Validation of Donor-Specific Tolerance of Intestinal Transplant by a Secondary Heart Transplantation Model.

OBJECTIVES: It is well accepted that survival after a second organ transplant without immunosuppressive agents indicates tolerance for the first transplant. To validate donor-specific tolerance, we established a rat model with a secondary heart transplant after intestinal transplant, which has so far not been described in the literature. MATERIALS AND METHODS: We transplanted intestine from Fischer F344 rats to Lewis rats orthotopically. Lewis rats received tacrolimus pretreatment before transplant and a 14-day course of rapamycin 1 month after transplant. At 120 days after primary intestinal transplant, hearts from 6 F344 rats (group A) or 6 Brown Norway rats (group B) were transplanted to Lewis rats that had survived intestinal transplant and without additional immunosuppressive agents. We analyzed survival data, histologic changes, cells positive for the ED1 macrophage marker in transplanted hearts, and 3 lymphocyte levels in both groups. RESULTS: Thirty days after secondary heart transplant, group A hearts were continuously beating; however, group B hearts stopped beating at around 10 days after transplant (8.5 ± 1.5 d; P < .05). Our histologic study showed that both groups had muscle damage and cellular infiltration in hearts that were distinctly different from normal hearts, with ED1-positive cells counted in both groups (85 ± 16 in group A, 116 ± 28 in group B; P > .05). Fluorescence-activated cell sorting showed that CD4/CD25-positive regulatory T cell, CTLA4/CD4/CD25-positive regulatory T cell, and Natural killer T-cell levels were significantly higher level in group A versus B (P < .05). CONCLUSIONS: The donor-specific tolerance that we observed was possibly a state of "clinical tolerance" rather than "immunologic tolerance." Our rat model is a feasible and reliable model to study donor-specific tolerance. The higher levels of lymphocytic T cells shown in intestinal transplant recipients were associated with longer allograft survival, possibly contributing to donor-specific tolerance.

The role of echocardiography in diagnosis and management of double aortic arch / 中华超声影像学杂志

Objective To evaluate the role of echocardiography in diagnosis and post-operative evaluation of infants and children with double aortic arch. Methods Echocardiography was performed in 6 patients with double aortic arch from January 2006 to June 2008. The outcome of postoperative follow-up was also evaluated. Results Six patients ranged in age from 3 months to 4 years and averaged 18 months. There were 2 boys and 4 girls. Echocardiography diagnosed double aortic arch in 4 patients, one balanced arch and 3 right arch dominant, and was confirmed by surgical observation in each patient. The size of the two arches were almost same in balanced arch,and the diameter of right arch was bigger than that of left arch in right arch dominant. Echocardiography failed to diagnose in 2 patients with balanced arch. Three patients had associated heart defect, such as patent ductus arteriosus and ventricular septal defect. Five of the 6 patients underwent surgical division of the left arch in order to relieve esophageal and tracheal compression. At about 2 years postoperative follow-up,echocardiography can clearly show the flow of aortic arch and it's branches. Conclusions It is an important clue to double aortic arch if only two branches of aortic arch was shown on supersternal view by echocardiography. As a non-invasive techniqe, echocardiography is useful for diagnosing and post-operative evaluating of patients with double aortic arch.

The Clinical Observation on Treatment of Stable Cardiac Angina Pectoris due to Qi-deficiency and Blood-stasis with Yiqi Huoxue Jiedu Decoction / 国际中医中药杂志

Objective To investigate the effects of Yiqi Huoxue Jiedu Decoction on Syndrome,hemorheology and homocysteine(Hcy)of patients with stable cardiac angina pectoris due to qi-deficiency and blood-stasis.Methods 98 patients with stable angina pectoris due to qi-deficiency and blood-stasis are randomly divided into a treatment group and a control groups.Conventional treatments as inhaling oxygen,dilating coronary artery,and resisting coagulation were used for the both group.Besides conventional treatments.Yiqi Huoxue Jiedu Decoction was additionally given to the treatment group.Observe the changes of Syndrome,hcmorheology and homocysteine.Results The improvement of Syndrome,hemorheology and homocysteine in the treatment group was significantly better than the Control group(P＜0.01 or P＜0.05).Conclusion The curative effect of treating stable a.gina pectoris due to qi-deficiency and blood-stasis with conventional treatments together with Yiqi Huoxue Jiedu Decoction is better than conventional western medical treatment.