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Objective:To evaluate the effect of portal vein restriction combined with hepatic artery ligation on Sprague Dawley(SD) rats liver regeneration and injury.Methods:Twenty-four healthy and clean SD male rats, 250-280 g, 7-8 weeks old, were randomly divided into portal vein ligation (PVL) group, mild restriction group and moderate restriction group with 8 rats in each group. In PVL group, the right, caudal and left branches of portal vein were ligated, and only the right branches of portal vein were preserved. The operation of mild and moderate restriction group was the same as PVL, however, the left branch of the portal vein was slightly and moderately restricted, and the left branch of the hepatic artery was ligated at the same time. At 72 hours after the operation, the left middle lobe was stained with hematoxylin-eosin and the total necrosis score was calculated. The right middle lobe was immunostained for Ki-67 and the number of positive cells was counted. The liver regeneration rate of the right middle lobe was calculated and the serum liver function indexes were measured.Results:The hepatic regeneration rate of right middle lobe in PVL group was (109.1±10.9)%, while that in moderate restriction group was (105.0±12.3)%, which was significantly higher than that in the mild restriction group (67.1±6.4)%, the differences were statistically significant ( P<0.05). The Ki-67 result was also higher in the PVL group than the mild restriction group. The total necrosis score was 4.50(3.25, 6.00) in moderate restriction group, 2.00(1.25, 3.00) in PVL group and 0(0, 0.75) in mild restriction group. The three groups showed a decreasing trend and the differences were statistically significant ( P<0.05). Alanine aminotransferase in mild restriction group was (48.4±11.4) U/L, was significantly lower than that in PVL group (67.2±12.2) U/L and moderate restriction group (74.3±14.2) U/L, the difference was statistically significant ( P<0.05). There were no significant differences in serum levels of aspartate aminotransferase, albumin and total bilirubin among the three groups ( P>0.05). Conclusion:Appropriate portal vein restriction combined with hepatic artery ligation can effectively induce the regeneration of liver tissue on the reserved lobe and control the damage of liver tissue on the occluded lobe.
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Objective To evaluate the value of intermittent splenic artery occlusion in the treatment of iatrogenic splenic injury and the cause of ischemia reperfusion injury.Methods Experimental animals using dogs were divided into experimental group and control group according to whether the splenic artery was blocked.The animal model of iatrogenic splenic injury was established by general anesthesia.Experimental group was treated with intermittent splenic artery blockage combined with gelatin sponge oppression of the wound to stop bleeding.The first time of splenic artery occlusion was 15 min and continued for 10 min and for another 5 rmin if still bleeding.Then hemostatic effect after removing blocking and oppression was observed.Control group was only treated with gelatin sponge compression to stop bleeding.Blood samples and tissue samples were collected before blocking and after reperfusion for 2 hours in experimental group,and before compression and relieving the compression for 2 hours in control group.IL-1 (interleukin),SOD (superoxide disproportionation enzyme),MPO (myeloperoxidase),MDA (malondialdehyde) and caspase-3 (aspartame acid cysteine protease) were detected.Results The control group still had bleeding,while the experimental group had successfully stopped bleeding.Serum markers before and after occlusion in the experinental group were IL-1 (124.4 ± 106.8 vs.121.2 ± 105.1),SOD (4.7 ± 2.7 vs.5.2 ± 1.8) and MDA (8.8 ±6.5 vs10.8 ±7.5).There were no significant differences on serum markers in two groups after occlusion/oppression including IL-1 (121.2 ± 105.1 vs.162.8 ± 73.8),SOD (5.2 ± 1.8 vs.4.7 ± 2.8) and MDA (10.8 ±7.5 vs.9.6 ±6.6) (P＞0.05).Histological indicators before and after occlusion in the experimental group included MPO (0.62 ±0.23 vs.0.68 ±0.21) and Caspase-3 (0.90 ±0.29 vs.0.86 ± 0.26),and there was no statistical difference on MPO (0.68 ±0.21 vs.0.86 ±0.23 after two sets of experiments) and Caspase-3 level (0.86 ± 0.26 vs.1.21 ± 0.18) (P ＞ 0.05) in two groups after occlusion/ oppression.Conclusion The therapeutic effect of intermittent splenic artery occlusion combined with gelatin sponge compression hemostasis is safe and effective and without obvious ischemia reperfusion injury.
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Objective:To investigate the effect of early enteral nutrition combined with Bacillus in the treatment of patients with digestive tract perforation.Methods:59 patients with emergency digestive tract perforation were randomly divided into experimental group (EN plus Bacillus,n =31) and control group (TPN,n =28).The patients in the experimental group were given enteral nutrition plus Bacillus after first days (＜ 24 h),and the control group was treated with parenteral nutrition support on the first day after surgery.The average hospitalization time,length of ICU stay,incidence of complications,and serum C-reactive protein in the two groups were analyzed.Results:The average length of hospitalization time,ICU stay,recovery of bowel function and eating time were significantly shorter in the experimental group than in the control group(P ＜ 0.05).There was no significant difference in nutrition index between the two groups during the perioperative period (P ＞ 0.05).The C-reactive protein in the experimental group was significantly lower than that in the control group fourth days after operation (P ＜ 0.05).The incidence of postoperative wound infection in the experimental group was significantly lower than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of other complications.Conclusion:Early administration of enteral nutrition combined with Bacillus can significantly shorten the intestinal function recovery time,decreasethe average hospitalization days,reduce the postoperative wound infection rate and thus improve the outcome of patients with digestive tract perforation.
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Objective To assess the effect of continuous low-dose infusion of adenosine on hepatic arterial flow (HAF) of patients with liver graft during surgery.Methods From Jan 2009 to Aug 2009,44 patients underwent orthotopic liver transplantation (OLT).10 patients were enrolled to receive adenosine treatment and 34 patients served as controls.Following arterial reperfusion,a 16G central venous catheter was placed into the gastroduodenal artery and adenosine was continuously infused at doses ranging from 0.7 to 4.2 μg · kg-1 · min-1 for 30 min.HAF and portal vein flow (PVF) were measured using a real-time time flow meter prior to,during and 10 min after adenosine infusion.Data on gender,age,postoperative hospital stay,ICU stay,hepatic biochemical indicators and 1-year survival rate were compared between the two groups.Results Adenosine significantly increased HAF at doses from 1.4 to 2.8 μg · kg-1 · min-1 Doses ＞2.8 μg · kg-1 · min-1 did not further increase HAF.HAF increased by 150.3％ ± 161.2％ (P ＜0.05) while PVF showed no significant changes (P ＞ 0.05) during adenosine infusion.No significant differences were found on MAP [(85.6 ± 13.0) vs 84.0 ± 13.6,P ＞0.05] and HR [(74.5 ± 10.0) vs (74.1 ± 9.6),P ＞ 0.05] before and after adenosine infusion.In addition,there were no significant differences between the adenosine group and the control group on patients' gender,age,postoperative hospital stay,ICU stay,hepatic biochemical indicators and 1-year survival rate.Conclusion This pilot study concluded that adenosine administration directly into the HA significantly increased HAF of liver grafts without systemic side effects.