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30 April 2010, Volume 14 Issue 18 Previous Issue    Next Issue

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Immune effect of thymus induction on rat liver transplantation Zhang Yan, Chen Xi-hai, Ji Yan-chao, Zhai Zhe, Wu Bo 2010, 14 (18):  3231-3234.  doi: 10.3969/j.issn.1673-8225.2010.18.001 Abstract ( 228 )   PDF (867KB) ( 383 )   Save BACKGROUND: During xenogenic liver transplantation, major histocompatibility antigen can induce immunological rejection, and immunosuppressant can cause adverse effect on organism. Recently, treatment prior to transplantation induces immune tolerance, which is perspective for organ transplantation. OBJECTIVE: To investigate the correlation between thymus induction and immunological rejection during liver transplantation. METHODS: A total of 40 male SD rats of clean grade were selected as donors. Moreover, 30 male Wistar rats of clean grade and 10 male SD rats of clean grade were selected as recipients. The donor rats were divided into allogeneic gene transplantation, allotransplantation, cyclosporine, and thymus induction groups, with 10 rats in each group. The modified Kamada and improved two-cuff technique was used to establish a stable rat orthotopic liver transplantation model. The cyclosporine group was given cyclosporine (50 mg/kg) for 5 successive days. Thymus induction group was injected with major histocompatibility antigens (50 µL) for 5 successive days. Other groups were not given any interventions. Survival time of rats was recorded in each group. Pathological observation and mixed lymphocyte cultured were performed at days 3, 7, 14, 21, and 28 after transplantation. RESULTS AND CONCLUSION: Survival time was longer in the thymus induced group compared with other groups (> 60 days), damaged level was mild, local immunological rejection was reduced, and lymphocytes were decreased. The effect after liver transplantation was similar to allogeneic gene transplantation but superior to cyclosporine intervention (P < 0.05). This suggested that thymus induction relieved immunological rejection following liver transplantation. Related Articles | Metrics

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Cryopreservation of rat liver in self-prepared PV solution: Compared with UW solution Luo Gang, Luo Di-lai, Li Xiao-zheng, Zhang Rong-chuan, Zhu Dong-liang 2010, 14 (18):  3235-3238.  doi: 10.3969/j.issn.1673-8225.2010.18.002 Abstract ( 361 )   PDF (834KB) ( 339 )   Save BACKGROUND: At present, many scholars make improvements to the UW solution composition, aiming to further explore the principle of organ preservation, improve preservation techniques and to extend the preservation time limit; simplified composition of UW solution can further meet the clinical transport, storage and ease of use; suitable alternatives should be found to reduce the cost of UW solution to satisfy the needs of the market. OBJECTIVE: To discuss the effectiveness of self-prepared PV solution for preserving rat’s liver at a lower temperature, and to compare the results with UW solution. METHODS: A total of 90 Wistar rats were randomly divided into three groups: UW group, PV group and normal saline (NS) group. Rats in each group were prepared for non-circulated isolated perfused rat liver models, and preserved for 0, 6, 12, 18, and 24 hours respectively, with 6 animals in each subgroup. The changes of hepatic enzymology (alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase) in corresponding time period, amount of metabolic production of oxyradicals from perfusion effluent liquid, and the bile secretion and changes in hepatic morphology under the microscope were observed. RESULTS AND CONCLUSION: Amounts of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase and superoxide dismutase in perfusion effluent liquid were close between the PV group and UW group, and the difference was not significant (P > 0.05). After 6 hours of preservation, tumor necrosis factor α titre in the PV fluid group was greater than that in the UW group (P < 0.05); after 12 hours of preservation, amount of malonaldehyde in the UW group was evidently increased than that in the PV group (P < 0.05); after 18 hours of preservation, bile secretion in the PV group was lower than that in the UW group (P < 0.05); morphological changes of hepatic cells were similar in the two groups under the optical and electron microscope. The results demonstrated that PV solution and UW solution have a similar effect on protecting Wistar rat’s liver function, and PV solution is superior to UW solution in antioxidation and scavenging oxygen free radicals. Related Articles | Metrics

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Protective effect of reduced glutathione Atomolan on donor liver injury Zhang Bin, Wang Xuan, Li Zeng-cai, Lu Lei 2010, 14 (18):  3239-3242.  doi: 10.3969/j.issn.1673-8225.2010.18.003 Abstract ( 364 )   PDF (1199KB) ( 419 )   Save BACKGROUND: It is an important subject that how to relieve liver injury during perfusion preservation, and the pretreatment for donated liver is considered to be an effective method in this process, however, most studies are limited in animal experiment. Atomolan is a kind of reduced glutathione, which possess bidirection regulation of metabolism and detoxication.  OBJECTIVE: To study the protective effect of reduced glutathione Atomolan on donor liver injury. METHODS: Totally 80 patients received liver transplantation in the Liver Transplantation Center, 81 Hospital of Chinese PLA, from May 2003 to August 2006, were divided into the control (n = 42), and Atomolan (n = 38) groups. The perfusion preservation conditions were similar, except 2.4 g glutathione was added into solutions in later group. Adenosine triphosphate (ATP) and malonaldehyde levels in liver tissues were measured, meanwhile, the liver tissues were observed under a light microscope and an electron microscope. Recipient plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin concentrations were assessed at 1 day post-operation.   RESULTS AND CONCLUSION: Compared with the control group, the liver ATP level of the Atomolan group was markedly increased (P < 0.01), MDA was decreased (P < 0.01), and the concentrations of ALT, AST, as well as total bilirubin were notably decreased (P < 0.01). Under a light microscope, it showed that the degrees of liver swelling histopathologic hepatic alterations were significantly lessened in the Atomolan group. While under an electron microscope, the structure of liver cells of the Atomolan group was clearer and included a higher number of mitochondria (P < 0.01). Results suggested that reduced glutathione has protective effect on donor liver injury during the procedure of hot and cold ischemia and perfusion. Related Articles | Metrics

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Isogeneic bone marrow mesenchymal stem cells transfusion combined donor spleen tissue transplantation induces allograft tolerance in liver transplant rats Wang Qian, Li Li, Li Xiao-yan, Chen Gang 2010, 14 (18):  3243-3246.  doi: 10.3969/j.issn.1673-8225.2010.18.004 Abstract ( 229 )   PDF (744KB) ( 365 )   Save BACKGROUND: Studies have shown that isogeneic splenocyte transplantation can induce immune tolerance and prolong liver graft survival under the effect of immunosuppressant. It is reported that bone marrow mesenchymal stem cells (BMSC) transplantation can also prolong the liver graft survival. OBJECTIVE: To observe the antirejection effect on liver grafts by simultaneous transplantation of isogeneic BMSC and spleen tissue in liver transplant rats. METHODS: Recipient Lewis rats were randomly divided into 4 groups: in acute rejection group, DA rats as the donor and Lewis rats as the recipients for liver transplantation; in cyclosporine A (CsA) group: recipients received CsA after liver transplantation. In the BMSC group, recipient Lewis rats received simultaneous BMSC transfusion and liver transplantation. In the spleen tissue group, the recipient Lewis rats received DA rat liver, spleen tissue and isogeneic BMSC transplantation. The serum cytokine levels were determined, and liver pathological changes and survival were observed postoperatively. The level of chimerism in the spleen of Lewis rats were also observed. RESULTS AND CONCLUSION: The blood levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin interleukin-2 (IL-2) and interferon gamma of spleen tissue group were significantly reduced compared with the other groups (P < 0.05), but IL-6 and IL-10 were increased (P < 0.05), and donor positive cells were increased at 30 days (P < 0.05). Liver pathology revealed a mild acute rejection in liver graft of CsA and BMSC groups, severe acute rejection in acute rejection group, but no rejection in spleen tissue transplantation group. Results indicate that isogeneic BMSCs transfusion combined donor spleen tissue transplantation can induce allograft tolerance in liver transplant rats. Related Articles | Metrics

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Protective effect of hyperoxic fluid on rat liver transplantation Liang Zhong-ping, Lao Xue-jun, He Wen-fang, Ding Hong-wen, Su Ze-xuan 2010, 14 (18):  3247-3251.  doi: 10.3969/j.issn.1673-8225.2010.18.005 Abstract ( 339 )   PDF (884KB) ( 393 )   Save BACKGROUND: Organ for transplantation is insufficient, and primary transplant of nonfunction caused by perfusion cryopreservation occasionally occurs. It is clinically significant to reduce organ damage caused by perfusion preservation. OBJECTIVE: To explore the protective effect of hyperoxic perfusion fluid on liver transplantation in rats. METHODS: A total of 40 Wistar rats were randomly divided two groups (n = 20) and respectively poured with Ringer lactate solution or hyperoxic ringer lactate solution. Each group comprised equal number of donors and recipients to prepare liver, kidney, and pancreas transplantation models. Hyaluronic acid (HA), alanine aminotransferase (ALT) and CD8+CD28- T cells were compared between two groups at the end of perfusion, and 1st and 3rd days after liver transplantation. The acute rejection score of liver tissues were also compared after operation. RESULTS AND CONCLUSION: The HA, ALT and CD8+CD28-T cells were no significantly different between two groups before operation (P > 0.05). The HA and ALT of hyperoxic ringer lactate solution group was significantly Ringer lactate solution group after liver transplant (P < 0.05), but the CD8+CD28- T cells were greater (P < 0.05). The acute rejection scores for liver in hyperoxia liquid group were significantly less than the common liquid group (P < 0.05). Results show that hyperoxic solution can attenuate ischemia/reperfusion injury and protect rats undergoing liver transplantation. Related Articles | Metrics

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Modified model of reduced-size liver transplantation in rats Liu Jing, Li Jiang, Zhang Sheng-ning, Li Zhu, Li Lai-bang, Ran Jiang-hua1, Li Li 2010, 14 (18):  3252-3257.  doi: 10.3969/j.issn.1673-8225.2010.18.006 Abstract ( 319 )   PDF (1068KB) ( 481 )   Save BACKGROUND: There are few studies on liver regeneration following living liver transplantation. Improvement of operation methods and techniques and successful rate are the basis for rat liver transplantation study and data acquisition.  OBJECTIVE: To investigate the efficacy of improved model of reduced-size liver transplantation in the rat.  METHODS: Healthy SD rats were selected. 70 pairs of rats were subjected to reduced-size liver transplantation before modification, and 100 pairs subjected to reduced-size liver transplantation after modification. The donors were female and the recipients were male, and the body mass of donors was 10 g less than the recipients. Operation of donor was performed by only one person with the naked eye, and reduced-size donor liver was performed in the donor operation. The handle of self-made cannula was placed in the front of portal vein and inferior vena cava, respectively, and the tied ligature of pyloric veins was turned inside out of the self-made cannula. Furthermore, the tied ligature was placed in the left of the self-made cannula; the same to inferior vena cava except that the tied ligature of right renal vein was placed in the right of the self-made cannula; the portal vein and inferior vena cava were washed with self-made perfusate respectively. Operation of the receptor was performed by two persons with the naked eye, with improved dual-cuff technique of Kamada and stay pipe of biliary tract, the fixed points of left and right were connected by anastomosis of “8” type with turning inside out while inosculating inferior vena cava.   RESULTS AND CONCLUSION: The average modified operation time of the donor and the donor liver preparation time was (32±2) minutes and (6±2) minutes, respectively. The average operation time of the recipient and the anhepatic time was (40±3) minutes and (14±3) minutes, respectively. The general successful rate was 92%; three-day survival rate was 85% and two-week survival rate was 83%. The postoperative complications reduced significantly (P < 0.05), and cold conservation time of donor was shortened (P < 0.05). The modified model of reduced-size liver transplantation was more safe and reliable, with high success rate of liver transplantation and survival rate of recipient. Moreover, the postoperative complications of receptor decreased significantly. It provide an effective method of investigating liver graft regeneration following reduced-size liver transplantation. Related Articles | Metrics

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Hepatitis B virus recurrence following liver transplantation: A 19-case report in the same treatment center within 43 months Yu Ru-sheng, Jiang Yi, Lü Li-zhi, Cai Qiu-cheng 2010, 14 (18):  3258-3261.  doi: 10.3969/j.issn.1673-8225.2010.18.007 Abstract ( 270 )   PDF (485KB) ( 305 )   Save BACKGROUND: Hepatitis B virus (HBV) recurrence following liver transplantation has been difficultly treated, and antiviral therapy following HBV recurrence has been less reported yet. OBJECTIVE: To investigate the antiviral therapy using Adefovir + Lamivudine + anti-hepatis B immunoglobulin on liver functional improvement following liver transplantation. METHODS: A total of 208 cases with hepatitis B-related end-stage liver disease following liver transplantation were selected from Liver Transplantation Center of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January 2005 to October 2008. All patients were treated with Lamivudine + anti-hepatis B immunoglobulin so as to prevent from HBV recurrence. At 6-43 months after following up, HBV recurrence was found in 19 cases, including 13 with positive HBeAg and 8 with YMDD mutation. The 19 patients were treated with Adefovir based on the application of Lamivudine + anti-hepatis B immunoglobulin. RESULTS AND CONCLUSION: At 12, 24, and 48 weeks after treatment, DNA and glutamic-pyruvic transaminase of 19 cases were significantly decreased (P < 0.01). After 48-week treatment, recovery rate of glutamic-pyruvic transaminase, negativity rate of HBeAg, and negativity rate of HBV DNA were 84.1%, 76.92%, and 78.9%, respectively. The results demonstrated that the application of Adefovir + Lamivudine + anti-hepatis B immunoglobulin effectively inhibited viral replication and prevented HBV recurrence following liver transplantation. Related Articles | Metrics

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Detction of urinary kidney injury molecule-1 for diagnosis of early graft function in kidney transplantation Huo Wen-qian, Jin Feng-shuo, Nie Zhi-lin, Li Qian-sheng, Zhu Fang-qiang, Zhang Ke-qin 2010, 14 (18):  3262-3266.  doi: 10.3969/j.issn.1673-8225.2010.18.008 Abstract ( 376 )   PDF (646KB) ( 461 )   Save BACKGROUND: Urinary kidney injury molecule-1 (KIM-1) has been proved to be a novel kidney-specific injury molecule as a marker for the diagnosis of acute renal ischemia injury, and KIM-1 participated in the progress of renal injury repair. However, no one reported the significance of its dynamic expression during the functional rehabilitation of renal graft.   OBJECTIVE: To investigate the relations between urinary KIM-1 level and the early renal graft function in order to provide rational approaches for evaluating or predicting early renal graft function. METHODS: The 46 patients were divided into 3 groups, including 22 cases of immediate graft function (IGF), 14 cases of slow graft function (SGF) and 10 cases of delayed graft function (DGF). The 24-hour urine specimen was collected every day for 2 weeks since the operation. The urinary KIM-1 content was detected by enzyme linked immunosorbent assay (ELISA), and at the same time the urinary and serum creatinine levels were detected. The diversity of urinary KIM-1 level was observed during the recovery of the graft function, and the clinical significance was evaluated by analyzing the correlation of urinary KIM-1 level and serum creatinine. RESULTS AND CONCLUSION: At the first 2 days after kidney transplantation, the urinary KIM-1 levels were high and no significant difference was observed between the three groups (P < 0.05). Two days later, the urinary KIM-1 level descended quickly along with the descent of the serum creatinine in IGF and SGF groups; the urinary KIM-1 maintained high levels until the serum creatinine reached normally. In DGF group, the urinary KIM-1 decreased quickly to a low level after 2 days from operation, but it increased promptly 1 to 2 days before the recovery of graft function and kept a high level until the serum creatinine reached normally. This suggested that consecutive detection of urinary KIM-1 is useful for monitoring the early graft function after kidney transplantation, and high urinary KIM-1 may suggest the recovery of graft function. Related Articles | Metrics

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Time-zero renal biopsy: Correlation analysis of clinical predonation parameters and histological abnormalities Guo Jun-qi, Xu Zi-zhong, Wu Wei-zhen, Yang Shun-liang, Tan Jian-ming 2010, 14 (18):  3267-3270.  doi: 10.3969/j.issn.1673-8225.2010.18.009 Abstract ( 323 )   PDF (457KB) ( 440 )   Save BACKGROUND: The number of living renal donation has increased in China and abroad, thus, it is important to guarantee the safety of donors. How to accurately diagnose potential renal disease and provide guidance plays an import role in protecting safety of living renal donors. OBJECTIVE: To establish an evaluation method for analyzing the correlation between histological abnormalities and clinical predonation parameters. METHODS: The related data on renal transplantation of Fuzhou general Hospital of Nanjing Military Area Command of Chinese PLA were retrospectively reviewed. Paracentesis were performed when the vessels of kidney were mutilated and perfusions were finished. Time-zero renal biopsy was evaluated for following pathological changes: interstitial fibrosis, tubularatrophy, arteriolar hyalinosis, mesangial proliferation, and glomerulosclerosis. Predonation data were demography, body weight, body mass index, systolic/diastolic blood pressure, serum creatinine, glomerular filtration rate, and proteinuria. RESULTS AND CONCLUSION: There were no signs of kidney disease in preoperative examination of all the 62 patients, time-zero renal biopsy found there were 28 donors with histological changes, interstitial fibrosis with age and serum creatinine, tubularatrophy with diastolic blood pressure and protein excretion rate, arteriolar hyalinosis with serum creatinine and glomerular filtration rate, mesangial proliferation only with body mass index, and finally the presence of glomerulosclerosis did not correlate with any variable. Related Articles | Metrics

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Treatment of bladder transitional cell carcinoma recurrence by transurethral resection followed by submucosal injection Epirubicin in renal transplantation recipients: Is it safe and effective? Zhang Yong, Wang Yong, Zhang Xiao-dong, Li Xiao-bei, Yang Yong 2010, 14 (18):  3271-3274.  doi: 10.3969/j.issn.1673-8225.2010.18.010 Abstract ( 308 )   PDF (441KB) ( 362 )   Save BACKGROUND: The renal transplanted recipients were in poor immunosuppressive state. Compared to common person, the bladder transitional carcinoma in recipients was aggressive and easy to recurrence. Looking for a more effective therapy method to decrease the recurrence of recipients’ bladder transitional carcinoma is the hot and difficult problem in clinical study. OBJECTIVE: To analyze the efficacy and safety of submucosal injection epirubicin following transurethral resection of bladder tumor (TUR-Bt) to treat the recurrence of bladder transitional cell carcinoma in renal transplantation recipients. METHODS: Totally 9 renal transplantation recipients with transitional cell carcinoma of bladder were retrospectively studied. The patients’ periods without cancer, the frequency of recurrence within one year, the rates of side effect, the changes of tumor grading following recurrence and allograft function were recorded when the routine method and submucosal injection epirubicin following TUR-Bt were used in different period respectively.  RESULTS AND CONCLUSION: Submucosal injection epirubicin following transurethral resection of bladder tumor was safe and effective to treat bladder transitional cell carcinoma recurrence in renal transplantation recipients. Compared to the routine perfusion, periods without cancer and the frequency of recurrence within 1 year were significantly decreased, which can elevate recipients life quality and long-term survival rates. Related Articles | Metrics

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Occurrence and treatment of urological complications following renal transplantation: Data review in 1 223 cases Nie Zhi-lin, Li Qian-sheng, Jin Feng-shuo, Zhang Ke-qin, Zhu Fang-qiang, Huo Wen-qian, Ma Qiang 2010, 14 (18):  3275-3278.  doi: 10.3969/j.issn.1673-8225.2010.18.011 Abstract ( 303 )   PDF (459KB) ( 392 )   Save BACKGROUND: Urological complication is one of common surgical complications following transplantation and severely threatens renal function, even patient’s lives. Urological complications following renal transplantation mainly contain urinary fistula, ureteral obstruction and ureter backflow. OBJECTIVE: To retrospectively analyze the incidence and management of urological complications following kidney transplantation. METHODS: A total of 1 223 patient times following kidney transplants were selected at the Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University of Chinese PLA from December 1993 to April 2007. According to ureter of donor kidney and the urinary tract of recipients, ureteroneocystostomy was used for urinary tract reconstitution in 948 patient times, and end-to-end ureteroureterostomy in 275 patient times. Urological complications such as urinary fistula, ureteral obstruction and vesicoureteral reflux (VUR) were treated by the different methods on the basis of the different causes, mainly by surgical procedures. Reason of urological complications, surgical management of urological complications and its clinical outcome, the 3-year survival rate of grafted kidney were measured. RESULTS AND CONCLUSION: In a total of 1 223 patients, urological complications were encountered in 92 cases (7.5%), including 43 cases of urinary fistula (3.5%), 35 ureteral obstruction (2.9%), 14 VUR (1.1%). 35 cases of urinary fistula, 29 ureteral obstruction, 6 VUR were cured by surgical procedures including ureteroureterostomy in 35 patients (50%), revision of ureteroneocystostomy in 18 (25.7%), endourology in 11 (15.7%) and other operation in 6 (9.6%). All recipients with urological complications regained normal graft function except one undoing transplanted nephrectomy due to the pelvis and urteral necrosis. There was no grafted kidney and recipient loss secondary to these complications in the present series. The 3-year survival rate of graft with urological complications and without urological complications did not show significant difference (P > 0.05). These indicated that most of urological complications following kidney transplantation request surgical management, and ureteroureterostomy are frequently used. The long-term graft survival is not affected by a correctly treated urological complication. Related Articles | Metrics

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Ischemic precondition inhibits pancreatic acinar cells apoptosis in rats with ischemia/reperfusion injury following pancreas transplantation: Role of reactive oxygen and mitochondrial DNA repair enzyme Hou Yi-ling, Bo Hai, Liu Zi-quan, Xia Shi-hai 2010, 14 (18):  3279-3285.  doi: 10.3969/j.issn.1673-8225.2010.18.012 Abstract ( 317 )   PDF (750KB) ( 520 )   Save BACKGROUND: Ischemic preconditioning (IPC) can induce endogenous protection mechanism, which effectively prevent ischemia/reperfusion injury following organ transplantation. Cold and warm ischemia may induce ischemia/reperfusion injury of pancreas transplantation, and apoptosis of pancreatic acinar cells is one of the important reasons of pancreas graft functional defect after transplantation. Mitochondrial DNA has repair system, and its balance with mitochondrial DNA injury influences disease occurrence and outcome. OBJECTIVE: To observe the effect of IPC on apoptosis of transplanted pancreatic acinar cells, and the possible role of reactive oxygen (ROS) and mitochondrial DNA repair enzyme. METHODS: A total of 50 health, male, Sprague-Dawley rats were randomly divided into three groups: sham operated (n = 10), donors (n = 20) and recipients (n = 20). The recipients were randomly divided into ischemia/reperfusion group (IR, n = 10) and IPC group (n = 10). The sham operated group was subjected to abdominal open and close operation. IR group and IPC group received establishment of diabetic model by streptozotocin injection. IR rats received whole pancreatic-duodenal transplantation alone. IPC rats received whole pancreatic-duodenal transplantation exposed ischemic preconditioning with 5 minutes ischemia and 5 minutes reperfusion twice. All grafts were keep with warm ischemia time 15 minutes and cold ischemia (in 4 ℃ UW preservation solution) time 180 minutes. Twelve hours after reperfusion, serum amylase, blood glucose, Caspase-3, -9 activity were detected. Pancreatic acinar cell apoptosis was measured by flow cytometry. Mitochondrial cross-membrane potential (△Ψ) was measured by monitoring the fluorescence spectrum of rhodamine 123. Mitochondrial H2O2 generation was determined using dichlorofluorescein as a probe. 8-oxodG in mitochondrial DNA (mtDNA) was measured with HPLC system.  Release of cytochrome C, phosphorylation of Akt and mitochondrial OGG1 protein expression were determined by Western-blotting. RESULTS AND CONCLUSION: The ischemia preconditioning can relieve the pancreatic acinar cell apoptosis in pancreas graft and relieve IR injury by decreasing mitochondrial oxidative stress, mtDNA injury, and increasing phosphorylation of Akt and mitochondrial OGG1 expression. Related Articles | Metrics

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Pancreas-kidney transplantation in 5 cases Wang Qiang, Cai Ming, Shi Bing-yi, Qian Ye-yong, Li Zhou-li, Li Xiao-li, Xu Liang, Pei Xiang-ke 2010, 14 (18):  3286-3288.  doi: 10.3969/j.issn.1673-8225.2010.18.013 Abstract ( 1060 )   PDF (314KB) ( 378 )   Save Related Articles | Metrics

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Effects of body mass index on the outcome of in vitro fertilization and embryo transfer treatment Li Xing, Yang Jing, Yin Tai-lang, Xu Wang-ming, Li Jin-ping, Zhao Qing-hong 2010, 14 (18):  3289-3292.  doi: 10.3969/j.issn.1673-8225.2010.18.014 Abstract ( 329 )   PDF (515KB) ( 619 )   Save BACKGROUND: Whether overweight and obesity have impact on the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment remains poorly understood. OBJECTIVE: To investigate the effect of women’s body mass index (BMI) on the outcome of IVF-ET treatment. METHODS: A total of 184 cases were divided into 3 groups according to BMI: lankness group (BMI < 18.5 kg/m2), normal group (18.5 kg/m2 ≤ BMI < 24 kg/m2), overweight and obesity group (BMI ≥ 24 kg/m2). Treatments of ovulation induction and IVF-ET were regularly performed in the Reproductive Medical Center, Renmin Hospital of Wuhan University. The duration and dose of gonadotrophic hormone (GTH) treatment, estradiol level at the day of human chorionic gonadotropin (hCG) injection, and the differences of retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate were compared. RESULTS AND CONCLUSION: The dose of GTH used was in the overweight and obesity group was greater than that of the other groups (P < 0.05), and the dose was increased with BMI increasing. There was no significant difference in other aspects such as estradiol level, retrieved oocytes numbers, fertility rate, embryo quality, implantation rate, pregnancy rate and abortion rate at the day of hCG injection among the three groups (P > 0.05). All results demonstrated that overweight and obese patients require a higher hCG dose to achieve follicular maturation than normal weight patients. However, overweight and obesity does not affect negatively results of IVF-ET. Related Articles | Metrics

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Factors influencing the outcomes of the vitrified frozen-thawed embryo transfer Zhao Qing-hong, Yang Jing, Yin Tai-lang, Xu Wang-ming, Long Wen, Yu Nan 2010, 14 (18):  3293-3296.  doi: 10.3969/j.issn.1673-8225.2010.18.015 Abstract ( 304 )   PDF (377KB) ( 507 )   Save BACKGROUND: Considerable debate exists which factors influence the outcomes of the vitrified frozen-thawed embryo transfer because lack of clinical applications. OBJECTIVE: To explore the factors influencing the outcomes of the vitrified frozen-thawed embryo transfer in assisted reproductive technology. METHODS: A retrospective statistical analysis was performed in Reproductive Medicine Center, Renmin Hospital of Wuhan University of 142 patients, 154 thawing cycles. The patients were grouped according to the age of patients, embryonic development, fertilization methods, endometrial preparation programs, the endometrial thickness, the process of transplantation and the survival cell ratio of embryo recovery, the implantation rate and clinical pregnancy rate were compared between various groups. RESULTS AND CONCLUSION: Among the groups of the different age, fertilization methods, endometrial preparation programs, endometrial thickness and the process of embryo transfer embryo implantation rate and clinical pregnancy rate were no significant difference (P > 0.05); between the two groups of the second day fertilized embryos (D2) and the third day (D3) fertilized embryos, the clinical pregnancy rate was not significant (P > 0.05), but the embryo implantation rate of D3 group was significantly higher than D2 group. The survival cell ratio of embryo recovery has a significant effect on implantation rate and clinical pregnancy rate (P < 0.05). In the frozen-thawed embryo transfer cycles, embryo quality plays a major role in pregnancy rate, and preparation for appropriate endometrial thickness can improve the clinical pregnancy rate. Related Articles | Metrics

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Expression of growth associated protein 43 at the corresponding dorsal root ganglia following sciatic nerve transplantation in rats Zhao Dong-bo, Sun Hong-bin, Li Qiang, Cui Shu-sen 2010, 14 (18):  3297-3300.  doi: 10.3969/j.issn.1673-8225.2010.18.016 Abstract ( 350 )   PDF (462KB) ( 428 )   Save BACKGROUND: Following peripheral nerve transplantation, the time phases and law of growth associated protein 43 (GAP-43) expression in sensory neuron soma of the corresponding dorsal root ganglia remain unclear. OBJECTIVE: To investigate the expression of GAP-43 at the corresponding dorsal root ganglia following sciatic nerve transplantation in rats. METHODS: Adult male Wistar rats were randomly divided into 2 groups: control group (sham-operated group) and experimental group (nerve transplantation group). The rats were killed at 3 days, 1, 2, 4, 6, and 8 weeks after operation and the dorsal root ganglia L4-5 of every rat was taken for observation. The expression of GAP-43 mRNA and protein in the corresponding segments of spinal cord were detected by RT-PCR and Western-blot techniques. RESULTS AND CONCLUSION: GAP-43 mRNA showed a low level of expression in the control group, which had no obvious changes in different phases. In the experimental group, GAP-43 mRNA expression was observed remarkably in the dorsal root ganglia at the first week, reached a peak at the second week and gradually descended from the sixth week. The GAP-43 protein expression showed the same laws as that of GAP-43 mRNA. The results demonstrated that there exists damage reactivity change in the regeneration ability of neurons. Related Articles | Metrics

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Effect of follicle stimulating hormone on cryopreserved sheep ovarian tissue xenotransplantation Wang Yan-sheng, Xie Sha-sha, Wang Yan-rong, Hei Chang-chun, Zheng Xiao-min 2010, 14 (18):  3301-3304.  doi: 10.3969/j.issn.1673-8225.2010.18.017 Abstract ( 257 )   Save BACKGROUND: Transplantation of fragments of ovarian cortex is performed without vascular reanastomosis, therefore, to increase the tolerance of ovarian tissue to the freezing-thawing and ischemic injuries is critical for follicular survival and functional longevity of the graft. OBJECTIVE: To investigate the effect of follicle stimulating hormone (FSH) on the morphological and function of sheep ovary tissue in the process of cryopreservation, so that to provide new freezing method for human ovary tissues. METHODS: Healthy BALB/c strain female nude mice were equally and randomly divided into 3 groups and subjected to heterotopic transplantation of fragments of sheep ovarian cortex. (1) Control group: transplantation following sampling; (2) experimental group: transplantation following freezing-thawing, and the solution was free of FSH; (3) FSH group: the freezing and thawing and culture fluid contained FSH. The estrous cycle recovering rate, estrous cycle recovering time, the number of follicle were observed following transplantation. The histological changes, and the level of E2 in blood serum were observed at 4 weeks after transplantation. RESULTS AND CONCLUSION: There were no significant differences in estrous cycle recovering rate and number of follicle/PHF between FSH and control groups (P > 0.05), but the number of follicle was greater than the experimental group (P < 0.05). Moreover, the time of estrous cycle recovering in FSH group was similar to control group, but shorter than experimental group  (P < 0.05). There were more developing follicular in FSH group, but few in experimental group at 4 weeks. No significant difference was detected in E2 level in blood serum between FSH and control group (P > 0.05), but significantly greater than the experimental group (P < 0.05). Results show that FSH addition in vitrification fluid can improve ovarian follicle survival following cryopreserved sheep ovary tissue transplantation. Related Articles | Metrics

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Repair of spinal cord injury using Schwann cells in rats: Feasibility and superiority of intravenous transplantation Li Hui, Feng Shi-qing, Chen Jia-tong, Han Ming-yuan, Wang Chun-yuan, Yu Tie-qiang 2010, 14 (18):  3305-3309.  doi: 10.3969/j.issn.1673-8225.2010.18.018 Abstract ( 295 )   PDF (982KB) ( 389 )   Save BACKGROUND: Emerging studies have focused on cell transplantation. Schwann cells (SCs) can secrete various neurotrophic factors and improve local environment around injury. Plenty of documents have demonstrated that SCs could promote functional recovery following spinal injury. Many transplanting methods are available for treating spinal cord injury, and the intravenous cell transplantation is profitable for easy operation and avoidance of additional trauma. OBJECTIVE: To investigate the effects of intravenous transplantation of SCs on spinal cord injury in rats. METHODS: The bilateral sciatic nerves of Wistar rats were separated in vitro, cultured by tissue clot method, identified by S-100 and labeled by Hoechst33342. Sixty rat models with T10 spinal cord injury were prepared using impactor model-Ⅱ type weight drop apparatus. Then the injured rats were randomly divided into 3 groups: blank control, DMEM control and SCs transplantation groups. No treatment was performed in the blank control group. Totally 1 mL DMEM and or SCs was injected into rats of DMEM control and SCs transplantation groups by tail vein respectively. Basso Beattie Bresnahan (BBB) scores were performed at 1 day before and 1, 3 days, 1 week and weekly after operation. The migration of transplanted SCs was observed at 2 weeks and 4 after transplantation. The expressions of glial fibrillary acidic protein (GFAP) and neuron specific enolase (NSE) were detected by haematoxylin-eosin staining and immunofluorescence staining. RESULTS AND CONCLUSION: The purity of SCs reached 95%. Hoechst33342 positive cells were observed throughout the injured and the nearby region of spinal cord at 1, 2, and 4 weeks after transplantation. The statistical difference of BBB score among the SCs transplantation, blank control, and the DMEM control groups displayed at 4 weeks after transplantation (P < 0.05), and the BBB scores of the SCs transplantation were higher than other groups. Haematoxylin-eosin staining showed the cavity formed in each group at 8 weeks after transplantation, but the area of SCs transplantation was smaller than that of the blank control and DMEM control groups. The immunofluorescence staining indicated that the expression of GFAP were more intense in the blank control group and DMEM control than SCs transplantation (P < 0.05), while the expression of NSE was more intense in SCs transplantation than other groups (P < 0.05). It implied that intravenous transplantation of SCs promotes regeneration of axon and improves neurological functions after spinal cord injury in rats. Related Articles | Metrics

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Swim-up and density gradient centrifugation preparation techniques for intrauterine insemination: A systematic review Li Tao, Guo Qing-hua,Tian Jin-hui Zhang Wei, Guo Bai-hong, Li Guo-ping, Luo Neng-qin, Li Zhao-bin, Jiang Lei, Jia Wen-qin, Li Ren-ju, Zhang Peng, Chen Yi-rong 2010, 14 (18):  3310-3313.  doi: 10.3969/j.issn.1673-8225.2010.18.019 Abstract ( 318 )   PDF (659KB) ( 501 )   Save BACKGROUND: There are many in vitro selection method of sperm, and swim-up and density gradient centrifugation are commonly used. It remains unclear which method minimizes bad stimulation to the sperm and select sperm with high fertilization potential. OBJECTIVE: To evaluate the effectiveness of swim-up and gradient centrifugation preparation techniques on intrauterine insemination (IUI). METHODS: A computer-based online search of Cochrane Library, PubMed, EMBASE databases was performed, and some related journals were manually searched for related articles published between January 1966 and February 2009. The quality of included randomized controlled trials (RCT) and q-randomized trials (Q-RCT) was evaluated and Meta-analysis was conducted by the Cochrane Collaboration’s software RevMan5.0. Experts. RESULTS AND CONCLUSION: A total of 6 studies were included, involving 4 RCTs and 2 Q-RCTs. A total of 486 patients     (1 099 IUI cycles) were enrolled. The Meta-analysis indicated that there was no difference between swim-up and gradient centrifugation preparation techniques for the IUI in terms of cycle pregnancy rates [OR = 1.11, 95%CI (0.8, 1.55)], miscarriage rates [OR = 0.31, 95%CI (0.09,1.04)], sperm count [the weight mean difference (WMD) = -0.89, 95%CI(-14.17, 12.38)], sperm motility [WMD = -2.31, 95%CI(-7.27, 2.65)]. There is insufficient evidence to confirm which is the best method in the two specific preparation techniques. The quality of study methods should be improved. And more measure parameters should be included when comparing it before or after treatment, such as sperm motility, sperm count, sperm function. Related Articles | Metrics

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Influence of different immunosuppressants on monocyte chemoattractant protein-1 secretions in the whole blood Wang Ming, He Yi, Liu Zhan-guo, Luo Yu-wei, Wu Kai, Sun Er-wei, Zhao Ming 2010, 14 (18):  3314-3317.  doi: 10.3969/j.issn.1673-8225.2010.18.020 Abstract ( 322 )   PDF (716KB) ( 393 )   Save BACKGROUND: In the field of organ transplantation, patients often take immunosuppressants after organ transplantation, such as CsA, FK506, DEX and MPA. However, their mechanisms of immunosuppression are different. The effect of immunosuppressive drugs on monocyte chemoattractant protein-1 (MCP-1) remains poorly understood. OBJECTIVE: To investigate the effects of different immunosuppressants on the secretions of MCP-1 in whole blood. METHODS: The whole blood of healthy volunteers was mixed with different immunosuppressants for 6 hours, such as CsA, FK506, DEX and MPA, which included low, middle and high concentrations, followed by PMA and IONO stimulation for 6 hours. MCP-1 levels in whole blood samples were compared. The whole blood cultured alone served as control. RESULTS AND CONCLUSION: MCP-1 secretion was inhibited by DEX (1, 10 mg/L) and CsA (0.25, 1.25 mg/L). However, FK and MPA exhibited no such effect. Therefore, DEX and CsA may inhibit the function of monocytes and macrophages in immune system by diminishing the secretion of MCP-1. The combination of FK (5 µg/L), MPA (10 mg/L) and DEX (1mg/L) or CsA    (0.25 mg/L), MPA (10 mg/L) and DEX (1 mg/L) can inhibit the secretion of MCP-1, but only DEX among all the immunosuppressants mentioned above exhibited significant effect on inhibiting the secretion of MCP-1 when using alone. Related Articles | Metrics

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Antitumor efficacy of intratumoral injection of xenoantigen in mice Hu Xi-gang, Sun Li-bin, Zhang Ji-ren 2010, 14 (18):  3318-3322.  doi: 10.3969/j.issn.1673-8225.2010.18.021 Abstract ( 360 )   PDF (874KB) ( 451 )   Save BACKGROUND: Herterologous antigen has strong immunogenicity and easily induces immunological response. Introduction of herterologous antigen into tumor may induce a serial of immunological reactions in the tumor and may reverse the immunosuppression of tumor microenvironment to treat tumor. OBJECTIVE: To evaluate the antitumor efficacy of intratumoral injection of human erythrocyte membrane antigens in mice bearing S180 sarcoma. METHODS: Kunming mice bearing S180 sarcoma model were established and treated with 5 g/L human erythrocyte membrane antigens suspension or normal saline for five days. Tumor volume was calculated before the first injection and 3, 7, and 14 days after the first injection. In addition, the tumor cells in combination with human erythrocyte membrane antigens group, the injection of saline group (the control group), and the injection of human erythrocyte membrane antigens or saline group (pre-immunized by suspension of human erythrocyte of blood group type A). Another 60 mice bearing S180 sarcoma were established and subjected to the above pre-immunization and injection of saline or human erythrocyte membrane antigens. Six mice selected from each group were sacrificed 14 days after the first injection, and tumors were weighed, followed by histological examination. Survival of remainders in each group was observed. RESULTS AND CONCLUSION: Tumor volumes in each group increased gradually. Tumor volumes in the human erythrocyte membrane antigens injection group, the tumor cells in combination with human erythrocyte membrane antigens group, and the human erythrocyte membrane antigens injection group (immunized) were smaller than the control group, Intratumoral injection of human erythrocyte membrane antigens significantly reduced tumor weights. Tumor necrosis, infiltration of inflammatory cells such as lymphocytes were observed in tumor tissues section examination following the intratumoral injection of human erythrocyte membrane antigens. The mouse survival time showed no statistical difference among different groups. Intratumoral injection of heterologous erythrocyte membrane antigens can inhibit tumor growth of S180 sarcoma bearing mice. Related Articles | Metrics

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Proliferation of scar tissues following fresh versus preserved amniotic membrane transplantation with trabeculectomy Guo Jing, Wang Hong-wei, Yang Xue-fang 2010, 14 (18):  3323-3326.  doi: 10.3969/j.issn.1673-8225.2010.18.022 Abstract ( 331 )   PDF (714KB) ( 387 )   Save BACKGROUND: Fresh amniotic membrane has been extensively used in treating ocular surface disease, which can inhibit fibrous tissue proliferation, inhibit neovascularization, and relieve inflammation. However, its application in treating glaucoma is rarely reported. OBJECTIVE: To explore the antiproliferative effect of fresh amniotic membrane on postoperative scar and compared with preserved amniotic membrane. METHODS: A total of 36 New Zealand white rabbits were randomly divided into 3 groups. Fresh amniotic membrane and preserved amniotic membrane combined with trabeculectomy separately underwent fresh amniotic membrane and preserved amniotic membrane transplantation. The control group was subjected to trabeculectomy alone. After 1, 2, 3, and 4 weeks, the morphology and function of filtering bleb were checked, and the platelet-derived growth factor (PDGF) of surrounding tissue was determined by immunohistochemical method.  RESULTS AND CONCLUSION: Fresh amniotic membrane and preserved amniotic membrane groups displayed bulged filtering bleb with good filtering function. Pathological observation showed that fibroblasts of the filtration pathway had less, but more sparse scar tissues than control group, but inflammatory infiltration was observed in all groups. The cavity of different sizes and shapes were detected in filtration pathway of control group, which was replaced by fibrous tissue hyperplasia, with a large number of fibroblasts. Immunohistochemical results showed that the expression of PDGF was significantly less in fresh amniotic membrane and preserved amniotic membrane groups compared with the control group, and the PDGF expression was less in fresh amniotic membrane group than the preserved amniotic membrane group. Fresh and preserved amniotic membrane can improve the filtering bleb function, reduce scar formation, and maintain the patency of filtering pathway. Moreover, the effects of fresh amniotic membrane is better than preserved amniotic membrane. References | Related Articles | Metrics

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Skin regeneration following scar removal and in situ replantation for treating hypertrophic scar Zhao Xian-zhong, Sun Kee-yan, Ge Yong-liang, Zhang Dong-bo, Yin Dong-jing 2010, 14 (18):  3327-3330.  doi: 10.3969/j.issn.1673-8225.2010.18.023 Abstract ( 245 )   PDF (833KB) ( 506 )   Save BACKGROUND: Existing research shows that in situ regeneration of skin deep within the second degree burn wound and donor site wound healed without physical scarring, can promote three-degree burn wounds liquefied necrotic tissue removement, the growth of transplanted skin, reduce scar; scar-shift using the in situ regeneration is expected to reach significantly reduce scar symptoms, and to reduce the effect of scar, which have not be reported. OBJECTIVE: To observe effects of skin regeneration in situ method to remove scar in the treatment of hypertrophic scar. METHODS: A total of 32 patients with many hyperplastic scars, including 25 males and 7 females, aged 16-52 years, disease course of 1-11 years. Two similar scar regions were selected from each patient for self control. In the experimental group, scar removal, scar skin replantation after the application of in situ regeneration of the skin treatment using burn cream coated yarn. In the control group, scar removal, scar skin replantation after the application of traditional Vaseline covered by treatment. Curative effects were observed and compared. Scar hyperplasia was assessed using Vancouver Scar Assessment Scale assessment. RESULTS AND CONCLUSION: Replanted scar skin explants were survived in both groups. In the experimental group, healing speed and quality of wound surface were better than the control group (P < 0.05). After 6 months, the Vancouver Scar Assessment Scale assessment in the experimental group was better than control group (P < 0.05, P < 0.01). Scar caused by pain, itching and other symptoms disappeared, skin formation and color back to pre-implantation were significantly improved compared with the surrounding skin almost. Results indicated that with regarding to the lack of autologous skin source, large area of scar in patients with hypertrophic scars or unwilling to add a new donor site wounds in patients, in situ replantation method is an ideal approach. Related Articles | Metrics

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Construction and identification of eukaryotic expression vector of rat Delta1 gene Zheng Kai, Tan Jian-ming, Wu Wei-zhen, Yang Shun-liang 2010, 14 (18):  3331-3334.  doi: 10.3969/j.issn.1673-8225.2010.18.024 Abstract ( 255 )   PDF (853KB) ( 378 )   Save BACKGROUND: Recent data suggested that Notch signal pathway plays important regulatory effects in peripheral transplantation immunological response, promotes differentiation of regulatory T cells, induces antigen specific immune tolerance. We proposed that Notch/Notch ligand may play important roles in MHC/TCR interface. OBJECTIVE: To construct the eukaryotic expression vector of rat Delta1 gene (Notch ligand), and to examine its expression in dendritic cells. METHODS: The complete encoding cDNA of rat-Delta1 was isolated from bone marrow cells by reverse transcription-polymerase chain reaction (RT-PCR) and this gene was recombined into pcDNA3.1(+) plasmid vector. pcDNA3.1/Delta1 plasmid was transfected into rat dendritic cells with lipofectamine gene transfection method. RESULTS AND CONCLUSION: Double enzyme digestion detection demonstrated that Delta1 had been successfully constructed in HindIII and XbaI of pcDNA3.1. A positive clone pcDNA3.1/Delta1 was delivered to Shanghai Sangon Biological Engineering Technology & Services Co., Ltd. for sequencing. Sequencing results were identical to Delta1 gene sequence in Genebank, with correct reading frame. The Delta1 gene-transfected dendritic cells showed similar morphology as their parent cells. Western blotting assay detected that Delta1 expression was significantly increased in cells. The eukaryotic expression vector pcDNA3.1/Delta1 was constructed, and significant increase of Delta1 expression was detected after transfection. Related Articles | Metrics

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Expression of Tpap gene in mouse testis Tang Ai-fa, Yu Zhou, Zhang Xiao-yan, Zhang Zhen-ming, Gui Yao-ting, Ye Jiong-xian, Cai Zhi-ming 2010, 14 (18):  3335-3338.  doi: 10.3969/j.issn.1673-8225.2010.18.025 Abstract ( 357 )   PDF (717KB) ( 395 )   Save BACKGROUND: These serial processes for forming male gametes are basically controlled by the programmed expression of a number of stage-specific genes. However, many aspects of the mechanisms of spermatogenesis have remained elusive because of a lack of suitable in vitro or in vivo models. OBJECTIVE: To screen genes involved in spermatogenesis, and to analyze its expression characteristics.  METHODS: Testes cDNA samples from Balb/C mice of different postnatal days (4, 9, 18, 35, 54 days and 6 months, respectively) were hybridized with mouse whole genome Affymetrix chip to screen the testis-ralated genes. The characteristics of the selected genes were analyzed by various bioinformatics tools. RT-PCR was used here to identify the expression of the selected genes in mice testis.  RESULTS AND CONCLUSION: The Affymetrix chip probe of mouse Tpap was graduated higher expression with developmental stages of mouse testis. The scaling hybridization signal intensities of the tested testis on days 4, 9, 18, 35, 54, and 6 months of postnatal were 4.4 (Absent expression, A), 12.9 (A), 262.4 (Present expression, P), 1136.7 (P), 1617.5 (P) and 1128 (P), respectively. These results indicated that the expression of mouse Tpap wasn’t detected on days 4 and 9, but was detected on days 18, 35, 54, and 6 months of mouse testis in our Affymetrix chip analysis. By combination with the RT-PCR analysis of mouse Tpap, we observed mouse Tpap began to express at the age of day 18 in mouse. Tpap is an age-dependent gene in mouse testis. The expression of Tpap corresponds to the appearance of spermatids of mice and indicates that Tpap may have an important role in male mammalian spermatogenesis. Related Articles | Metrics

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Effect of ginsenoside rb1 on survival of dorsal random-pattern skin flap with large length-to-width ratio in rats Cao Chang, Li Qi, Cen Ying 2010, 14 (18):  3339-3342.  doi: 10.3969/j.issn.1673-8225.2010.18.026 Abstract ( 367 )   PDF (818KB) ( 464 )   Save BACKGROUND: Ginsenoside Rb1 has been extensively used in the protection and treatment of heart, encephalon, lung, kidney and liver damage. However, its application in skin flap is rare. OBJECTIVE: To investigate the effects of intraperitoneal injection of ginsenoside Rb1 on the survival of the dorsal random-pattern skin flap with large length-to-width ratio in rats. METHODS: Healthy adult SD rats were randomly divided into experimental and control groups. A caudally based dorsal random pattern skin flap, 80 mm×20 mm (length: width = 4: 1), was symmetrically made. Ginsenoside Rb1 (2 mg/kg) was intraperitoneally injected into the experimental group rats, and the same volume of normal saline was injected into the control group. Malonyl dialdehyde (MDA) and nitric oxide (NO) level of the flaps were tested 1 day after operation; the amount of viable tissues of the flaps were examined by planimetry 10 days after operation. Specimens from the proximal, middle and distal flaps were harvested for HE staining to examine the microstructure.  RESULTS AND CONCLUSION: At the first day after operation, NO level was higher in the experimental group than the control group (P < 0.01), while MDA level was lower than the control group (P < 0.01). At the 10th day after operation, the survival rate of the flap was significantly greater in the experimental group than the control group (P < 0.001). Histological observation showed that compared with the control group, the edema and inflammatory cells infiltration were less, while the fiber hyperplasia and the microvascular growth were more obvious in the experimental group. Results show that intraperitoneal injection of ginsenoside Rb1 can enhance the blood supply of the flaps and improve the survival of the random-pattern skin flaps with large length-to-width ratio in rats. This may involve its effects of improving NO activity, decreasing lipid peroxidation, and promoting angiogenesis of skin flaps. Related Articles | Metrics

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Protective effect of ligustrazine on skin flap ischemia-reperfusion injury Cao Zheng-pin, Cheng Chun-sheng, Zhao Zhi-wei, Shan Hai-min 2010, 14 (18):  3343-3346.  doi: 10.3969/j.issn.1673-8225.2010.18.027 Abstract ( 281 )   PDF (798KB) ( 403 )   Save BACKGROUND: Recent studies have demonstrated that ligustrazine removed oxygen-derived free radicals and protected vascular endothelial cells. Howerver, the effect of ligustrazine on skin flap ischemia-reperfusion injury was less reported. OBJECTIVE: To investigate the effect of ligustrazine on skin flap ischemia-reperfusion injury, and to analyze reaction pathway. METHODS: A total of 24 healthy SD rats were used to establish ischemia-reperfusion injured skin flap along superficial epigastric artery. All rats were randomly divided into sham-surgery, model control, and ligustrazine groups, with 8 rats per group. Ischemia-reperfusion injury was not induced in the sham-surgery group; saline (4 mL/kg) was given in the model control gorup 30 minutes prior to operation; an intraperitoneal injection of ligustrazine (4 mL/kg) was given in the ligustrazine group immediately after ischemia-reperfusion injury. Distal tissue was selected from skin flap in the model control group immediate after formation of skin flap, 8 hours after ischemia, and 1 hour after reperfusion, as well as in the sham-surgery group immediate after formation of skin flap, 8 and 9 hours after operation to measure superoxide dismutase (SOD) and malonaldehyde (MDA) contents. Histological morphology was observed under optic and electron microscopes.  RESULTS AND CONCLUSION: At 8 hours after ischemia and 1 hour after reperfusion, SOD activity in the model control group was significantly less than in the sham-surgery group (P < 0.05-0.01), but the SOD activity in the ligustrazine group was significantly greater than in the model control group (P < 0.05-0.01). At 1 hour after reperfusion, MDA content in the model control group was significantly greater than sham-surgery group (P < 0.01), but the MDA content in the ligustrazine group was significantly less than in the model control group (P < 0.01). As compared with model control group, ultramicrostructure and vascular endothelial cell were mildly damaged in the ligustrazine group, suggesting that ligustrazine inhibited activation and adhesion of neutrophilic granulocytes, relieved inflammatory reaction, protected endothelial cells, resisted lipid peroxidation of free radicals, and prevented skin flap ischemia-reperfusion injury. Related Articles | Metrics

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Application of vacuum sealing drainage in full-thickness skin grafts Li Qing-hua, Li Xia, Zhang Jian, Wang Ming-qing 2010, 14 (18):  3347-3351.  doi: 10.3969/j.issn.1673-8225.2010.18.028 Abstract ( 279 )   PDF (944KB) ( 544 )   Save BACKGROUND: Full-thickness skin graft was a base for burn and plastic surgery, while uniform pressure and regional brake were key factors to ensure skin graft survival and avoid from necrosis. Traditionally, package and pressurized fixation were performed after skin transplantation; however, it induced residual dead space and unclear skin graft fixation, as well as suturing scar. OBJECTIVE: To study the effect of vacuum sealing drainage applied to full-thickness skin graft. METHODS: A total of 8 New Zealand rabbits were used to establish full-thickness skin graft models in three regions of bilateral spine. Vacuum sealing drainage, traditional pressurized suture and common wrapping were performed in the three regions, respectively. The skin graft survival was observed, and survival rate was calculated at 14 and 21 days. On the 3rd, 7th, and 14th days, samples were selected from skin graft and stained. The morphology was observed under light microscope and transmission electron microscope. The time to remove the drain vessel was that when the fluid was not increased or the fluid was clear. RESULTS AND CONCLUSION: The survival rate of vacuum sealing drainage group was significantly higher than that in other two group (P < 0.05), while the survival rate of traditional pressurized suture group was significantly higher than that in the common wrapping group (P < 0.05). Morphology examination demonstrated that regional cuticular layer was necrotic in the vacuum sealing drainage group after early skin transplantation, while inflammatory cell infiltration, fibroblast degeneration, and mitochondrial swelling were also observed. At later skin transplantation, fibroblast and basal cell were proliferated, and function of mitochondria and plasmid was active. This suggested that vacuum sealing drainage promoted survival rate of skin graft. Related Articles | Metrics

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Comparison of biomechanical properties between human aortic and pulmonary valves Cui Bin, Liu Ying-long, Xie Ning, Zhang En-ping 2010, 14 (18):  3352-3354.  doi: 10.3969/j.issn.1673-8225.2010.18.029 Abstract ( 280 )   PDF (323KB) ( 550 )   Save BACKGROUND: The human homograft valve has been widely used in the operation of the valve replacement and congenital heart disease. However, reports concerning pulmonary valve biomechanical suitability as a long-term substitute for aortic valve are limited. OBJECTIVE: To compare the biomechanical properties between human aortic and pulmonary valves conserved with ultra low temperature in liquid nitrogen. METHODS: A contrast observation trial was conducted in the laboratory of Congenital Heart Disease of Fuwai Hospital from March to July in 2004. Six samples of heart aorta valves and pulmonary valves were collected from the cadaveric heart within 6 hours, and the experimental procedure was disposed according to ethical criteria. The biomechanical properties of the circumferential direction of the valve were investigated using uniaxial tensile tests. The thickness of the valve was measured by HD-10 thickness instruments. RESULTS AND CONCLUSIONS: Compared to human aortic valves, the thickness of the human pulmonary valves was thinner significantly, but the stress-strain, tensile strength and the maximum tangent modulus E (the slope of linear segment) in the curve had no significant difference (P > 0.05). Biomechanical differences between the aortic and pulmonary valve are minimal, in respect, pulmonary valve can be considered biomechanically suitable for aortic valve replacement. Related Articles | Metrics

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Random flap microcirculation and pedicle division timing: Can laser Doppler imaging evaluate them? Yao Yue-ming, Shao Hong-bo, Zhang Qing-fu, Feng Jian-ke, Bai Yong-qiang, Wang Che-jiang 2010, 14 (18):  3355-3358.  doi: 10.3969/j.issn.1673-8225.2010.18.030 Abstract ( 337 )   PDF (484KB) ( 343 )   Save BACKGROUND: Random flap as a primary means of wound healing, is widely used at present, its blood circulation to establish the situation is also researched a lot, but not yet the system of random skin flap perfusion were observed and measured. In addition, the timing of pedicle division of a pedicle flap random is also a hot topic, but not yet a mature clinical testing method has been discovered to determine the best timing. OBJECTIVE: By means of laser Doppler blood perfusion imaging, this study was designed to dynamically observe random flap microcirculation, to understand the changes on random flap blood flow, and to determine the best timing of pedicle division. METHODS: A total of 18 cases were divided into traditional pedicle division group and early pedicle division group. Pedicle flap blood perfusion values were statistically measured immediately after surgery, at 3, 7, 11, 15, and 19 days after surgery, before division, immediately after division, and at 24 hours after pedicle division, 8-9 phases in total. RESULTS AND CONCLUSION: Distal blood perfusion value was increased with the time prolongation in both groups; while, the blood perfusion in various time phases was significantly different from that after surgery (P < 0.05); but, the blood perfusion was decreased immediately after surgery, which was still significantly compared with traditional pedicle division group (P < 0.05). There was no significant different in blood perfusion between early pedicle division and immediate after surgery of pedicle division (P > 0.05), but there was significant difference between 24 hours after pedicle division and immediate after surgery of pedicle division (P < 0.05). Blood perfusion values were less changed in both groups (P > 0.05). The ratio of both groups peaked before pedicle division and then gradually decreased after pedicle division. The best timing of pedicle division was the ratio of 1.2. Related Articles | Metrics

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Relevant factors for severe neurologic complications after coronary artery bypass grafting Yan Yi-guang, Wang Dong-jin, Wu Zhong, Li Qing-guo, Zhou Qing 2010, 14 (18):  3359-3362.  doi: 10.3969/j.issn.1673-8225.2010.18.031 Abstract ( 369 )   PDF (317KB) ( 504 )   Save BACKGROUND: Neurological complications after coronary artery bypass grafting still have a high incidence rate, and the etiology is multiple. OBJECTIVE: To retrospectively investigate the occurrence and relevant factors of severe neurological complications after coronary artery bypass grafting (CABG). METHODS: A total of 761 consecutive patients with undergoing CABG were included in this study from September 2002 to August 2009 at the Nanjing Drumtower Hospital, including 443 males and 318 females, aged from 32-89 years. All patients were grouped according to age(more than or less than 70-year-old) and on pump or off pump coronary surgery. Disclose the relationship between the risk factors and the neurological complications by statistics analysis. RESULTS AND CONCLUSION: Totally 41 patients had serious neurological complications in this study. There was a higher complication incidence in ≥70-year-old group patients (n =22) than < 70-year-old group (n =19)(14.9% vs. 3.1%, P < 0.001). The neurological complications incidence was similar in on-Pump CABG group (n =7) and off-Pump CABG group (n = 34) (5.3% vs. 5.4%, P=0.39). The incidence rate of severe neurological complications was high in carotid artery stenosis > 50% patients. A total of 8 cases died, 2 for massive hemorrhage of gastrointestinal tract; 1 for severe sepsis; 4 for multiple organ dysfunction syndrome; 1 for epilepsia gravior postoperatively. Finally, 33 cases survived. The average time of follow up was 3 years, 3 cases died, 3 cases recovery from limitation of limb or hand movement partly, and 1 case had severe mental retardation. Results displayed that elderly patients(≥ 70 years) undergoing CABG are at higher risk of neurological dysfunction. Carotid artery stenosis is the most risk factor. There are no significant effects on postoperative complications between on-pump CABG and off-pump CABG. Related Articles | Metrics

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Transplantation of autologous costal cartilage to repair post-traumatic saddle nose deformity in 21 cases Chen Nian, Deng Ying, Li Ming, Zeng Li, Xie Hong-ju 2010, 14 (18):  3363-3366.  doi: 10.3969/j.issn.1673-8225.2010.18.032 Abstract ( 306 )   PDF (385KB) ( 546 )   Save BACKGROUND: The soft tissues would shrink with nasal framework collapse following surgical trauma, which cause aseptic inflammation, lead to parts of cartilage resorption. Accordingly, long-term saddle nose deformity usually accompanied by short nasal columella. Complications such as skin perforation or ulceration would appear if corrected the deformity using medical silicone rubber with large tension. OBJECTIVE: To explore the effectiveness of repairing post-traumatic saddle nose deformity with autologous costal cartilage transplantation. METHODS: A total of 21 cases with post-traumatic saddle nose deformity accompanied by short nasal columella were selected, including 6 males and 15 females, aged 16-45 years. All of the cases had trauma history and agreed with the treatment. The costal cartilage was obtained from the seventh rib and formed to babylon weeping willow leaf shape and columella nasi stent to repair post-traumatic saddle nose deformity. The “V-Y” progradation suture was used in the philtrum introcession and the bottom of nasal columella to extend the nasal columella. The recovery of saddle nose deformity after transplantation, discharge of transplanted cartilage, as well as the incision scar status was observed. RESULTS AND CONCLUSION: The results were satisfactory and there were no complications after transplantation. All the cases were followed up from 6 months to 2 years. No case suffered costal cartilage grafts discharge or chondral deformation. The scar was little at the bottom of nasal columella. It is an ideal method for repairing post-traumatic saddle nose deformity using transplantation of autologous costal cartilage with “V-Y” progradation suture. Related Articles | Metrics

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Meniscus injury repair by xenogenic or tissue-engineered meniscus replacement therapy Wang Ze-jin, Huang Hua-yang, Li Ping-yue, Zhang Tao 2010, 14 (18):  3369-3372.  doi: 10.3969/j.issn.1673-8225.2010.18.034 Abstract ( 222 )   PDF (551KB) ( 1765 )   Save BACKGROUND: Meniscus injury is a common sports injury of knee joint. Severe meniscus injury is difficult for clinical treatment due to the blood supply features. Effective repair of meniscus injury can prevent osteoarthritis of knee joint. OBJECTIVE: To review meniscus injury repair and transplantation replacement treatment of meniscus injury. METHODS: A computer-based online search of CNKI (www.cnki.net) and Medline database (www.pubmed.com) was performed for related articles published between January 2000 and March 2009, with the keywords “meniscus, repair, transplanted replacement therapy” in Chinese and English. Unrelated and repetitive studies were excluded. A total of 29 articles were included. RESULTS AND CONCLUSION: There are a number of treatment for meniscus injury, and indications and appropriate repair methods are very important. Xenogenic meniscus transplantation and tissue-engineered meniscus provide novel approach for meniscus injury repair, in particular the repair of avascular zone. However, the two methods require validation of immunology, epidemiology, anatomy, biomechanics, and clinical effect. Related Articles | Metrics

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A retrospective analysis of 23 out of 1 160 cases with ureteral complications following renal transplantation from the same center within ten years Li Xiang-tie, Yang Xian-zhen, Zhang Ai-min, Hao Jun-wen, Li Shen-qin, Liu Shao-ge, Xu You-he, Liu Yang-dong, Liu Yi, Song Hua, Shi Yan, Shen Yi-zhen, Lin Chang-sheng 2010, 14 (18):  3373-3376.  doi: 10.3969/j.issn.1673-8225.2010.18.035 Abstract ( 367 )   PDF (351KB) ( 450 )   Save BACKGROUND: Ureteral obstruction is mainly caused by surgical technic, ischemic, and peripheral lesion compression as well as rejection; in particular, the surgical technic factor is the most important. How to effectively reduce ureteral complications following renal transplantation is significant for prompt diagnosis and clinical treatment. OBJECTIVE: To retrospectively analyze the diagnosis of 23 cases with ureteral complications following renal transplantation, and to summarize pathogeny and preventing management. METHODS: The retrospective analysis was conducted on 23 (1.98%) out of 1 160 cases with ureteral complications following renal transplantation who were selected from General Hospital of Jinan Military Area Command of Chinese PLA from January 1998 to December 2008. In 924 cases of renal transplantation with cadaver kidneys, ureteral stenosis occurred in 18 cases (1.95%), while in 236 cases with relative kidneys, ureteral stenosis occurred in 5 cases (2.12%). A total of 17 cases were performed with ureterovesicostomy; 2 with uretero-autoallergic anastomosis of ureter; 1 with cutaneous ureterostomy; 1 with ureteral liberation, resetting ureteric branch stand; 1 with saccule dilation; 1 with retrograde ureteric branch stand under cystoscope. Type-B ultrasonic examination was re-checked to determine pyeloureterectasis following treating ureteral complications. RESULTS AND CONCLUSION: Of the 23 cases, stenosis of ureterovesical junction occurred in 19 cases, necrosis of the ureter on 2 cases, and twisting of ureter graft on 2 cases. Following up was performed after treatment for 3-98 months. In 20 cases, renal pelvis and urinary bladder of transplanted kidney were smooth, and function was recovered remarkably. At 4 days after surgery, serum creatinine level was decreased, and no recurrence was rechecked postoperatively. One patient had skin stoma for 8 years at least postoperatively, and the renal function was still normal. The skin stoma was replaced regularly. Therapeutic effect was poor in a patient with distension and 1 with detaining ureteric branch stand, and patients still had stricture of ureter, which was treated by a surgery. The results demonstrated that the etiology of ureteral obstruction after kidney transplantation was complex, and stenosis of ureterovesical junction was most common. Most of obstruction request surgical management. The graft function and the long-term graft survival were not affected by a correctly treated ureteral obstruction. Related Articles | Metrics

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Cyclosporin A withdrawal following respective development of bladder carcinoma and autologous renal pelvic carcinoma at 11 and 18 years after renal transplantation in one case: Stability of renal function at 12 weeks following drug withdrawal Zhan Sheng-li, Cai Ming, Shi Bing-yi, Li Zhou-li, Wei Xing, Liang Tao, Li Peng-cheng, Liu Chang 2010, 14 (18):  3377-3380.  doi: 10.3969/j.issn.1673-8225.2010.18.036 Abstract ( 275 )   PDF (492KB) ( 385 )   Save BACKGROUND: Removal of immunosuppressants in patients with recurrent tumor in long-term following organ transplantation is always a hot controversial point in academic circles. To further elevate clinical efficiency, people began to invent new immunosuppressant and studied immune efficiency of various immunosuppressant component. They tried to reduce the application of cyclosporin A (CsA). OBJECTIVE: To analyze the CsA safe withdrawal of a case of kidney recipients, at 18 years after renal transplantation, who developed bladder carcinoma and renal pelvic carcinoma at 11 years and 18 years after transplantation, respectively. METHODS: After identified diagnosis, we performed transurethral resection of bladder tumor (TURBt) and total nephro- ureterectomy merobladder excision. Pathologic examination revealed grade Ⅰ-Ⅱ of bladder and renal pelvic transitional cell carcinoma. After the operation, patient was treated with immune suppression program of CsA withdrawal gradually in 12 days. Within 12 days, 5 mg CsA was decreased every 3 days, and complete withdrawal was done at 12 days. The dosage of azathioprine tablets and prednisone acetate tablets was not changed. Serum creatinine levels were rechecked every 3 days during drug withdrawal, and blood pressure, urine volume, physical symptom of patients and ultrasound of transplanted kidney were observed. RESULTS AND CONCLUSION: During the three months of CsA withdrawal, the blood creatinine levels were from 65 to       70 μmol/L; urinary volume was 2 500-3 000 mL every day. There was no acute rejection or tumor relapse, diversion. These indicated that the CsA gradually withdrawal of a case of kidney recipients after renal transplantation, who developed transitional cell carcinoma and was performed transurethral resection of bladder tumor (TURBt) and total nephro- ureterectomy merobladder excision, was safe. No tumor relapse or diversion was found. Related Articles | Metrics

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Curative effect of transplantation of brachial triceps long head branch from radial nerve in restoration of anterior branch of axillary nerve: Functional analysis in 13 cases Xu Ming-zhu, Li Chun-yu, Zhang Wei-zhong, Sun Hong-bin, Cui Shu-sen 2010, 14 (18):  3381-3384.  doi: 10.3969/j.issn.1673-8225.2010.18.037 Abstract ( 376 )   PDF (423KB) ( 438 )   Save BACKGROUND: Injury of axillary nerve leads to the inability of abduction in the upper limb which needs surgery treatment. However, which way of operative approach is more preferable is still uncertain. Whether one-stage posterior operation of nerve transfer can achieve better effects remains unclear, the choice of approach method is an argument. OBJECTIVE: To explore the therapeutic effect of the transposition operation of the branch to long head of triceps branchii to recover the anterior branch of axillary nerve that can restore the function of deltoid muscle and refrain from the deprivation of function to extend elbow. METHODS: A total of 13 cases with axillary nerve injury without any recovery sign admitted at the Department of Hand Surgery, China-Japan Union Hospital of Jilin University were selected, including 11 males and 2 females, aged 18-55 years, mean aged 28.4 years; Under 10-times operating microscope, the anterior branch of axillary nerve was chosen to coincide the branch to long head of triceps branchii in use of 11-0 atraumatic nylon in posterior approach. The standard issued by the Hand Surgery Society of Chinese Medical Association was adopted to assess the upper limb function postoperatively. RESULTS AND CONCLUSION: All patients were followed-up for 6-53 months with an average of 21 months. All incisions after surgery gain primary healing. The function of shoulder abduction had recovered in some degree. Among of total, 7 cases had deltoid strength of M4 or even more; 4 cases had deltoid strength of M3; one had M2 and one had M1. The effective rate was 92%, and excellent rate was 85%. There was no impact on the extension of elbow in all cases. It was a reliable and convenient technique to recover shoulder abduction with the branch to long head of triceps brachii from radial nerve in restoration of the function of deltoid muscle. It was beneficial to the restoration of axillary nerve with partially injured brachial plexus, and severe quadril. Related Articles | Metrics

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Three different tissue transplantation methods for repairing traumatic nail bed defects in one stage: A follow-up comparison among 40 cases with 51 finger nail beds Zhang Yang, Zhou Hui, Zhang Yan, Wang Xu-liang, Zhang Yan, Zhong Wei-min, Chen Ke, Zhou Hai-ying, Li Fang, Shu Ling-xia 2010, 14 (18):  3385-3388.  doi: 10.3969/j.issn.1673-8225.2010.18.038 Abstract ( 624 )   PDF (399KB) ( 584 )   Save BACKGROUND: Treatment methods for defects of fingertip skin or soft tissue combined with partial deletion bed include the phalanx shortening or flap coverage of wounds, each with shortcomings. OBJECTIVE: To investigate the efficacy of repairing finger nail bed defects by different treatments in one stage, and to evaluate the functional recovery of nail beds comprehensively. METHODS: From December 2002 to February 2009, 51 fingers with nail bed defects in 40 patients (11 thumbs, 22 index fingers, 14 middle fingers, 4 ring fingers) were repaired. Under the situation that the periosteum exist, when the area of nail bed defect area was less than one third of the nail, the graft was taken from the same finger. If the area of nail bed defects were larger than one third of the nail or two nail bed defects, the grafts were taken from the nail beds of 1st or 2nd toes. Under the situation that the periosteum nonexist, when the area of nail bed defect area was less than one half and more than one third of the nail, the split tissue flap was transferred from the same finger. The finger appearance and functions were observed in the follow-up. RESULTS AND CONCLUSION: All patients were followed up from 1 month to 2 years with an average of 6 months, 86.3% grafts survived very well, no pain, no infection and obvious deformed growth of nail were found. It revealed that using different treatment to repair nail bed defect is available. The grafted nail can grow in good appearance, and finger can act in good function. Related Articles | Metrics

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Peritonitis complicated with continuous ambulatory peritoneal dialysis: Analysis of 108 cases in 3 years Wang Qing-hua, Yuan Fang, Li Qiang-xiang, Zhang Zhuo, Chen Jing-jing 2010, 14 (18):  3389-3392.  doi: 10.3969/j.issn.1673-8225.2010.18.039 Abstract ( 270 )   PDF (433KB) ( 578 )   Save BACKGROUND: Peritonitis is the common detective complications at the end-stage of renal failure patients during continuous ambulatory peritoneal dialysis (CAPD) treatment, which easily repeatedly occurred if not handled properly. Although the plumbing designs of peritoneal dialysis have done a lot of effort and improved in recent years, it still hard to avoid.  OBJECTIVE: To explore the relative factors and treatments of infectious peritonitis complicated with CAPD. METHODS: Totally 115 cases received CAPD were selected, including 55 males and 60 females, aged (56.2±8.7) years. 68 cases of which were suffered infectious peritonitis, aged (58.5±8.3) years. All received a (30.3±5.5)-month CAPD treatment. The relative factors such as the nutrition situation, whether complicated with diabetes mellitus or not, culture background, domestic environment, whether operating by special person and so on were investigated, and the relationship between those factors and infectious peritonitis were analyzed. The pathogen method was used to check pathogenic bacteria, and those patients were treated with irrigation of abdominal cavity and antibiotics in two ways, that is, systemic and intra-abdominalcavity. Hemodialysis instead of CAPD was used in those infectious peritonitis patients. RESULTS AND CONCLUSION: Those patients with good nutrition situation, higher culture background, better domestic environment, and operating by special person had low chances to infect peritonitis. And those patients with diabetes mellitus had high chances to infect peritonitis. Treatments of abdominal cavity and anti-infection in two ways-systemic and intra-abdominal cavities were effective to those infectious peritonitis patients. Gram-positive bacteria were the most common pathogen, which were susceptive to vancomycin and cefazolin. If the pathogen was gram-negative bacteria, etimicin sulfate, amikacin, and imipenem cilastatin could be selected. Infectious peritonitis complicated with CAPD affected by many factors. CAPD patients should be provided better nutrition and domestic situation. Also patients should operate in aseptic ways. Doctors should choose proper patients who can operate CAPD right. Related Articles | Metrics

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Investigation and analysis of consciousness of cornea donation in Chengde city Deng Zhi-hong, Dong Wei-li, Cui Feng-mei, Jia Shu-jun, Li Chun-yan, Xu Xue-mei 2010, 14 (18):  3393-3396.  doi: 10.3969/j.issn.1673-8225.2010.18.040 Abstract ( 298 )   PDF (545KB) ( 474 )   Save OBJECTIVE: Chengde is a city with many corneal blindness patients in north China. Lacking of corneas donation is the main reason which prevents corneal transplantation. Survey was made by questionnaire in Chengde to evaluate the current situation and the influential factors of corneal donation. METHODS: Survey was made in 3 200 Chengde residents aged 18 years or older, includes outpatients and inpatients of ophthalmology, some undergraduate students and people met accidentally in park, supermarket, station and centre for elders. 48.6% are male and 51.4% are female. Self-made questionnaire includes general state, questions about cornea donation and factors influencing cornea donation. RESULTS: Among 3 200 questionnaires, 2 971 were valid. The effective rate was 92.84%. Over 50% people support donating cornea. More than 40% people intend to donate their corneas and support their relatives to donate. Among the factors for not intending to donate cornea, lacking knowledge of cornea donation was the main reason accounting for 42.81%, and worrying about the misusage of donating cornea without corresponding law became the second factor, which accounting for 21.07%. It has no influence on the consciousness of cornea donation by the difference of sex and location between city and countryside. Whereas, age, profession and level of education indeed influence the consciousness of cornea donation, which of the people from 18 to 40 years old was greater than those of over 40, medical workers was greater than those from other fields, the people graduating from secondary specialized school or higher was greater than those graduating under secondary specialized school. CONCLUSION: People in Chengde have a positive attitude towards cornea donation. It is very necessary to enhance the education of cornea donation, establish an easy and smooth way for donation may promote cornea donating. Consummate legislation is also needed for cornea donation. Related Articles | Metrics

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Long-term therapeutic effect of liver transplantation in patients with hepatic myelopathy Du Guo-sheng, Lu Hong, Shi Bing-yi, Song Ji-yong, Jin Hai-long, Cai Ming, Qian Ye-yong,Zhu Zhi-dong 2010, 14 (18):  3397-3400.  doi: 10.3969/j.issn.1673-8225.2010.18.041 Abstract ( 335 )   PDF (178KB) ( 370 )   Save BACKGROUND: Hepatic myelopathy results from liver disease, which lacks of effective cure method. Liver transplantation has attempted to cure this disease; however, the long-term therapeutic effect is rarely reported. OBJECTIVE: To explore the long-term therapeutic effect of liver transplantation in patients with hepatic myelopathy. METHODS: The clinical data of 2 patients with hepatic myelopathy, who underwent orthotopic liver transplantation, in August 2002 and November 2004, at the 309 Hospital of Chinese PLA, were analyzed retrospectively. The time of follow-up was 18 and 43 months, respectively. The muscle strength of double lower limbs in 2 patients was assessed prior to and after operation. RESULTS AND CONCLUSION: Two patients recovered well at 4 weeks after transplantation, the clinical symptom and physical signs of patients were improved obviously, the blood routine examination and other biochemical index were normal, and the function of transplanted kidney was normal. Two patients discharged at 6 weeks after transplantation. Patient 1 could stand for a long time at months 6 after transplantation, walked slowly with the supporter after 12 months and without the supporter at 43 months. The muscular strength of two lower limbs was grade 4. And the liver function was normal. Patients 2 could move his lower limbs in bed at months 6 after transplantation, walked with the supporter at 18 months. The muscular strength of two lower limbs was grade 3. The liver function was normal. It demonstrated that liver transplantation is beneficial to control hepatic myelopathy and recover muscular strength of two lower limbs. It is a newly developed, effective curing method for treating hepatic myelopathy. However, the numbers were small with short time observation, thus, the long-term therapeutic effect still need to be explored. Related Articles | Metrics

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Holoprotein expression in four biliary cast syndrome patients after liver transplantation Zhu Xiao-dan, Shen Zhong-yang, Zang Yun-jin, Liu Feng, Wang Hong-li 2010, 14 (18):  3401-3404.  doi: 10.3969/j.issn.1673-8225.2010.18.042 Abstract ( 272 )   PDF (147KB) ( 528 )   Save BACKGROUND: The formation mechanism of biliary cast syndrome following liver transplantation has not been thoroughly illuminated, and it is unclear that whether some proteins correlated to the formation mechanism of biliary cast or prewarning to the formation of biliary cast. OBJECTIVE: To investigate the holoprotein expression in biliary cast syndrome patients following liver transplantation. METHODS: Four patients underwent liver transplantation at Liver Transplantation Institute, General Hospital of Chinese People's Armed Police Force. Three months later, 10 g biliary cast was harvested. Four kinds of biliary cast specimens at different colors and textures were preserved at deep hypothermia, followed by protein abstraction and restriction enzyme digestion, the total protein abstraction solution of biliary cast were analyzed by high definition mass spectrometry and query on MASCOT database. All protein name of biliary cast were list, the conjunct protein was found by comparing 4 specimens. RESULTS AND CONCLUSION: There were totally 208 proteins in 4 biliary cast specimens, 82, 44, 56 and 65, respectively. By comparison, 5 proteins were found to overlay in 2 biliary cast specimens, 7 proteins in 3 specimens and 13 proteins in 4 specimens. Among the latter 13 proteins, 5 unnamed-proteins, as well as 8 named-proteins (termed alpha-fibrinogen precursor, beta-fibrinogen precursor, fibrinogen gamma chain, proapolipoprotein, Chain A of Human Cathepsin G, S100 calcium-binding protein A9, lactoferrin) were included. The proteins exists in biliary cast, the common proteins of 4 biliary cast specimens imply a correlation between the formation of biliary cast and the exudative inflammation following the damage of biliary tract epithelium; Some proteins might be considered as a marker of prewarning the presence of biliary cast syndrome, judging the inflammation severity following the damage of biliary tract epithelium and the prognosis of biliary cast syndrome Related Articles | Metrics

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Cell-mediated immune response of tilapia-to-rat hepatocyte xenotransplantation Zhou Zhu-qing, Zhao Zhong-xin, Yong June-Kong, Zhu Zhe 2010, 14 (18):  3405-3407.  doi: 10.3969/j.issn.1673-8225.2010.18.043 Abstract ( 279 )   PDF (284KB) ( 411 )   Save BACKGROUND: Many scholars attempt to xenotransplantation because of shortage of human donor hepatocytes. In the field of hepatocyte xenotransplantation, two different mammalian species, i.e., pig-to-rat, and pig-to-rodent, are much reported. Hepatocyte transplantation between two different classes has been rarely reported. OBJECTIVE: To investigate the mechanisms of cell-mediated immune response in hepatocytes xenotransplantation between tilapia and rat. METHODS: The tilapia (donor) hepatocytes were isolated by collagenase cold digestion and adjusted to 2×107 /mL using physiological saline. Thirty-six SD (recipient) rats were randomly divided into transplantation and control groups (n = 18). Rats from the control group received injection of physiological saline into the spleen, and those from the transplantation group received injection of tilapia hepatocytes. At each time point (4 hours, 8 hours, 24 hours, 3 days, and 5 days) after transplantation, two rats were respectively sacrificed for histological changes examination using hematoxylin-eosin staining and detection of CD4+/CD8+ lymphocytes surrounding the grafts using immunohistochemical SABC method. RESULTS AND CONCLUSION: The transplanted hepatocytes were rejected a few hours after transplantation. Surviving hepatocytes in spleens were hardly seen 8 hours after transplantation. The aggregation of CD4+/CD8+ lymphocytes was detected surrounding the grafts 4 hours after transplantation. These findings suggest that tilapia hepatocytes transplantation into rat spleen induces rejection within a few hours, cell-mediated immune response is involved in the rejection of hepatocytes xenotransplantation, and natural killer cells may play an important role in this kind of rejection. Related Articles | Metrics

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Clinical efficacy and safety of conversion from cyclosporine A to tacrolimus-based regimen for different pathological types of chronic allograft nephropathy patients Gao Sen, Gao Yi, Liu Yong-guang, Liu Ding, Guo Ying 2010, 14 (18):  3408-3411.  doi: 10.3969/j.issn.1673-8225.2010.18.044 Abstract ( 325 )   PDF (221KB) ( 465 )   Save BACKGROUND: Recent studies have suggested that conversion from cyclosporine A (CsA) to tacrolimus (FK 506)-based regimen can improve renal allograft function and survival rate. But little is known about whether the conversion from CsA to tacrolimus(FK 506) plus mycophenolate mofetil (MMF)-based regimen exhibits the same or similar clinical efficacy. OBJECTIVE: To investigate the clinical efficacy and safety of converting CsA to FK506 plus MMF in treatment of different types of chronic allograft nephropathy (CAN). DESIGN, TIME AND SETTING: An observational and controlled trial was performed at the Center for Organ Transplantation, Zhujiang Hospital, Southern Medical University from January 2005 to October 2007. PARTICIPANTS: Fifteen-nine enrolled patients received CsA-based regimen after renal allografting. Following pathological confirm and typing, all patients were assigned to two groups: CAN with chronic rejection (CR, n = 31) and CAN without chronic rejection (non-CR, n = 28). FK 56 was purchased from Fujisawa Pharmaceutical Company, Ltd., Japan. MMF was sourced from Shanghai Roche Pharmaceutical Co., Ltd., China. METHODS: When patients were diagnosed CAN, the CsA regimen was conversed to FK506 plus MMF regimen. FK506 initiated at a dose of 0.08 mg/kg per day and then was adjusted to achieve steady-state whole blood trough levels of approximately 5-8 µg/L. MMF was used at a fixed dosage, 1.0 g/d, twice a day, only if relative adverse events occurred. All patients were followed up at least 6 months.  MAIN OUTCOME MEASURES: Serum creatinine(Scr), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), 24-h proteinuria, glomerular filtration rate (GFR), and complications. RESULTS: All initial 59 patients were included in the final analysis. At 6 months after regimen conversion, the levels of Scr, TC, TG, LDL, and 24-hour proteinuria were significantly reduced in non-CR, in particular CR, groups, compared with prior to conversion (P < 0.05). GFR was markedly increased in both the CR and non-CR groups (P < 0.05). In the CR group, 20 patients obtained improved results, 7 got stable results, and 4 showed ineffective results. The effective rate of regimen conversion was 64.5% and 32.1% in the CR and non-CR groups, respectively, and significant difference existed between the two groups (P < 0.05). Compared with prior to conversion, the incidence of hypertension and hyperlipemia was significantly decreased after regimen conversion (P < 0.05). There was no significant difference in diabetes mellitus, opportunistic infection, and malignancy between prior to and after regimen conversion. CONCLUSION: FK506 plus MMF-based regimen can markedly improve the function of renal graft of CAN, in particular CR, patients.    Related Articles | Metrics

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Transplantation of artificial bone with autologous bone marrow combined with iliac periosteum for treatment of refractory bone nonunion in limbs Comparison to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation Ge Jian-hua, Zhuo Nai-qiang, Lu Xiao-bo, Zhang Zhong-jie, Chen Ge 2010, 14 (18):  3412-3416.  doi: 10.3969/j.issn.1673-8225.2010.18.045 Abstract ( 428 )   PDF (273KB) ( 371 )   Save BACKGROUND: Autologous bone marrow is the only tissue that contains abundant osteoinductive osteogenitor cells and is the first-choice transplantation materials for treatment of bone nonunion. Artificial bone with osteoinductive capacity can provide a supporting effect for the in-growth of osteocytes. Iliac periosteum can be used for treatment of bone nonunion due to the advantages including abundant blood circulation, easy harvesting, and able to improve local arterial blood supply.  OBJECTIVE: To treat refractory bone nonunion in limbs using artificial bone with autologous bone marrow combined with iliac periosteum transplantation, and to compare the therapeutic efficacy to artificial bone with autologous bone marrow transplantation and simple iliac periosterum transplantation.  METHOD: Thirty-nine refractory bone nonunion limbs from 36 patients were assigned to three groups: artificial bone with autologous bone marrow combined with iliac periosteum transplantation (combination group, n = 19), artificial bone with autologous bone marrow (bone marrow group, n = 9), and autologous iliac periosteum (iliac periosteum group, n = 11). The time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score were evaluated. RESULTS AND CONCLUSION: All initial 39 limbs acquired bone union and were followed up for an average period of 18.5 months. The combination group yielded better therapeutic effects than the bone marrow group and the iliac periosteum group in terms of the time for bone healing, limb function score 1 month after fixture removal, and postoperative X-ray score (P < 0.05). These findings indicate that artificial bone with autologous bone marrow combined with iliac periosteum transplantation exhibits better clinical therapeutic effects in treatment of refractory bone nonunion in limbs. Related Articles | Metrics

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Analysis on biliary complications after orthotopic liver transplantation using biliary tract endoscopy Yang Yu-long, Liu Zhen-wen 2010, 14 (18):  3417-3420.  doi: 10.3969/j.issn.1673-8225.2010.18.046 Abstract ( 304 )   PDF (177KB) ( 444 )   Save BACKGROUND: Biliary complications are a common cause of death in patients after liver transplantation, biliary endoscopic minimally invasive technique is gradually becoming an important tool to solve biliary complications following orthotopic liver transplantation. OBJECTIVE: To analyze the literatures on the biliary tract complications after liver transplantation, and to demonstrate a clear role of bile duct endoscopy in biliary complications. METHODS: Using “orthotopic liver transplantation, biliary complications, biliary tract, endoscope technique” in English for the search term, Pubmed database were searched between January 1980 and October 2008; Using “liver transplantation, biliary complications, bile duct cast, cholangioscopy” in Chinese for the search term, Vip Chinese Periodical Database and CNKI database were searched between 1994 and January 2009. Literature language was limited to English and Chinese. The studies related to bile duct injury-caused biliary complications after liver transplantation were included, while other research unrelated to biliary complications after liver transplantation were excluded. RESULTS AND CONCLUSION: A total of 52 literatures were screened out by the primary computer inspection, according to inclusion and exclusion criteria, 30 ones were involved for analysis. Biliary complications and vascular complications are considered as a common cause of death in patients after liver transplantation, particularly in biliary complications has become the major reason limiting the development of liver transplantation. Because of the difficulties on early recognition and treatment, the importance of the treatment for the complications in liver transplant patients is increasingly attracting more and more attention. Endoscopic operation technology and their subsidiary parts are improving, particularly therapeutic endoscopic retrograde cholangiopancreatography and biliary mirror technology are developing and continuously improving, biliary endoscopic minimally invasive technique is gradually becoming a major approach to solve biliary complications after orthotopic liver transplantation, The minimally invasive endoscopic diagnosis and treatment is an intuitive, reliable and credible means for the biliary complications after liver transplantation, serving as the most preferred method for diagnosing and treating biliary complications after liver transplantation. Related Articles | Metrics