale (SAS) before and after treatment. The efficacies were evaluated using the comprehensive functional assessment of CP children. Results:After 6 months of treatment, the Gesell scores of CP children and SAS scores of the parents were significantly improved in both groups, and there were intra-group and inter-group statistical differences (bothP Conclusion:The spleen-strengthening and mind-regulating acupuncture method can effectively improve the comprehensive ability of CP children, alleviate the anxiety in parents of CP children, improve the quality of life of CP children and their parents, and play an active role in rehabilitative care of CP children.
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Objective To observe the clinical efficacy of acupuncture plus moxibustion at Baihui (GV 20) in treating post-stroke insomnia.Method Sixty-five patients with post-stroke insomnia were randomized into a treatment group of 33 cases and a control group of 32 cases. The treatment group was intervened by acupuncture plus moxibustion at Baihui (GV 20), while the control group was by conventional acupuncture. The SPIEGEL scale and Stroke-specific Quality of Life (SS-QOL) were evaluated before and after intervention, and the clinical efficacies were compared between the two groups.Result The SPIEGEL and SS-QOL scores were significantly changed after intervention in both groups (P<0.05). After intervention, the SPIEGEL and SS-QOL scores of the treatment group were significantly different from that of the control group (P<0.05). The total effective rate was 93.9% in the treatment group, versus 68.8% in the control group, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus moxibustion at Baihui (GV 20) is an effective method in treating post-stroke insomnia.
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Objective To compare the effect of mechanical perfusion and simple cold preservation on donation after cardiac death (DCD)pancreas in pigs.Methods Ten healthy pigs were randomized into simple cold preservation group and the mechanical perfusion group (5 pigs in each group ).DCD model was established in pigs.The pancreas was cut and stored in University of Wisconsin solution (UW solution).The pancreas of the simple cold preservation group was preserved with simple UW solution and that of the mechanical perfusion group was preserved by mechanical perfusion.Specimen was collected from pancreatic tail at 1,2,3,4,6 and 24 h to prepare tissue section.Then,the tissue section was stained with hematoxylin-eosin (HE).Histopathological examination was conducted and pathological score of the two groups was compared.Results Microthrombus in DCD pancreas of pig was removed at 180 min of mechanical perfusion and injury to pancreas islet caused by excessive perfusion was avoided.The pathological score of the mechanical perfusion group was (4.2 ±0.8)and that of the simple cold preservation group was (8.4 ±1.1),and the difference had statistical significance (P <0.05).Conclusions Mechanical perfusion may effectively remove thrombus in pancreatic vessels.Compared with simple cold preservation,mechanical perfusion may maintain the integrity of pancreas islet better after the preservation of the same period of time.
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Objective To investigate the function of melatonin (MEL)on liver transplantation by detecting the effect of MEL on glucose regulated protein-78 (GRP-78)and CCAAT enhancer-binding protein homologous protein (CHOP)involved in the endoplasmic reticulum stress (ERS)pathways in livers of rats with liver transplantation.Methods The rat orthotopic liver transplantation model was established by using‘magnetic-loop method’.Male SD rats were randomized into 3 groups:the sham operation group (Sham group),the orthotopic liver transplantation group (OLT group)and the orthotopic liver transplantation +MEL treatment group (OLT +MEL group),8 rats in each group.Serum sample and liver sample were collected at 24 h after operation.Serum alanine aminotransferase (ALT)and aspartate aminotransferase (AST)levels were detected.Liver tissues were stained with hematoxylin-eosin (HE)and pathological changes of liver tissues of each group were observed.The messenger ribonucleic acid (mRNA)and protein expression levels of GRP-78 and CHOP were detected by polymerase chain reaction and Western blot.Results Compared with the Sham group,the serum ALT and AST of the OLT group increased significantly (both in P <0.01 ),liver tissues injury was serious,and mRNA and protein expression levels of GRP-78 and CHOP increased significantly (all in P <0.01).Compared with the OLT group,ALT and AST of the OLT +MEL group decreased significantly (both in P <0.05),liver tissues injury was alleviated,and mRNA and protein expression levels of GRP-78 and CHOP decreased significantly (all in P <0.05 ).Conclusions MEL may reduce mRNA and protein expression levels of GRP-78 and CHOP involved in the ERS pathways of transplant liver,which may be one of its mechanisms to alleviate liver injury after liver transplantation.
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Objective To investigate the clinical efficacy of Jin’s Three Needles plus twelve Jing-Well points in treating post-stroke shoulder-hand syndrome. Methods Sixty patients meeting the inclusion criteria of post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture with Jin’s Three Needles plus twelve Jing-Well points and the control group, conventional acupuncture. The Clinical Neurological Disfunction Scale (CNDS) score, the Fugl-Meyer Assessment (FMA) score, the Visual Analogue Scale (VAS) score and the Functiional Comprehensive Assessment (FCA) score were observed in the two groups before and after two weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the CNDS, FMA, VAS and FCA scores in the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 96.7%and 55.7%in the combination group, respectively, in the treatment group and 83.3%and 26.7%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Acupuncture with Jin’s Three Needles plus twelve Jing-Well points is an effective way to treat post-stroke shoulder-hand syndrome.
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Objective To observe the influence of warm ischemia time on acquisition of rat pancreatic islets and islet function.Method Male Wistar rats were used.After heart beats stopped,the pancreases in four groups of rats were harvested,and warm ischemia time was 0,15,30 and 45 min separately.The pancrease was preserved in UW at 4℃C for 8 h,and subjected to injection of collagenase solutions.After islets were acquired,the purity,survival rate and islet activity were tested,and statistical analysis was performed.Result The number of islets obtained in 0 min group,15 min group,30 min group and 45 min group was (433 ± 41),(396 ± 38),(350 ± 31) and (66 ± 17)IEQ/one,islet viability was 94％,88％,77％ and 25％,and purity was 88％,78％,60％ and 32％,and insulin release index was 2.38 ± 0.23,2.25 ± 0.18,2.19-± 0.18 and 1.25 ± 0.12,respectively.There was no significant difference in islet number,purity,survival rate and activity 15 min group and 30 min group between 15 min group or 30 min group and 0 min group (P＞0.05).There was significant difference between 45 min group and 0 min group in islet number,purity,survival rate and activity (P＜0.05).The survival rate and purity in 45 min group were lower than the clinical standards for islet transplantation (survival rate ＞ 75％,and purity ＞ 50％).Conclusion Warm ischemia time of 15 min in non-heart-beating brain death(NHBD) rats had no effect on islet isolation and purification.Warm ischemia time within 30 min showed no significant influence on islets of NHBD rats,which can be used in islet transplantation.Warm ischemia time at 45 min showed significant influence on islets of NHBD rats,which can't be used in islet transplantation.
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Objective:To observe the clinical effect of regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina for cerebral infarction. Methods:A total of 61 eligible cases with cerebral infarction were treated with regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina, once a day, 12 d for a course. There was a 3-day interval between two courses. These cases were treated for 3 courses. Before treatment, the infarction severity was graded using neurological deficit score. The score changes and correlation between infarction severity and therapeutic efficacy were evaluated after 1, 2 and 3 courses of treatment. Results:Before treatment, the neurological deficit score was (18.65±3.28), versus (13.63±3.91), (9.53±3.22) and (5.57±3.97) respectively after 1, 2 and 3 courses of treatment. When the third course was completed, 4 cases obtained almost full recovery, 33 cases obtained marked effect, 18 cases obtained improvement and 6 cases had no effect. The total effective rate was 90.2%. Conclusion:Regulating Conception Vessel and unblocking Governor Vessel by acupuncture combined with tuina can substantially improve limb function in patients with hemiplegia due to cerebral infarction.
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BACKGROUND:The use of donor rat of cardiac death inevitably experiences warm ischemia injury, so the length of warm ischemia time plays a significant role on the number and function of pancreatic islet obtained. OBJECTIVE:To investigate the effect of Exendin-4 on pancreatic islet function of donor rats with cardiac death at different heat ischemia time. METHODS:Islet cells from Wistar rats were cultured in vitro and randomly divided into three groups according to the experimental conditions:0, 30, 45 min heat ischemia groups. Each group was further assigned into two subgroups, control group was cultured for 24 hours while experimental group wad cultured with 10 nmol/L Exendin-4 for 24 hours. The number of isolated pancreatic islets was calculated with diphenylthiocarbazone staining, and the purity of the extracted islets was adjusted. The viability of the islets was examined by AO/EB staining, and insulin secretion index assay was used to detect the function of the islets. RESULTS AND CONCLUSION:With the time of heat ischemia increasing, the number, purity, viability and function of islet cells obtained were decreased. After the cells in heat ischemia 0, 30, 45 min groups were cultured with 10 nmol/L Exendin-4 for 24 hours, the number, purity and viability of isolated and purified islets were increased compared to the group without added Exendin-4. There was significant difference between experimental group and control group in 30-minute and 45-minute ischemia groups (P<0.05). Exendin-4 can protect pancreatic islet cells in donor rats with cardiac death at different heat ischemia times, reduce the apoptosis, and improve islet survival and functions. The use of Exendin-4 can be an effective pretreatment method at early ischemia phase of islet transplantation.
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BACKGROUND:How to control functional activity of donor liver after cardiac death and maintain the optimal function of grafts are the key issues in organ transplantation study. OBJECTIVE:To preliminarily explore the effect of warm ischemia injury on the morphology and function of rat donor liver after cardiac death. METHODS:Cardiac death model was established in Sprague-Dawley rats and the successful models were divided into six groups:control group (warm ischemia for 0 minute), warm ischemia 10 group (warm ischemia for 10 minutes), warm ischemia 20 group (warm ischemia for 20 minutes), warm ischemia 30 group (warm ischemia for 30 minutes), warm ischemia 40 group (warm ischemia for 40 minutes) and warm ischemia 50 group (warm ischemia for 50 minutes). The rat liver specimens in each group were cut into ultrathin sections. The structure of liver cells was observed and photographed by electron microscopy. Flameng score was applied to analyze the degree of mitochondrial damage. Liver mitochondria were extracted and then spectrophotometry was used to assess the viability of cytochrome C oxidase. RESULTS AND CONCLUSION:Under electron microscopy, there were no significant changes in liver cells within 30 minutes of warm ischemia, nuclear membrane was intact, mitochondria mildly swel ed, no mitochondrial crista ruptured, and Flameng score was<2 points. With the extension of warm ischemia time, the cells became swel ing, nuclear chromatin condensated, apoptotic body was clearly visible, mitochondrial matrix coagulated, mitochondria exhibited vacuolation, and Flameng score was 3-4 points. The viability of cytochrome C oxidase showed no significant difference within 30 minutes of warm ischemia, but began to significantly decrease at 40 and 50 minutes. The mitochondrial structure and function after liver injury is not obviously affected by 30 minutes of warm ischemia, and significant changes appear after 40 minutes.
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Objective To compare the early renal function recovery after kidney transplant from donation after cardiac death (DCD) and brain death (DBD).Methods The Medline (1950-2011),Embase and Cochrane library database were searched and supplemented by review of conference proceedings and publication bibliographies.All original single institution studies reporting outcomes for DCD and DBD kidney transplant recipients were considered.Odds ratios (OR) and 95％ confidence intervals (CI) based on random effects models were calculated.Results Nine publications,all cohort studies,involving 2049 DCD and 5498 DBD recipients,were included.DCD recipients had 7.24 times increased odds of DGF (OR=7.24,95％ CI =3.86-13.58),and 4.97 times increased odds of PNF (95％ CI =3.77-6.55).Conclusion DCD renal transplantation is associated with higher risks of DGF and PNF.
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Objective To isolate,purify and identify pancreatic duct derived stem cells (PDSCs) from the pancreatic duct of rats,and culture in the three-dimension cell culture system.Methods Adult male Wistar rats underwent perfusion with collagenase V via the pancreatic duct,then the pancreas was surgically procured,digested,followed by discontinued density gradient centrifuge to isolate ductal tissue from islets.The acinar and ductal tissue was cultivated in serumcontaining medium in the three-dimension cell culture to obtain adherent cells,as PDSCs,which were expanded by consecutive passages.The morphology and characterization of PDSCs on phenotype were examined.Results PDSCs could be obtained through in situ collagenase V digestion,discontinued density gradient centrifuge,and culture in the three dimension cell culture system.Morphologically,PDSCs had remarkable size,most with one nucleus.PDSCs grew in many layers in three-dimension cell culture system.PDSCs was revealed to express CD29,CD73,CD90,CD105,but not CD14,CD19,CD34,CD45 by FACS,in agreement with MSCs.Conclusion PDSCs of rats could be obtained through in situ collagenase V digestion,discontinued density gradient centrifuge,and culture in the three-dimension cell culture system.PDSCs lines were successfully established.
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Cerebral ischemia is one of the most common diseases treated by acupuncture therapeutics. Recent studies indicated that acupuncture treatment by needling the conception and governor vessels had positive effects in promoting neural regeneration in patients after cerebral ischemia injury. Acupuncture intervention could continuously promote the proliferation and differentiation of the neural stem cells in the brain, obviously up-regulate expression of growth factors, accelerate angiogenesis and inhibit apoptosis. Hence, it is necessary to present an exhaustive review on the mechanisms. The present review gives a detailed description of pathological changes of cerebral ischemia and acupuncture intervention applied to the conception and governor vessels, and proposes research prospects in the future.