Table of Content

30 July 2010, Volume 14 Issue 31 Previous Issue    Next Issue

For Selected:

Download Citations EndNote Reference Manager ProCite BibTeX RefWorks

Toggle Thumbnails

Select

Value of 64-slice spiral computerized tomography for three-dimensional reconstruction in renal transplantation Nie Zhong-shi, Li Chuan-zi, Xiao Jing-zhu, Che Xian-ping, Zhang Guo-qing 2010, 14 (31):  5701-5704.  doi: 10.3969/j.issn.1673-8225.2010.31.001 Abstract ( 320 )   PDF (707KB) ( 438 )   Save BACKGROUND: In recent years, some researchers began to apply a relatively non-invasive multi-slice spiral computerized tomography (CT) to replace digital subtraction angiography (DSA) to evaluate renal anatomy and function of kidney transplantation, but the relevant reports mainly focused on that in the 16-slice (or below) spiral CT, few on the 64-slice spiral CT. OBJECTIVE: To evaluate the value of 64-slice spiral CT three-dimensional reconstruction in donor and recipient kidney for renal transplantation. METHODS: Seven patients who were voluntary to donate their one kidney to their relatives and 6 patients who were about to receive kidney from others were done plain CT scan, arterial phase, venous phase and delayed phase enhanced scanning, and enhanced scanning periods were processed with three-dimensional reconstruction techniques including multiplanar reconstruction, volume rendering technique, maximumintensity projection and curved projection reconstruction. RESULTS AND CONCLUSION: In 7 donors, according to CT angiography, one renal artery in each side of the kidneys was presented in 4 cases, two renal arteries in the left kidney and one in the right in 1 case, three renal arteries in the left kidney and two renal arteries in the right in 2 cases; one renal vein and one set of renal pelvis and ureter were presented in both left and right kidney in all cases. MPR reconstruction showed left renal cyst in 1 case, kidney functions were normal in all cases according to CT urography. The above mentioned results shown by 64-slice spiral CT three-dimensional reconstruction were all proven by surgery. In recipients, according to CT angiography, renal artery, vein and ureter were no stricture and fistula in all 6 cases. CT scanning of 4 cases of the transplanted kidneys showed normal size, normal shape and density. Arterial phase enhanced scanning showed clear boundaries in renal cortex and renal medulla, and CT values were greater than 150 HU. Venous phase enhanced scanning showed the renal parenchyma uniform, CT urography showed urinary function normal. Artery enhanced scanning of 2 cases of the transplanted kidney showed unclear boundaries in renal cortex and renal medulla, CT values less than 100 HU. Venous phase enhanced scanning showed the kidney parenchyma were weak, delayed 10-minute scanning showed only a small amount of contrast medium excretion, which confirmed rejection by renal biopsy. 64 slice spiral CT three dimensional reconstruction can basically replace other imaging examinations before and after renal transplantation, and can be the best option for renal transplantation. Related Articles | Metrics

Select

Urinary neutrophil gelatinase-associated lipocalin and interleukin-18 in the predictive diagnosis of early graft disfunction following renal transplantation Huo Wen-qian, Jin Feng-shuo, Nie Zhi-lin, Li Qian-sheng, Zhu Fang-qiang, Zhang Ke-qin 2010, 14 (31):  5705-5708.  doi: 10.3969/j.issn.1673-8225.2010.31.002 Abstract ( 343 )   PDF (702KB) ( 451 )   Save BACKGROUND: Delayed renal graft function is a common complication of renal transplantation. Therefore, the predication etiological diagnosis is important for early treatment. Urinary neutrophil gelatinase-associated lipocalin (NGAL) and interleukin (IL)-18 have been proved to be specific and susceptible markers for the diagnosis of acute renal tubule injury. However, the role of NGAL and IL-18 in the prediction or etiological diagnosis of early graft disfunction following renal transplantation remains uncertain.   OBJECTIVE: To investigate the value of the urinary NGAL and IL-18 for the prediction or etiological diagnosis of early graft disfunction in renal transplantation. METHODS: The urinary NGAL and IL-18 of the first 24 hours in 71 patients following renal transplantation were detected by enzyme linked immunosorbent assay (ELISA). The patients were divided into 2 groups including 41 cases of immediate graft function and 30 cases of graft disfunction. The graft disfunction group were subdivided into acute tubular necrosis (ATN, n=18) and acute rejection (AR, n=12) according to the origin of graft disfunction, and they were divided into slow graft function (SGF, n=16) and delayed graft function (DGF, n=14) according to the type of graft function. The clinical significance was evaluated by analyzing the correlation of urinary NGAL or IL-18 and the recovery of graft function. RESULTS AND CONCLUSION: The urinary NGAL or IL-18 of all patients were significantly increased following renal transplantation, but the graft disfunction group was significantly greater than the immediate graft function group. For cases of graft disfunction, the level of IL-18 in AR group was significantly greater than ATN group (P < 0.01), but the level of NGAL was of no significant difference between the two groups (P > 0.05). However the level of NGAL of SGF group was significantly greater than the DGF group (P < 0.01), and the level of IL-18 was similar in the two groups (P > 0.05). Results show that urinary NGAL and IL-18 are useful for predicting the early graft function after renal transplantation. Moreover, high urinary IL-18 can help to the diagnosis of AR and high NGAL may suggest the recovery capability of graft function. Related Articles | Metrics

Select

Early application of Mycophenolate Mofetil dispersible tablets following in vivo living related renal transplantation: Comparison with Mycophenolate Mofetil capsules Zhang Yan-xuan, Qu Qing-shan, Miao Shu-zhai, Xing Li, Wang Zhen-pu, Chen Peng　 2010, 14 (31):  5709-5712.  doi: 10.3969/j.issn.1673-8225.2010.31.003 Abstract ( 377 )   PDF (378KB) ( 555 )   Save BACKGROUND: Pharmacokinetics of healthy volunteers and patients undergoing renal transplantation shows that Mycophenolate Mofetil enteric coating tablets, dispersible tablets, and capsule display identical biological effects. However, the clinical effects remain unclear. OBJECTIVE: To observe the effects and safety of cycopin (Mycophenolate Mofetil Dispersible Tablets) in combination with Cyclosporine A (CsA) and prednisone (Pred) as triple regimen for immunosuppressive therapy after living related renal transplantation. METHODS: A total of 90 recipients of living related renal transplantation were randomized into two groups. In the study group, 45 patients were treated with cycopin, CsA and Pred. In the control group, 45 patients were treated with Cellcept (Mycophenolate mofetil capsule), CsA and Pred. The same concentration ranges of CsA were controlled in two groups. The use of prednisone was the same in two groups. Cycopin and Cellcept (body mass ≤ 70 kg, 0.5 g; body mass > 70 kg, 0.75 g) was taken two times a day. Any adverse event and the laboratory results were recorded and analyzed. RESULTS AND CONCLUSION: All patients finished this study. The 6-month patient and graft survival rates in two groups were 100%. Only one case suffered from acute rejection respectively in each group. But the rejections were reversed by methylprednisolone. The difference of adverse event, the blood concentrations of triglyceride, total cholesterol and the level of serum creatinine in two groups were not significant. Cycopin is an effective and safe immunosuppressive drug for in vivo kidney transplantation and allows reducing the cost of drug. Related Articles | Metrics

Select

Effect of preoperative dialysis time on ocular complications in renal transplant recipients Zhang Di, Shang Wen-jun, Feng Gui-wen, Wang Li-ya 2010, 14 (31):  5713-5716.  doi: 10.3969/j.issn.1673-8225.2010.31.004 Abstract ( 400 )   PDF (512KB) ( 743 )   Save BACKGROUND: The ocular complications in renal transplant recipients are concerned with the age, primary diseases, accumulation of the toxic substances in vivo and long-term application of the immune depressant. It is to be authenticated the effect of preoperative dialysis time on ocular complications in renal transplant recipients. OBJECTIVE: To study the effect of preoperative dialysis time on ocular complications in renal transplant recipients. METHODS: Clinical data of 159 patients underwent renal transplantation were analyzed, including 108 male and 51 female, aged (40.3±8.7) years. The duration of renal transplantation was (3.8±2.1) years, and the time of preoperative dialysis was (2.7±1.9) years. There were 81 patients with cadaveric renal transplantation and 78 patients with living related renal transplantation. The relationship between the preoperative dialysis time and ocular complications after renal transplantation was investigated by chi-square criterion.  RESULTS AND CONCLUSIONS: There were 83 patients (52.2%) who had at least one ocular complication. There was no obvious abnormality in the rest 76 patients (47.8%). The most frequent ocular complication was pinguecula and conjunctival degeneration (33.3%), subsequent to catatact (26.3%), which showed a posterior capsule opacification. Four patients (3.5%) with glaucoma were open angle glaucoma. The examination of visual field showed paracentral scotoma for 1 patient, arcuate scotoma for 2 patients and nasal step for 1 patient. Preoperative dialysis time had a significant effect on the incidence of glaucoma in renal transplant recipients, the longer dialysis time results in high incidence rate. Related Articles | Metrics

Select

Living related donors versus cadaveric donors: Transplantation effect of 65:169 cases in the same center within 2 years Liang Tao, Cai Ming, Li Zhou-li, Shi Bing-yi, Wang Qiang, Zhan Sheng-li, Wang Shuang 2010, 14 (31):  5717-5720.  doi: 10.3969/j.issn.1673-8225.2010.31.005 Abstract ( 773 )   PDF (356KB) ( 712 )   Save BACKGROUND: The number of living donor kidney transplantation is greater than that of cadaveric kidney transplantation in some hospitals, however, the safety, superiority, surgical techniques, as well as the ethical issues of living donor kidney transplantation needs further explored. OBJECTIVE: To analyze the outcomes of kidney transplantation with different sources of kidney by reviewing clinical experience of the living donor and cadaveric donor kidney transplantation at the same periods. METHODS: Totally 65 cases received living donor kidney transplantation and 169 cases received cadaveric kidney transplantation from January 2002 to March 2008 in the Organ Transplantation Center, 309 Hospital of Chinese PLA, were collected. The data of recipients with different kidney sources, including gender, age, human leucocyte antigen-matching, surgery status, complications, immunosuppression scheme, kidney function and long-term follow-up were comparatively studied to clarify the clinical significance of living donor kidney transplantation． RESULTS AND CONCLUSION: All 65 cases of living donor kidney transplantation were successful, and the 1-year patient/graft survival rate was 100%．Cadaveric donor kidney transplantation was successful, 2 of which died of cerebral hemorrhage disease, 6 died of severe lung infection after 1 year, and the 1-year patient/graft survival rate was 95.26%. The living donor kidney transplantation was superior to the cadaveric donor kidney transplantation in complications and 1-year patient/graft survival rate and other factors. Living donor kidney transplantation provides a reliable means for patients with full preparation, good matching, few postoperative complications, and high patient/graft survival rate. Related Articles | Metrics

Select

Living-relative donor kidney transplantation versus cadaveric renal transplantation in 40 cases Luo Xiang-dong, Gao Hong-jun, Liang Tai-sheng, Wu Pei-zhong, Liang Fang-fang, Luo Huan, Yang Huan, Tan Zhen 2010, 14 (31):  5721-5724.  doi: 10.3969/j.issn.1673-8225.2010.31.006 Abstract ( 421 )   PDF (344KB) ( 515 )   Save BACKGROUND: It arouses increasing attention on the safety of donors and the transplant results with the growth of living-relative donor kidney transplantation. OBJECTIVE: To summarize the clinical experiences of 40 cases with living-relative donor kidney transplantation and to evaluate the effect and reliability. METHODS: Totally 40 cases received living-relative donor kidney transplantation at the Department of Transplantation and Urinary Surgery, Ruikang Hospital Affiliated to Guangxi Chinese Traditional Medicine College from June 2007 to August 2008 were included. The relevant clinical data of the donors and the recipients were reviewed and analyzed. Meantime, 40 cases received cadaveric renal transplantation at corresponding time period were selected as controls. The differences of recovery times of serum creatinine, occurrence rates of acute rejection, delayed graft function, related complication were compared. RESULTS AND CONCLUSION: The operating times of all donors were 1.0-2.0 hours, the warm ischemic time of donor kidney was about 15 seconds, and the cold ischemic times were 1.0-2.0 hours. No surgical complication and medical complication occurred during the peri-operation period. The kidney function of recipient recovered rapidly after operation. The urine volume in the first three days was 500-1 000 mL/h, and all of the creatinine levels could be restored to normal in 1 week. Up till now, all donors and recipients survived. Moreover, the functions of transplanted kidney were in normal range. Compared with the 40 cases with cadaveric kidney transplantation in the same period, the donors of living-relative donor kidney transplantation have more advantages in the following aspects: shorter recover time for creatinine, lower occurrence rates of acute rejection and delayed graft function after transplantation. Moreover, the living-relative donor kidney transplantation is charactered by shorter ischemic time of donor kidney and operative duration. The open operation in living donor nephrectomy also has the advantage of reliability. Related Articles | Metrics

Select

Preoperative evaluation for fatty liver before living donor liver transplantation Shi Rui, Jiang Wen-tao, Zhu Zhi-jun, Zheng Hong, Deng Yong-lin, Pan Cheng, Shen Zhong-yang 2010, 14 (31):  5725-5728.  doi: 10.3969/j.issn.1673-8225.2010.31.007 Abstract ( 362 )   PDF (369KB) ( 408 )   Save BACKGROUND: The condition of fatty liver has closely relationship with transplantation results in living donor liver transplantation. How to evaluate fatty liver with noninvasive method has great importance. OBJECTIVE: To evaluate the possibility and safety of body mass index (BMI), B ultrasound and CT examination in evaluating fatty liver graft before living donor liver transplantation. METHODS: The clinical data including 38 cases with living donor liver transplantation were retrospective analyzed. BMI, preoperative assessment of abdominal B ultrasound and CT were recorded and compared with intraoperative liver biopsy pathology reports. RESULTS AND CONCLUSION: The biopsy pathology showed that, there were 8 cases with mild fatty liver, and 3 cases with moderate fatty liver. According to the diagnostic criteria, namely, BMI ≥ 25 kg/m2 as mild fatty liver, there were 12 cases with fatty liver. Compared with pathological results, the specificity of BMI was 41.7% and sensitivity was 45.4%, of which had 100% sensitivity and 60% specificity in diagnosing moderate fatty liver. Preoperative CT diagnosis showed 9 cases had fatty liver, and the specificity was 44.4% and sensitivity 36.4%. Preoperative ultrasound diagnosis showed 5 cases had fatty liver, with 60% specificity, and 27.7% sensitivity. There were great differences among BMI, B ultrasound, CT and donor liver biopsy in evaluating fatty liver graft before living liver transplantation. Preoperative ultrasound diagnosis had relatively high specificity, and preoperative BMI diagnosis had relatively high specificity. Accordingly, it is needed to conduct comprehensive assessment with three methods, and transhepatic pathological examination could be performed if necessary. Related Articles | Metrics

Select

Expression of lymphocyte subsets and immune balance in recipients following liver transplantation Zhang Yong-ming, Hu Wei-yu, Li Yong, Hao Jian-shuai, Wu Li-qun 2010, 14 (31):  5729-5732.  doi: 10.3969/j.issn.1673-8225.2010.31.008 Abstract ( 344 )   PDF (475KB) ( 445 )   Save BACKGROUND: Documents reported that the peripheral blood lymphocyte changes are more sensible than hepatic enzymes changes following liver transplantation, but its specificity needs further explored. OBJECTIVE: To study the relationship among the levels of CD3-/HLA-DR+, CD3+/CD25+ and CD3+/HLA-DR-, the immune status of the recipients, and complications in recipients after liver transplantation. METHODS: The liver functions and lymphocyte subsets in 56 recipients were detected by the automatic biochemical analyzer and flowcytometry. The recipients were divided into 2 groups (normal and abnormal groups) according to liver function. And the recipients in the abnormal group were divided into the acute rejection group (n=7), drug reaction group (n=11) and unknown reasons group (n=9). The levels of CD3-/HLA-DR+, CD3+/CD25+ and CD3+/HLA-DR- in patients after liver transplantation of each group were measured, and  the relationship of their levels and complications were analyzed. RESULTS AND CONCLUSION: The expression of CD3-/HLA-DR+ and CD3+/CD25+ in the normal group was lower than that in the abnormal group (P =0.011, 0.002), while the expression of CD3+/HLA-DR- was higher in the normal group (P=0.012). And the expression of CD3-/HLA-DR+ and CD3+/CD25+ in the acute rejection group was greater than those in the drug reaction group (P=0.039, 0.048), but the expression of CD3+/HLA-DR- was higher in acute rejection group (P=0.007). There were a significantly correlations between the expression of CD3-/HLA-DR+, CD3+/CD25+ and CD3+/HLA-DR- and the immune status and complications of recipients, they may be a factor to assess the complications and adjust the immune status of recipients after liver transplantation. Related Articles | Metrics

Select

Early complications in infants following liver transplantation Sun Xiao-ye, Sun Li-ying, Zhu Zhi-jun, Rao Wei, Jiang Wen-tao, Zhang Jian-jun, Zhang Ya-min, Liu Yi-he, Shen Zhong-yang 2010, 14 (31):  5733-5736.  doi: 10.3969/j.issn.1673-8225.2010.31.009 Abstract ( 319 )   PDF (441KB) ( 758 )   Save BACKGROUND: Infant liver transplantation is difficult, with high postoperative complications and difficult perioperative management. Domestic clinical experience in liver transplantation lacks due to short application and small case. OBJECTIVE: To investigate the early complication of liver transplantation in infants and discuss the experiences in prevention and treatment methods. METHODS: From September 2006 to January 2010, 14 infants underwent liver transplantation in First Central Hospital of Tianjin, aged 6 months to 2 years and 8 months, including 1iving related liver transplantation in 8 cases and split liver transplantation in 6 cases. Preoperative condition, operation patterns, perioperative treatment, postoperative general condition and complications were recorded. RESULTS AND COCNLUSION: Of 14 cases undergoing liver transplantation, 1 case died from jejunum ulcer perforation leading to severe septic shock. Other early complications after operation included intraabdominal infection 3 man-times, virus infection 6 man-times, retrograde infection of biliary 3 man-times, chyle leakage 2 man-times, biliary leakage 3 man-times, biliary stricture 1 man-times, acute rejection 1 man-times, psychiatric symptom because of FK506 2 man-times. The early complication in infants after liver transplantation is high, especially infection and operative complications. Therefore, prevention and treatment are very important. Related Articles | Metrics

Select

Hemostatic and coagulative variations of patients at perioperative period following living related liver transplantation Song Li-jie, Yao Gui-ling, Liu Yu, Zhao Yi-wen, Ding Qi, Cui Juan-hong 2010, 14 (31):  5737-5740.  doi: 10.3969/j.issn.1673-8225.2010.31.010 Abstract ( 310 )   PDF (343KB) ( 470 )   Save BACKGROUND: The abnormality of hemostatic and coagulative indexes can result in serious complications, such as hemorrhage and thrombus, for patients following living related liver transplantation, however, the detail change laws remain poorly understood. OBJECTIVE: To study the hemostatic and coagulative variations at perioperative period following living related liver transplantation. METHODS: The venous blood were collected from 44 patients prior to and 1-7 days after living related liver transplantation. The dynamic changes of partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen contents, platelet, antithrombin activity, plasminonen activity, plasminogen activator inhibitor activity 1 (PAI-1), D-dimer, and fibrin degradation product were examined. Simultaneously, 32 healthy people were served as controls. RESULT AND CONCLUSION: A prolongation of APTT, TT and PT were observed in patients prior to transplantation (P < 0.01). The platelet count, antithrombin activity, and plasminonen activity were reduced (P < 0.01), but the PAI- 1 was increased (P < 0.01). The PT, APTT, TT, platelet count, antithrombin activity, and antithrombin activity were recovered to normal level at 1 week after transplantation, but the levels of plasminonen activity, PAI-1, D-dimer, and fibrin degradation product were still abnormal. The results revealed that the coagulant and anticoagulant functions could be normal by successful operation and the recovery of fibrinolvtic functions were delayed, which are the main reasons for severe hemorrhage. Thus, the monitoring of coagulation and hemostatic function play an effective role in preventing hemorrhage and thrombosis. Related Articles | Metrics

Select

Cardiopulmonary bypass model of pig heart preservation in a beating state Huang Ai-lan, Lin Hui,Mo An-sheng, Liang Ning, Hu Yan-yan, Zhu Wei-lin 2010, 14 (31):  5741-5744.  doi: 10.3969/j.issn.1673-8225.2010.31.011 Abstract ( 345 )   PDF (578KB) ( 517 )   Save BACKGROUND: Presently, simple cryopreservation is widely used in preserving donor heart. However, it can not transport for a long distance due to 4-6 hours safe duration, which would affect the effective application of donor heart. Thus, it is necessary to explore methods for heart preservation in a beating state. OBJECTIVE: To establish a cardiopulmonary bypass model of the heart preservation in a beating state, and to provide a laboratory basis for the beating heart. METHODS: A total of 12 adult Bama miniature pigs, weighing 25-30 kg, were randomly allocated into 2 groups. In the experimental group, the isolated rat heart were induced warm oxygenated blood by the bypass circuit (blood blow 60-80 mL per minutes), the heart preservation in a beating state for 8 hours. In the control group, heart was preserved in hypothermia UW solution for 8 hours. Physiological recorder was used to observe the changes of beating heart rate and the perfusion pressure. Hourly blood samples were taken for arterial blood gases and serum electrolytes parameter. After 8 hours, ATP and cardiac ultrastructure of donor heart were detected. RESULTS AND CONCLUSION: ①Transient 2:1 atrioventricular block occurred in a pig, and remained donor hearts were successfully preserved in a beating state in the experimental group. ②During preservation, perfusion pressure was not rising. The value of pH and BE in blood were gradually decreased. The value of serum potassium and serum calcium gradually increased in the experimental group. ③The levels of myocardial ATP in the experimental group was significant greater than the control group (P < 0.05). ④There were few mitochondrion swelling and myocardial ultrastructures were similar to the normal state in the experimental group. However, the myocardium was swelling and vacuolar degeneration could be found in the control group. Preservation donor heart with cardiopulmonary bypass in a beating state is feasible. The cardiopulmonary bypass has its own features. Related Articles | Metrics

Select

Limb ischemic preconditioning in immature heart transplantation Yang Feng, Song Jian-fei, Zheng Min, Yan Ying-wei 2010, 14 (31):  5745-5748.  doi: 10.3969/j.issn.1673-8225.2010.31.012 Abstract ( 299 )   PDF (456KB) ( 456 )   Save BACKGROUND: Some scholars propose that remote ischemic preconditioning can achieve ischemic preconditioning. Limb ischemic preconditioning is a self-regulating protective mechanism, whether it has protective effect on immature myocardium, and its value to heart transplantation remains unclear. OBJECTIVE: To explore the value of limb ischemic preconditioning on the donor heart preservation by comparing immature canines limb ischemic preconditioning with the traditional method in heart preservation. METHODS: A total of 12 canines were randomly divided into two groups, with 6 animals in each group. Femoral arteries were liberated and obstructed for 10 minites, followed by open 5 minutes, and then the chest was conventional opened after 3 cycles. The heart was dissociated, and ST.Thomas cardioplegia perfusion was infused via an inserted perfusion tube. The isolated hearts were preserved in the preservation fluid at 4 ℃ (3 mL blood was draw from the superior vena venous before the heart was removed). The treatment in the control group was similar to that of the experimental group except that the femoral arteries were not obstructed. The left ventricular myocardial samples were obtained every half an hour in the heart preservation duration     (3 hours), and the wet/dry ratio of apical myocardial was measured after preservation. The contents of malondialdehyde (MDA), superoxide enzyme (SOD), and cardiac troponin I (cTn-I) were measured.  RESULTS AND CONCLUSION: Compared with the control group, the content of pre-cTn-I had no significant changes (P > 0.05), but the myocardial MDA and wet/dry ratio were smaller (P < 0.05), the SOD was greater (P < 0.05) after heart removal. The results demonstrated that, limb ischemic preconditioning has protective effects on immature heart. The limb ischemic preconditioning before heart removal can increase preservation outcomes of heart and decrease myocardial edema. The cTn-I content is not changed before heart removal showed that, the limb ischemic preconditioning has no damage to myocardium, thus, it is a safe protective measure. Related Articles | Metrics

Select

Ultra-structure and anatomical basis of pancreatic segmental transplantation from young donors Ye Wei-jian, Zheng Yu-tao, Cai Zhao-ming 2010, 14 (31):  5749-5752.  doi: 10.3969/j.issn.1673-8225.2010.31.013 Abstract ( 339 )   PDF (439KB) ( 420 )   Save BACKGROUND: The success probability of young donors for pancreatic or islet transplantation is great due to easy vascular anastomosis. However, the anatomical basis of young donors for pancreatic segmental transplantation are insufficient. OBJECTIVE: To observe the microstructure, positive expression areas of pancreatic islet B cell glucagons and insulin, and immune positive staining area of pancreatic islet B cells in the pancreatic tails of young people, and to explore the pancreatic vascular anatomy of young cadavers. METHODS: Totally 12 cases of young cadavers were randomly selected. Their pancreatic tails sections were treated by hematoxylin-eosin staining and observed under an optic microscope. The number and area of pancreatic islets were measured with micrometer gauge. And the immunohistochemical staining was done with pancreatic glucagons antiserum and insulin antiserum. Pancreatic tails of another 3 young cadavers were stained with uranium and lead. The pancreatic islet B cells, the morphology, the quantity and the secreting granules and the vascular situation of the young donors were observed. RESULTS AND CONCLUSION: In the tissues of the young donors, the secreting granules in pancreatic islet B cells were abundant, organelles such as the endoplasmic reticula, the Golgi complex and the mitochondria were mature and advanced, the insulin islets were widely distributed, and the immune staining positive expression area of the insulin B cells was large. There were many and dense insulin B cells distributed at the pancreatic tails of the young donors, and there were many secreting granules in the insulin islets B cells. The blood vessels were suitable for end-to-side anastomosis. Since the secreting activities of pancreatic cells of the young donors were vigorous and the blood vessels were suitable for end-to-side anastomosis, the young donors are suitable for pancreatic segmental insulin islets transplantation. Related Articles | Metrics

Select

Protective effect of hyperoxic fluid on pancreas transplantation in rats Liang Zhong-ping, Lao Xue-jun, Ding Hong-wen, Su Ze-xuan 2010, 14 (31):  5753-5757.  doi: 10.3969/j.issn.1673-8225.2010.31.014 Abstract ( 279 )   PDF (975KB) ( 393 )   Save BACKGROUND: Organ for transplantation is insufficient, and primary transplantation of nonfunction caused by perfusion cryopreservation occasionally occurs. It has clinically significant to reduce organ damage caused by perfusion preservation. OBJECTIVE: To study the protective effect of hyperoxic perfusion fluid on pancrease transplantation in rats. METHODS: Totally 40 Wistar rats were randomly divided two groups and poured with natrium lacticum ringer’s solution or hyperoxic natrium lacticum ringer’s solution. After perfusion, the tail pancreases of rats were checked by electron microscopy. The glucose concentrations and acute rejection score of pancreas tissues were compared between two groups at 1 and 3 days after pancreas transplantation. RESULTS AND CONCLUSION: There was no statistics difference between two groups prior to operation. The ultrastructure of pancreatic tissue was basically normal, with completely nuclei and plenty of mitochondria in the hyperoxia liquid group after perfusion. The pancreatic tissues still orderly arranged in the control group, with obviously swelling in mitochondria, and parts of mitochondria were vacuolar degenerated. The glucose concentrations of the hyperoxia liquid group were lower than that of the control group at 1 and 3 days after transplantation (P < 0.05). The acute rejection scores of the hyperoxia liquid group were lower than that of the control group (P < 0.05). Thus, hyperoxia liquid can mitigate the ischemia reperfusion injury and protect pancreas transplantation in rats. Related Articles | Metrics

Select

Construction of a recombinant human interleukin 10 against skin allograft rejection model Feng Ji-hong, Sun Wan-bang, Luo Jun-min, Liu Kai-shan, Zhang Lei, Wen Qiong-na, Chen Fu-chao, Wang Sheng-xiang 2010, 14 (31):  5758-5762.  doi: 10.3969/j.issn.1673-8225.2010.31.015 Abstract ( 349 )   PDF (963KB) ( 572 )   Save BACKGROUND: Previous studies demonstrated that interleukin-10 (IL-10) has application prospect in preventing and treating allograft rejection, which may be served as a new immunosuppressant. Animal transplantation models provide platform for studying immunosuppressant. Mouse is widely used in establishing skin allograft model, which require highly transplantation technique. OBJECTIVE: To establish a model of skin allograft rejection in rabbits and to study the effects of recombinant human IL-10 (rhIL-10) against skin allograft rejection. METHODS: The skin flap from rabbit back was cut into three kinds of skin grafts: the full thickness flap with dermis, the middle thickness flap with dermis and the thin layer flap without dermis, which were transplanted into rabbits. The rabbits were randomly divided into the brake group and non-brake group, those in the former group was wore a self-made collar in order to restrict his head and neck. Models that drugs against rabbit allograft rejection were divided into three groups: rhIL-10 experimental group, CsA positive control group and negative control group. The mixed lymphocyte reactions were used to observe the proliferation index. The graft rejection time and the average survival time were continuously observed for 30 days. RESULTS AND CONCLUSION: The effects of the donors and recipients mixed on proliferation of T lymphocytes showed that allogeneic major histocompability complex were different in rabbits, and rejection may be occurred when skins were transplanted each other. The middle thickness skin graft was optimal. The self-made neck-collars could fix and protect the transplanted wounds and skin grafts. The rabbit model of rhIL-10 against skin allograft rejection was established successfully, and rIL-10 has anti-agraft rejection effect. Related Articles | Metrics

Select

Effect of serum estradiol and progesterone level and progesterone/estradiol ratio on the day of human chorionic gonadotropin administration in pregnancy outcome of in vitro fertilization-embryo transplantation Yu Nan, Yang Jing, Yin Tai-lang, Zhao Qing-hong 2010, 14 (31):  5763-5766.  doi: 10.3969/j.issn.1673-8225.2010.31.016 Abstract ( 421 )   PDF (647KB) ( 1168 )   Save BACKGROUND: Controlled ovarian hyperstimulation makes more follicular development, and serum progesterone and estradiol levels are significantly higher than natural menstrual cycles. However, it remains controversial whether this can change oocyte quality and endometrial receptivity, and reduce the implantation rate and clinical pregnancy rate. OBJECTIVE: To discuss the effect of serum estradiol and progesterone level and progesterone/estradiol (P/E2) ratio on the day of human chorionic gonadotropin (HCG) administration in pregnancy outcome of in vitro fertilization (IVF)-embryo transplantation (EF). METHODS: A retrospective analysis was performed in the medical records of 218 patients undergoing IVF-ET treatment. Patients were divided into three groups according to serum estradiol concentration: E2 < 3 000 ng/L; 3 000 ng/L ≤ E2 <         5 000 ng/L and E2 ≥ 5 000 ng/L on the day of HCG administration. According to serum progesterone concentration: P ≤ 0.9 ng/L; 0.9 ng/L < P ≤ 3 ng/L and P > 3 ng/L. According to P/E2 ratio: P/E2 ratio > 1 and P/E2 ratio ≤ 1. The implantation rate and clinical pregnancy rate were analyzed. RESULTS AND CONCLUSION: With the increased E2 levels and P/E2 ratio, the implantation rate and clinical pregnancy rate were slightly declined (P > 0.05). The implantation rate and clinical pregnancy rate were significantly decreased in P > 3 ng/L group than the other two groups (P < 0.01). Results show that serum progesterone levels on the day of HCG administration have an adverse effect on implantation rate and clinical pregnancy rate in IVF-ET cycles. Related Articles | Metrics

Select

Spermatogenic function of transplanted spermatogonial stem cell following cryopreservation Ma Liang-hong, Ding Qiang, Feng Li-xin, Li Pei-jun, Chen Fu-bao 2010, 14 (31):  5767-5772.  doi: 10.3969/j.issn.1673-8225.2010.31.017 Abstract ( 361 )   PDF (1468KB) ( 549 )   Save BACKGROUND: Cryopreservation of spermatogonial stem cell has potential clinical value for the treatment of male infertility. However, the process and ability of spermatogenesis of stem cell after cryopreservation is not yet entirely clear. OBJECTIVE: To observe the spermatogenic function of spermatogonial stem cell cryopreserved after transplantation. METHODS: Using C57BL/6 mice of postnatal 6-10 days and SD rat of postnatal 10 days as germ cell donors respectively, male germ cells were obtained by combination with compound enzymatic digestions, velocity sedimentation and discontinuous percoll density gradient centrifugation. The recipients were male BALB/c nude mice, in which endogenous spermatogenesis were destroyed by intraperitoneal injection of busulfan at 6 weeks of age. The donor stem cells were divided into cryopreservation and non-cryopreservation groups, and xenotransplanted into the seminiferous tubules. Morphological methods were used to observe the process of spermatogenesis, and the epididymal semen was collected to observe sperm shape and perform in vitro fertilization (IVF). The expression level of α6-Integrin protein was analyzed by immunohistochemical SABC staining at months 1, 2 and 3 after transplantation. The process of spermatogenesis was observed by scanning electron microscope at week 1, months 1 and 3 after transplantation. RESULTS AND CONCLUSION: The cell viability rate was higher before cryopreservation than after cryopreservation (P < 0.01). SABC staining showed that spermatogonia expressed α6-Integrin positively on cytomembrane and cytoplasm in both non-cryopreservation group and cryopreservation group, and the expression level increased with time prolonged, but there were no significant difference between two groups. When germ cells of SD rats were transplanted into testes of BALB/c mice, spermatogonial stem cell could colonize and proliferate in the recipient seminiferous epithelium, and produce plenty of spermatozoa with rat-sperm shape, both the rat-derived spermatogenesis and the endogenous spermatogenesis came from the mouse spermatogenesis nest in which the number of sperm originated from the donor were more than those from the recipient themselves. IVF experiment indicated that spermatozoa generated from donor spermatogonial stem cells had normal function and capability to fertilize. These results show that spermatogonial stem cell can colonize and proliferate in the recipient seminiferous epithelium, and differentiate to form mature sperm after conventional cryopreservation and transplantation. Related Articles | Metrics

Select

Comparative study between off-pump and on-pump coronary artery bypass grafting: A Meta-analysis Zhao Yan, Pan Jun, Wang Dong-jin 2010, 14 (31):  5773-5777.  doi: 10.3969/j.issn.1673-8225.2010.31.018 Abstract ( 332 )   PDF (603KB) ( 439 )   Save BACKGROUND: Studies demonstrated that the living quality of patients had no significant differences following off-pump (OPCAB) or on-pump coronary artery bypass grafting (CCAB). The decrease of living quality related to graft lesions and arrhythmia. OBJECTIVE: To evaluate whether OPCAB is superior to conventional CCAB. METHODS: The comparative studies regarding therapeutic effects of OPCAB and CCAB from 2000 to 2009 were searched, and collecting relevant data was Meta analyzed using RevMan 4.2 statistical software. RESULTS AND CONCLUSION: A total 16 documents were included in this study, including 1 392 cases in the OPCAB group and 1 252 cases in the CCAB group. Results of Meta analysis demonstrated that, OPCAB was superior to CCAB in ICU duration, ventilation time, hospitalization time, postoperative 24-hour drainage volume, and postoperative complications (P < 0.05), but the graft number was lower than that of the CCAB group (P < 0.05). However, the age had no difference between the two groups   (P > 0.05). The results revealed that compared with CCAB, OPCAB receives superior short term outcome in the treatment of coronary artery disease, but the long term effectiveness needs to be explored. Related Articles | Metrics

Select

Immunosuppressive effect of hydroxycamptothecin on corneal transplantation rejection in rats: A comparison with cyclosporin A Jin Chuang, Li Bing, Huo Yan, Zhang Ben 2010, 14 (31):  5778-5781.  doi: 10.3969/j.issn.1673-8225.2010.31.019 Abstract ( 371 )   PDF (1083KB) ( 454 )   Save BACKGROUND: Recent studies have shown that the hydroxycamptothecin has immunosuppression effect in some organ transplantations, but which in corneal transplantation has never been reported. OBJECTIVE: To observe the immunosuppresive effect by used hydrocamptothecin on allogeneic corneal transplantation in rat models and to compared with cyclosporin A. METHODS: Penetrating corneal transplantation model was established using 18 adult female Wistar rats as donors and 36 adult male Sprague Dawley rats as recipients. Recipients were randomly assigned to the three groups, hydroxycamptothecin group, cyclosporine A group and control group (n = 12). Hydroxycamptothecin and cyclosporine A groups were respectively given with intraperitoneal injection of hydroxycamptothecin 2.0mg/kg per day and cyclopsorine A 10 mg/kg per day, starting on the first day after operation and for 12 consecutive days. Cornea transplant was observed, and turbid, edema and new vessels were considered as clinical assessment criteria. The corneal survival time was recorded. RESULTS AND CONCLUSION: The survival time of corneal graft in the hydroxycamptothecin group, cyclopsorin A group and control group respectively were (21±2), (19±2) and (11±2) days. Graft survival time in each of treatment groups was significantly prolonged compared with control group (P < 0.01). Hydroxycamptothecin group was significantly superior compared with cyclosporine A group (P < 0.05). Experiment results indicated hydroxycamptothecin has a inhibitory effect on immunological rejection, a promotive effect on corneal allografts survival and a significantly preventive effect on vascular growth of corneal allograts, which would be superior to cyclopsorin A in rats following penetrating corneal transplantation. Related Articles | Metrics

Select

Specific quantitative immunological assay to monitor the immune status in vivo Jiang Ze-sheng, Gao Yi 2010, 14 (31):  5782-5785.  doi: 10.3969/j.issn.1673-8225.2010.31.020 Abstract ( 334 )   PDF (640KB) ( 431 )   Save BACKGROUND: Currently, the immunological detection method has limitation due to complexity of immunoreactions. It is difficult to evaluate body immune status by a single index. Thus, it is urgent to establish a joint evaluation pattern to monitor the immune status of recipients following transplantation.    OBJECTIVE: To establish a method of donor specific cytotoxicity assay in vivo for quantitatively detecting the immune status of the recipients, and to explore technical parameter of flow cytometry, conditions for fluorescence staining, number of transfused cells, and to determine the optimal testing times.   METHODS: C57 and Balb/c splenocytes were prepared for cell suspension, labeled by 5, 6-carboxyfluorescein diacetate succinimidyl ester (CFSE) with different final concentrations. A skin transplantation model was established with the recipients BALB/c mice and the donors C57BL/6 mice. Balb/c mice without skin transplantation served as controls. After intravenous transfusion of the CFSE-labeled donor/recipient splenocytes mixture, the following examinations were carried out at 1, 2, 4, 10 hours and 1, 2, 3, 6 days. A quantitative estimate of the ratio of donor/recipient splenocytes labeled with CFSE in host peripheral blood. The percent specific lysis was calculated using the equation. RESULTS AND CONCLUSION: The flow cytometry was setting lymphocyte gate, and the CRSE concentration was controlled within 20-fold. The number of infused cells had no effects on results in certain range. It is optimal to detect at 2-4 hours after cell transfusion. The results demonstrate that in vivo cell toxicity test is simple, precise, reliable and well suited for quantitatively detecting the immune status of skin transplant recipients in vivo. Related Articles | Metrics

Select

Injury and regeneration of rat peripheral nerves with limb transplantation following short-term immunosuppression therapy Song You-xin, Ma Ying-hua, Wang Rui-juan, Chen Bin, Liu Jian-feng 2010, 14 (31):  5786-5789.  doi: 10.3969/j.issn.1673-8225.2010.31.021 Abstract ( 353 )   PDF (663KB) ( 440 )   Save BACKGROUND: It is decisive for limb transplantation carrying out extensively in the clinic whether the immunotolerance and function recovery can be achieved effectively.     OBJECTIVE: To investigate the effect of short-term immunosuppression therapy on nerve regeneration and functional recovery following limb transplantation.  METHODS: Thirty adult male Sprague Dawley rats were randomly divided into 3 groups. Short-term group: rats received immunosuppression therapy for 14 days after limb transplantation. Long-term group: rats received received immunosuppression therapy for 4 weeks after limb transplantation. Control group: rats received intraperitoneal injection of physiological saline after transplantation. The nerve regeneration and functional recovery were evaluated using footprint analysis, immunohistochemistry and histological observation.  RESULTS AND CONCLUSION: There was no obvious difference between the short- and long-term groups in functional recovery (P > 0.05), both of which were superior to the control group (P < 0.05). Results of histological observation suggested that neural functional recovery of the short-term group was better than that of the control group (P < 0.05), but there were no significant differences between the short- and long-term groups in nerve regeneration. Three animals die due to immunosuppressant in the long-term group, no animal lost in the other two groups. The results demonstrated that, short-term immunosuppression therapy can mitigate immunological rejection, improve microenvironment for peripheral nerves regeneration, increase recovery rate and quantity, and reduce adverse reaction, thus, it has a potential for clinical application. Related Articles | Metrics

Select

Effect of skeletal satellite cells allotransplantation on regeneration of damaged sciatic nerve Zhang Yong, Cao Hong, Zhang Ting-shen 2010, 14 (31):  5790-5793.  doi: 10.3969/j.issn.1673-8225.2010.31.022 Abstract ( 333 )   PDF (993KB) ( 406 )   Save BACKGROUND: Previous studies demonstrated that skeletal satellite cells not only have strong proliferative and adaptive abilities in vitro, but also exhibit low immunogenicity, few immunologic rejection and long survival time after allotransplantation. Accordingly, it is suppose that allotransplantation of skeletal satellite cells may promote regeneration of damaged sciatic nerve. OBJECTIVE: To explore the effects of skeletal satellite cells transplantation on regeneration of damaged sciatic nerve. METHODS: A total of 16 Wistar rats were randomly divided into the transplantation and control groups. The sciatic nerve of right posterior limb was cut off, and then the end of defect nerve was packaged with the biodegradable membrane to form the regenerative chamber of defect nerve. Liquid containing satellite cells (0.2 mL) were injected into the regenerative room in the transplantation group. The physiological saline was injected into same position in the control group. At 4, 8 and l2 weeks after operation, the rats gait were calculated and the regenerated nerve were observed by OSO4 staining. The function index of sciatic nerve, recovery rate of wet nerve gastrocnemius, and the changes of number, diameter and thickness of regenerated myelinated nerve fiber were observed. RESULTS AND CONCLUSION: The remaining rate of wet weight of gastrocnemius, quantity, diameter and thickness of regenerated myelinated nerve fibers between the transplantation and control groups had significant difference (P < 0.05). The recovery of function index of sciatic nerve in the transplantation group was obviously superior to that of the control group at 8 and 12 weeks after operation (P < 0.05). Thus, It is considered that skeletal satellite cell which was transplanted into nerve regeneration chamber can promote regeneration and mature of the defect nerve. Related Articles | Metrics

Select

A rabbit model of partly autologous submandibular gland transplantation Pan Chun-hui, Wang Bo-jun, Ou Yu-lun, Luo Bing-qing 2010, 14 (31):  5794-5796.  doi: 10.3969/j.issn.1673-8225.2010.31.023 Abstract ( 277 )   PDF (703KB) ( 407 )   Save BACKGROUND: Recently, vascularized autologous submandibular gland transplantation for treating severe keratoconjunctivitis sicca has achieved better therapeutic effects in clinic; however, dacryorrhea as postoperative complication was observed usually. Patients needed another or more operations to partly excise transplanted gland to reduce the symptom of dacryorrhea. For decreasing the complication of dacryorrhea post-operation, the feasibility of partly submandibular gland autotransplantation is still needed to be verified. OBJECTIVE: To investigate the feasibility of partly submandibular gland transplantation in rabbits. METHODS: The two third part of left submandibular gland was transfered to the space beneath temple skin with blood vessel anastomosis technique of microsurgery. At 14 days post-operation, the graft was taken out to observe pathological changes with HE staining. RESULTS AND CONCLUSION: Seven out of 15 survival rabbits had normal pathological structure of graft, and normal value of 6 cases was about 30% or even more, that of only 2 was less than 30%. The results suggested that partly submandibular gland transferring in rabbit model was feasibility and worth for treating dacryorrhea. Related Articles | Metrics

Select

An isolation method to obtain high purity Sertoli cells Mai Hai-xing, Chen Li-jun, Qu Nan, Zhao Li, Huang Chen, Wang Ya-lin, Li Xue-chao　 2010, 14 (31):  5797-5800.  doi: 10.3969/j.issn.1673-8225.2010.31.024 Abstract ( 402 )   PDF (745KB) ( 975 )   Save BACKGROUND: Studies demonstrated that Sertoli cells have immunosuppression, which can provide immune privilege for transplanted cells in vitro. Previous researches indicated that Sertoli cells-secreted active compounds have promotive effects on other cells. However, there is not a complete method for Sertoli cells purification. OBJECTIVE: To discuss a method for isolating Sertoli cells with high purity. METHODS: The testicular seminiferous tubules were isolated from 20-day old male SD rats, digested by enzyme and were plated onto poly-L-lysine (PLL)-coated tissue culture dishes followed by 7 days culture, and then incubated with Tris-HCL. Purity of Sertoli cells were identified by immunohistochemistry of FasL with a counterstain of Hoechst33342. RESULTS AND CONCLUSION: Most Sertoli cells began to stick on the flasks with round or oval shapes at 24 hours after culture, and many germ cells could be seen floating on the liquid. The cytoplasty become greater and refraction turned to weakening at 48 hours after culture. After 4-6 days, cells were fully spread and become monolayer. And the mass to charge ratio was (7-9):1, the shape and proportion of the cells had no change. The purity of the Sertoli cells was (95.64±2.76)%. The results demonstrated that this method is a relatively easy, cheap, stable, and efficient for isolating Sertoli cells. Related Articles | Metrics

Select

Culture and transfer of blastocysts Hao Gui-qin, Li Rong, Geng Lan, Xu Jin-bei, Wen Xi, Guo Qing-qing 2010, 14 (31):  5801-5804.  doi: 10.3969/j.issn.1673-8225.2010.31.025 Abstract ( 399 )   PDF (692KB) ( 858 )   Save BACKGROUND: The blastocysts were transferred into the uterine cavity following blastocyst culture. It may shorten the period of embryo development and implantation. On the other hand, uterine contractility decreases gradually. Thus, it would decrease the opportunity of the embryo implantation in vitro. The blastocyst transfer is fit for the physiological function. OBJECTIVE: To observe the pregnancy rate following blastocyst transfer. METHODS: Patients underwent superovulation with gonadotropin releasing hormone agonist and gonadotropin. Oocyte-cumulus-corano complex were isolated from follicular fluid and immediately placed in human insemination media supplemented with human serum albumin. Fertilization was assessed and scored at 16-18 hours after insemination and transferred to cleavage media. Development of embryo and number f blastomere at 3 days were assessed and graded. RESULTS AND CONCLUSION: Only one patient was pregnant after embryo transfer among those 33 patients who had no blastocyst was transferred. The clinical pregnancy rate of 238 patients after blastocyst transfer was 49.16%. It was no statistically different of the success rate among the different maternal age. 122 patients were transferred at least one good-quality blastocyst, the clinical pregnancy rate was 56.56%. 116 patients were transferred poor-quality blastocyst, the clinical pregnancy rate was 41.38%. It showed that it is no effect of the maternal age on the clinical pregnancy rate after blastocyst transfer. It may be cancelled if the patient was no blastocyst. But the blastocyst should be transferred whether there is good-quality blastocyst or not. Related Articles | Metrics

Select

Age-related morphology and structure changes of mouse thymus Liu Yang-bin, Li Qi-hua 2010, 14 (31):  5805-5808.  doi: 10.3969/j.issn.1673-8225.2010.31.026 Abstract ( 697 )   PDF (833KB) ( 979 )   Save BACKGROUND: Dendritic cells are the most important antigen presenting cells in vivo and play a double role of immune response and immune tolerance. There are more dendritic cells in thymus. With the increasing age of mouse, structure of mouse thymus shows degradation tendency, and the role of antigen-presenting dendritic cells is also reduced. OBJECTIVE: To explore the morphologic change of different growth period mouse thymus. METHODS: The thymus structures of the 4-week-old, 20-week-old and 10-month-old mouse were observed; dendritic cells occupied area percentage in the thymus were observed and analyzed by S100 immunohistochemistry and the dendritic cells density was calculated. RESULTS AND CONCLUSION: Following age increasing, thymic cortex became thinning and the limit between cortex and medulla were more distinct. The glandular substance of 10-month-old mouse were obviously decreased and substituted with interstitial substance to be full of adipocytes. S100+ dendritic cells area and dendritic cells density in 20-week-old mouse were significantly higher than in 4-week-old mouse, but were decreased obviously in 10-month-old mouse (P < 0.01). Simultaneously, there were more S100+ macrophage on juncture between cortex and medulla in 10-month-old mouse thymus. Results demonstrated that, with age increasing, structure of mouse thymus trends to degradation; lower of antigen presenting effect of dendritic cells in gerontism mouse were closely related to reduction of quantity of dendritic cells. Related Articles | Metrics

Select

Reliability of lung and lung cancer tissue microarray in detecting PBK/TOPK protein expression Zhao Yun-fei, Shen Hong 2010, 14 (31):  5809-5812.  doi: 10.3969/j.issn.1673-8225.2010.31.027 Abstract ( 338 )   PDF (630KB) ( 401 )   Save BACKGROUND: Tissue microarray (TMA) technology can be used to detect biomelecule in tissues. However, the diameter of organization used in TMA is only 0.6 mm, and tumor cells has heterogeneous. Therefore, the reliability of test results of TMA remains unclear. OBJECTIVE: To examine the reliability of TMA for detecting PBK/TOPK compared to the original paraffin sections containing normal human adult type Ⅱ alveolar epithelial cells, embryonic pneumocytes, primary focus of lung carcinoma and lymph node metastasis. METHODS: The TMA technology was used to construct a paraffin tissue microarray containing 760 tissue cores, including normal adult human lung, embryonic pneumocytes, primary focus of lung carcinoma and lymph node metastasis, primary focus of lung adenocarcinoma and lymph node metastasis, primary focus of lung small cell carcinoma and lymph node metastasis, as well as primary focus of lung large cell carcinoma and lymph node metastasis. The immunohistochemical SP method was employed to determine the PBK/TOPK protein expression in TMA and original conventional paraffin sections. The positive unit of PBK/TOPK protein and positive rate of expression were assessed quantitatively with the Leica Q500MC image analysis system using results from the paired conventional full sections as controls. RESULTS AND CONCLUSION: There was no significant difference in PBK/TOPK expression between TMA and paired conventional full sections in positive unit and positive expression rate, and the relative deviation was less than 0.6%. TMA detection of PBK/TOPK protein expression in lung carcinoma is highly concordant with the original paraffin sections. TMA is reliable in detecting PBK/TOPK protein expression of lung, embryonic lung and normal lung tissue. Related Articles | Metrics

Select

Protective effect of salidroside on liver injury of rats under altitude hypoxia simulation Rong Li, Dai Li-li, Zeng Wei-zheng, Jiang Ming-de, Wu Xiao-ling, Zhang Hua 2010, 14 (31):  5813-5817.  doi: 10.3969/j.issn.1673-8225.2010.31.028 Abstract ( 353 )   PDF (1195KB) ( 647 )   Save BACKGROUND: Epidemiologic survey demonstrated that high-altitude hypoxia may result in liver injury, but there are few studies relate to the pathogenesis. Salidroside, the main active component of Gold Theragran, has been showed effects on removing oxygen free radical and protecting cell membrane. OBJECTIVE: To observe the protective effect of salidroside on rat’s liver injury caused by imitating altitude liver hypoxia with hepatic artery ligation. METHODS: Wistar rats were randomly divided into 3 groups: ligation group, salidroside + ligation group and normal control group. Rats in the former two groups were prepared for hepatic artery ligation models and divided into five time sections as 1, 2, 4, 6, 8 hours. In the salidroside + ligation group, rats were intraperitoneal injected salidroside solution at 2 days, 1 day and 2 hours prior to ligation. Liver function targets in serum were detected by automatic biochemistry analyzer; the content of malonaldehyde was detected by thiobarbituric acid method; the activity of superoxide dismutase (SOD) was detected with xanthine oxidase method; pathological changes in liver tissue were observed by hematoxylin-eosin staining; the level of hypoxia-inducible factor 1α (HIF-1α) protein was detected with immunohistochemistry; and apoptosis in liver tissue was detected by TUNEL method. RESULTS AND CONCLUSION: Imitating altitude liver hypoxia by hepatic artery ligation could cause liver’s acute injury. Intervention with salidroside could improve rat’s liver function targets (P < 0.05), lower the content of malonaldehyde and heighten the activity of SOD (P < 0.05), abate liver tissue’s histopathological change, increase HIF-1α protein level (P < 0.05), and lessen cell apoptosis in liver tissues (P < 0.05). Salidroside have protective effect on rat’s acute liver injury induced by imitating altitude liver hypoxia with hepatic artery ligation by opposing oxidative stress and inhibiting cell apoptosis. Related Articles | Metrics

Select

Low concentration of cholic acid up-regulates JNK protein expression: Can it promote synthesis of liver cell DNA? Dong Xiu-shan, Zhao Hao-liang, Ma Xiao-ming　 2010, 14 (31):  5818-5822.  doi: 10.3969/j.issn.1673-8225.2010.31.029 Abstract ( 385 )   PDF (1021KB) ( 489 )   Save BACKGROUND: Under physiological conditions, bile acids play an important role in the digestion and absorption of lipids and cholesterol metabolism, and the bile acid overload can lead to liver cell apoptosis and necrosis. However, studies of the effect of the low-concentration bile acids on liver cell proliferation are still few. OBJECTIVE: To investigate the effect of the low-concentration cholic acid (CA) on rat liver cell proliferation and JNK, p38-MAPK protein expression. METHODS: Rat hepatocytes were cultured in primary culture for 48 hours, then they were incubated in medium containing 0, 10, 20, 40, 80 μmol/L CA for 12 hours. The cell survival rate was determined by MTT assay. The cell cycles were detected by flow cytometry, and the relative percentage of S phase was calculated. The expression of JNK and p38-MAPK protein was detected by western blotting. RESULTS AND CONCLUSION: There was no significant difference in survival rate below the concentration of 40 μmol/L CA; however, the relative percentage of S phase and JNK protein expression were significantly increased by 40 μmol/L CA (P < 0.05, P < 0.01). 80 μmol/L CA significantly decreased survival rate, relative percentage of S phase, and JNK expression (P < 0.01) but significantly increased p38-MAPK protein expression (P < 0.01). Therefore, low-concentrations CA could promote liver cell DNA synthesis, which might be caused by an increase of the JNK protein expression. Related Articles | Metrics

Select

Sirolimus-induced adverse reactions following kidney transplantation Huo Wen 2010, 14 (31):  5825-5828.  doi: 10.3969/j.issn.1673-8225.2010.31.031 Abstract ( 460 )   PDF (933KB) ( 519 )   Save BACKGROUND: Sirolimus is a new generation of immunosuppressive agent with little renal toxicity, and it has been used effectively in Chinese kidney transplantation recipient patients to prevent acute rejection. OBJECTIVE: To analyze the clinical characteristics and related factors of adverse drug reaction (ADRs) induced by immunosuppressive agent sirolimus following kidney transplantation. METHODS: Retrieval-related contents were collected by computer from Chinese Journal Full-text Database in CNKI and Wanfang database with the key words of sirolimus and kidney transplantation during 2000 and 2009. ADRs cases induced by sirolimus reported in domestic medical journals were analyzed statistically by methods of bibliometries. The research thesis of sirolimus in clinical application and security were brought into the study, all ADRs cases must have detailed report in sex, age and ADRs syndromes. Reviews and simply reported literatures were excluded. RESULTS AND CONCLUSION: A total of 15 literatures were selected and 500 patients were included. Of all the 468 ADRs cases, hyperlipidemia (182 cases, 38.9%) were the most frequent adverse reactions, other ADRs were infection and fever (62 cases, 13.2%), liver dysfunction (54 cases, 11.5%), etc. The most frequent adverse reactions were hyperlipidemia, infection and liver dysfunction. Regular drug monitoring and reasonably dose modulation may increase the validity and security of sirolimu Related Articles | Metrics

Select

Application of immunosuppressive agents to renal transplantation Zou Ben-jing, Wang Zan-tao, Zhang Yong-li, Yang Hui, Wang Feng, Long Zhi-xin, Li Ying 2010, 14 (31):  5829-5832.  doi: 10.3969/j.issn.1673-8225.2010.31.032 Abstract ( 321 )   PDF (760KB) ( 541 )   Save OBJECTIVE: To explore effects and safety of immunosuppressive agent on acute rejection following renal transplantation. METHODS: We retrieved Vip and Tsinghua Tongfang Databases for relevant articles published from January 2000 to October 2009. The key words were “renal transplantation, immunosuppressive agent, mycophenolate, tacrolimus, cyclosporine, rapamycin, anti-CD25 monoclonal antibody, anti-CD3 monoclonal antibody”. The contents should be associated with the study concerning prevention and treatment of immunosuppressive agent on acute rejection following renal transplantation. RESULTS: The use of immunosuppressive agent for renal transplantation can decrease the incidence rate of acute rejection, which can significantly improve the survival of transplanted kidney in a short period. However, the renal toxicity of immunosuppressive agent remains a key factor for restricting long-term survival of the transplanted kidney. Recently, novel immunosuppressive agents enable the long-term survival of transplanted kidney such as rapamycin and FFY720. Novel immunosuppressive agents should pay great attention on reducing adverse reactions, rather than the reduction in incidence rate of rejection alone. CONCLUSION: With the deep understanding of transplantation immunity, we have made great progresses in immunosuppressive agents, which provide more and more choices for clinical physicians. However, satisfactory immunosuppressive agents and schemes deserve further investigations. Related Articles | Metrics

Select

Eighty-two patients received coronary bypass transplantation in the same institute within two years: Psychological status prior to and after treatment Li Zhi-min, Hu Qiang, Cao Wei-dong, Li Hong-jian, Mao Ying 2010, 14 (31):  5833-5836.  doi: 10.3969/j.issn.1673-8225.2010.31.033 Abstract ( 306 )   PDF (792KB) ( 413 )   Save BACKGROUND: As a negative event, coronary artery bypass grafting (CABG) can lead to psychological stress for patients with coronary atherosclerotic heart disease. OBJECTIVE: To explore the change of psychological status and their influencing factors prior to and after CABG in patients with coronary disease. METHODS: A total of 82 patients received CABG at the Department of Cardiovascular Surgery, Fifth Hospital Affiliated to Xinjiang Medical University, from January 2007 to June 2009, were selected. All patients had normal cognitive and comprehension ability, without mental disorder history, and agreed to join the follow up. The patients were examined by the Chinese version of Symptom Check List-90 (SCL-90) in a day before operation and in the day before leaving hospital. RESULTS AND CONCLUSION: Prior to CABG, the factorial scores of global severity index, positive symptoms severity index, somatization, depression, anxiety, phobic were higher than norm, and the scores were significantly decrease on interpersonal sensitivity and paranoid ideation. After the procedure, the depression and anxiety score were higher than that before operation  (P < 0.05-0.01). The identical characteristics were that patients exhibited obviously depression and anxiety prior to and after operation. The depression and anxiety can increase side effects before and after CABG. The psychological state of the patients should be routinely assessed in the procedure, and at the same time the reasonable psychological intervention should be carried out, which can reduce the intraoperative complication and occurrence of cardiovascular events. Related Articles | Metrics

Select

Anatomical snuffbox versus forearm internal arteriovenous fistula for 214 hemodialysis patients with chronic renal failure: Which is the better method for permanent vascular access prior to kidney transplantation Wang Tao, Guo Dong-yang, Wei Meng, Wang Ying, Zhang Fan 2010, 14 (31):  5837-5840.  doi: 10.3969/j.issn.1673-8225.2010.31.034 Abstract ( 430 )   PDF (586KB) ( 596 )   Save BACKGROUND: Internal arteriovenous fistula of cephalic vein and radial artery in forearm is a necessary vascular access in hemodialysis before kidney transplantation. OBJECTIVE: To compare the clinical effect between anatomical snuffbox and forearm internal arteriovenous fistula in hemodialysis. METHODS: A total of 214 patients with chronic renal failure were randomly divided into snuffbox (n=118) and forearm internal arteriovenous fistula (n=96) groups, respectively underwent internal arteriovenous fistula at anatomical snuffbox and distal forearm. Success rate of operation, time of maturation, volume of blood flow, patency rate of short-term and long-term, and complications in two groups were observed and compared. RESULTS AND CONCLUSION: There were no significant differences between two groups in success rate of operation, time of mature, and volume of blood flow (P > 0.05). The patency rates in snuffbox and forearm groups were similar in short-term periods, but the patency rate was significantly greater in snuffbox group than forearm group at 2-3 years (P < 0.05), and the incidence rates of pseudoaneurysm and congestive heart failure in snuffbox group were significantly less than the forearm group (P < 0.05). Moreover, there were no significant differences in incidence rates of symptom swelling syndrome and steal syndrome between two groups (P > 0.05). Compared with forearm internal arteriovenous fistula, anatomical snuffbox internal arteriovenous fistula should be the first-chosen permanent vascular access in hemodialysis due to easier establishment, higher long-term patency rates, fewer complications and longer service life. Related Articles | Metrics

Select

Discrepancy of visual recovery following deep lamellar corneal transplantation and penetrating corneal transplantation Chen Xiao-yan, Xing Jian-qiang, Wang Kang-hong, Zhao Pu-ning 2010, 14 (31):  5841-5844.  doi: 10.3969/j.issn.1673-8225.2010.31.035 Abstract ( 502 )   PDF (701KB) ( 710 )   Save BACKGROUND: Corneal transplantation comprises optical penetrating corneal transplantation and therapeutic corneal transplantation, which aimed to recover the corneal transparency, increase visual acuity or reconstruct corneal integrity. OBJECTIVE: To compare the clinical results in improving the success rate and reducing complications following deep lamellar corneal transplantation and penetrating corneal transplantation. METHODS: A total of 43 cases (43 eyes) receiving deep lamellar corneal transplantation and penetrating corneal transplantation were selected, including 26 cases (26 eyes) receiving deep lamellar corneal transplantation and 17 patients (17 eyes) receiving penetrating corneal transplantation. Donor corneas were from donations after death and preserved within 24 h in 4 ℃ wet room. Routine anti-inflammatory medication was used following transplantation. All patients were followed up for 3-37 months. The naked vision and corrected visual acuity were observed before and after transplantation, the therapeutic effect, rejection and complication were compared.  RESULTS AND CONCLUSION: The naked vision and corrected visual acuity in the two groups were improved after transplantation (P < 0.05). One case suffered from posterior elastic membrane perforation and 2 cases of rejection following deep lamellar corneal transplantation. One case suffered glaucoma, 1 case with anterior synechia, and 4 cases with rejection following penetrating corneal transplantation. Deep lamellar corneal transplantation can reduce the incidence of rejection and complications, though there were no differences in restoring vision compared with penetrating corneal transplantation, patients with normal corneal endothelial lesions may be advised to select deep lamellar corneal transplantation. Related Articles | Metrics

Select

Application of autologous free skin graft in treatment of diabetic foot ulcer Wu Zhi-yuan, Liang Jie, Guo Xiao-rui, Huang Hai-hua, Hao Xin-guang 2010, 14 (31):  5845-5848.  doi: 10.3969/j.issn.1673-8225.2010.31.036 Abstract ( 380 )   PDF (782KB) ( 529 )   Save BACKGROUND: In the clinic, it was found that the flap survived difficultly after the diabetic foot using skin flap, whether random-pattern flap or axial pattern skin flaps are difficult to maintain a good blood supply. And it is difficult to heal where the flap for the formation to be a new wound. Transfer of local skin flap can induce poor blood supply and flap necrosis. OBJECTIVE: To explore clinical effects of autologous free skin graft transplantation in treatment of diabetic foot ulcer. METHODS: A total of 102 patients (57 males and 45 females) with diabetic foot ulcer were treated, with an average age of 54.5 years (35-83 years). The disease course of diabetes was 3 months to 23 years (12 years on average) and the disease course of diabetic foot was 20 days to 2.5 years (7 months on average). Before skin grafting, the patients were treated with general treatment, including insulin, antibiotics. Serial wound surface managements were achieved. When new layers of granulation tissues were formed over the wounds, the split skin grafts were transplanted. According to wound location, size, with the humby knife or drum dermatome to take skin from autologous donor site to graft skin with packaging method or stamp-like skin grafting. Affected limb was fixed using plaster slab. And pressure bandage with sterile pad to be ensure skin graft in close contact with the granulation wound. RESULTS AND CONCLUSION: 102 patients carried out the first partial debridement, later-stage used skin grafting. None of skin graft area formed a new ulcer because of severe wound infection or the undesirable growth. Of them, 83 cases of skin grafts survived well after the skin graft, and following wound healing they was discharged. 19 cases of skin graft survival were poor, and controlled through the dressing or replanted quickly, and then discharged, with a mean process of (21±7) days. A total of 89 cases were followed up for 15 months averagely (ranged from 3 months to 3.5 years). Eight patients developed new ulcers, with 3 lesions in situ and 5 lesions in new site. Other patients can stand or walk by themselves or with a cane. These indicated that autologous free skin graft is an effective method in treating diabetic foot ulcer. Related Articles | Metrics

Select

Quantitative detection of ICOS/ICOSL gene expression using Taqman Probe technology Zhao Lin, Gu Guo-hao, Shi Jin-fang, Jiang Min, Chen Yong-jing, Zhang Guang-bo 2010, 14 (31):  5849-5852.  doi: 10.3969/j.issn.1673-8225.2010.31.037 Abstract ( 354 )   PDF (738KB) ( 828 )   Save BACKGROUND: The inducible costimulatory molecule (ICOS) / its ligand (ICOSL) become more and more attractive in the field of anti-infection, anti-transplantation reaction, anti-tumor and treatment of autoimmune disease. Current studies focus on molecular level of ICOS/ICOSL gene expression, no study reports quantitative detection of ICOS/ICOSL mRNA expression. OBJECTIVE: To construct the plasmid standard samples of ICOS/ICOSL cDNA, and to detect the ICOS/ICOSL gene expression by the Taqman Probe technology. METHODS: The cDNA was synthesized by reverse transcription with Random 9 mers as the primer and total RNA from the gastric adenocarcinoma tissues as the template. The target sequences of human ICOS/ICOSL cDNA were amplified by polymerase chain reaction amplification from the resulting cDNA as mentioned above. The PMD-18-ICOS/ICOSL recombinant plasmids were constructed. Standard curve was made by Taqman Probe fluorescence polymerase chain reaction technology after gene sequencing. RESULT AND CONCLUSION: The composition of total RNA extracted from the tissues was complete and the sequences of the ICOS/ICOSL plasmid were consistent with the target fragments. The initial concentration of plasmids was 6.10×1013, 4.31×1013 copies/mL. The different diluted concentration of the plasmids had good linear relationship (R2=1) after amplifying by Taqman PCR and the linear range was 1012-1013 copies/mL, suggesting that the method which can quantitatively detect the concentration of ICOS/ICOSL gene by Taqman Probe technology was successfully constructed. Related Articles | Metrics

Select

Flow measurement of in situ and free-state left internal mammary artery in patients undergoing coronary artery bypass grafting Song Zheng, Li De-cai, Liu Chun-xiao, Zhang Hai-zhou, Zhang Wen-long, Wang Zheng-jun, Zi Jie 2010, 14 (31):  5853-5855.  doi: 10.3969/j.issn.1673-8225.2010.31.038 Abstract ( 469 )   PDF (521KB) ( 495 )   Save BACKGROUND: Left internal mammary artery (LIMA) bypass graft has become first choice and standard technique for coronary artery disease, which has reliable efficacy and long-term patency. However, the question whether sequential anastomosis is appropriate to LIMA and the sequential vessel blood flow is adequate for human body remains controversial. OBJECTIVE: To explore the differences in blood flow between in situ and free state of LIMA in patients with the coronary artery disease (CAD) undergoing off-pump coronary artery bypass grafting. METHODS: Between March 2008 and March 2009, 56 patients with CAD who had undergone off-pump coronary artery bypass grafting with LIMA bypass grafts were selected. A pedicle-free smooth segment of proximal LIMA was dissociated during surgery. LIMA’s in situ blood flow was measured when the hemodynamics stabilized. When the branch of LIMA was completely dissociated, the free state blood flow was measured. RESULTS AND CONCLUSION: The in situ mean flow of 56 patients was significantly better than free state flow [(32.0±5.0), (10.0±1.2) mL/min, P < 0.01]. Results show that the blood flow of LIMA is related with the number of branching vessel and the LIMA has the ability of flow reservation, which provides theoretical evidence for coronary artery bypass grafting sequential anastomosis. Related Articles | Metrics

Select

One case report of living donor liver transplantation between adult relatives Shi Jun, Ding Li-min, Xu Zhi-dan, Luo Wen-feng, Wang Yong-gang, Li Xin-chang, Luo Lai-bang, Long Cheng-mei, Chen Zhi 2010, 14 (31):  5856-5860.  doi: 10.3969/j.issn.1673-8225.2010.31.039 Abstract ( 311 )   PDF (829KB) ( 441 )   Save BACKGROUND: Living donor liver transplantation expands the source of donor, relieves the situation of donor liver shortage, and its cold ischemia time is short and quality is good. If the donor and recipient are relatives, it maybe have the merit of immunity interconsistency. OBJECTIVE: To summarize the clinical experiences of living donor liver transplantation (LDLT) between adult relatives, to explore the operation mode and transplantation effects of living donor liver transplantation between adult relatives for the treatment of end-stage liver disease. METHODS: The recipient was a 54-year-old woman who had been diagnosing post-hepatitis B cirrhosis (decompensation stage) combine portal hypertension. The donor was the patient’s nephew, who was a 23-year-old man. After surgery evaluation, procurement right lobe and transplantation to recipient, the operation was orthotopic liver transplantation. After the surgery, patient was given immunosuppression prevention of infection, hepatic protection, and other relevant supports, etc. RESULTS AND CONCLUSION: After surgery the donor had stable life signs, the operative duration for liver procurement was 4 hours, blood loss was about 150 mL, and liver function recovered to normal in 5 days postoperatively. Then he was performed upper abdominal CT scans and enhanced scans that suggested the liver coincided the changes which had been taken the right lobe in living donor transplantation. The recipient’s life sign was stationary, the surgery for live transplantation lasted 7 hours, and blood loss was about 500 mL. Color ultrasonic scan showed that liver vessels were patency, blood supply was satisfactory, and biochemical indexes recovered to normal gradually, which meant the transplantation liver function well. They survived without various complications, the follow-up survey that the function of liver retained normal in outpatient department. The case suggested that adult-to-adult living donor liver transplantation (A-A LDLT) was an excellent way to help tackle the problem of cadaveric liver shortage for treating end-stage liver disease. Related Articles | Metrics

Select

Clinical application of microsurgery in vascular reconstruction of severely injured donor liver and kidney: A 4-case report Liu Jian-ping, Chen Tao, Hong Li-xia, Wang Yang, Wan Yun-le, Lin Hao-ming, Zhou Kai-zhang, Shen Chang-li 2010, 14 (31):  5861-5864.  doi: 10.3969/j.issn.1673-8225.2010.31.040 Abstract ( 341 )   PDF (666KB) ( 446 )   Save BACKGROUND: In liver and kidney transplantation, donor liver and kidney acquisition and restoration can cause various liver and kidney vessel injuries. Moreover, the separation, drag and dissection may affect liver and renal donor quality. It is difficult to improve donor organ application by repairing liver and kidney vessel injuries. OBJECTIVE: To investigate the value of microsurgical vascular reconstruction in injured donor liver and kidney. METHODS: Hilar vessels were severely injured in 3 liver grafts and 1 kidney graft. Microsurgery was used for vascular reconstruction for arteries and veins of the grafts, followed by conventional procedure of transplantation. Clinical outcomes were analyzed. RESULTS AND CONCLUSION: All three liver grafts and one kidney graft were successfully rescued. Bile outputs were seen after reperfusion in all the three liver transplant recipients and urine output was also well in the kidney recipient. The urine volume was 1 500-2 500 mL per day. All 4 cases recovered and discharged in time. During 1.3 to 2 year’s follow up, all 4 cases survived with good graft function, with no complications. Microsurgical vascular reconstruction can be successfully applied for severely vascular injured liver and kidney graft. This might provide comparable good functional graft. Related Articles | Metrics

Select

Lymphatic fistula following liver transplantation in 3 cases Zhang Quan-sheng, Shi Yuan, Shi Rui, Teng Da-hong, Chu Zhi-qiang, Tang Zhao-he, Fang Zhen-yu, Zhang Jian-jun, Zheng Hong 2010, 14 (31):  5865-5868.  doi: 10.3969/j.issn.1673-8225.2010.31.041 Abstract ( 416 )   PDF (709KB) ( 581 )   Save BACKGROUND: Lymphatic fistula is rare complication following liver transplantation. However, portal hypertension can result in obstruction of lymph circumfluence. Thus, damage to lymphatic vessel should be prevented during transplantation. OBJECTIVE: To review the experience for lymphatic fistula after liver transplantation. METHODS: Three cases of lymphatic fistula after liver transplantation were retrospective analyzed. One case was diagnosed with hepatitis C cirrhosis, 2 cases with liver cancer combined with liver cirrhosis preoperatively. All cases were performed orthotopic liver transplantation. The diagnosis and treatment of 3 patients were recorded. RESULTS AND CONCLUSION: Normal diet were given to 3 patients at 6-8 days after liver transplantation, the right hepatic drainage from liver graft were suddenly increased, as milk white, which got clear again after low-protein diet. No abdominal pain, abdominal distension and fever were observed. Drainage fluid of 3 patients were positive for Sudan Ⅲ staining, and levels of triglyceride and total cholesterol in drainage fluid was similar to that in serum. Ultrasound showed seroperitoneum. Patients with lymphatic fistula after liver transplantation should be fasting firstly, and then given low-fat diet and parenteral nutrition for conservative treatment, thus, healing could be achieved after 1 week. The dissociation during liver transplantation should be ligated to prevent lymphatic fistula. Postoperative lymphatic fistula should be controlled by fasting and parenteral nutrition. Related Articles | Metrics

Select

Effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation　 Hou Yong-mei, Hu Pei-cheng, Liang Yan-ping, Mo Zhan-yu 2010, 14 (31):  5869-5872.  doi: 10.3969/j.issn.1673-8225.2010.31.042 Abstract ( 434 )   PDF (253KB) ( 578 )   Save BACKGROUND: Non-adherence to fluid restrictions is common in patients maintained on hemodialysis prior to and after kidney transplantation, which has a profound influence on the development and transfer of illness of the patients. Mental factors have great influences on adherence to fluid restrictions. OBJECTIVE: To investigate the effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation. METHODS: In total 100 patients maintained on hemodialysis were randomly assigned to an intervention group (n = 50) and a control group (n = 50). The control group received the conventional therapy. At the same time, the intervention group received the conventional therapy combined with rational-emotive therapy. All cases were assessed with the Symptom Checklist 90 (SCL-90) and Medical Coping Modes Questionnaire (MCMQ) prior to and after intervention. Clinical indices related to adherence to fluid restrictions were measured three successive times and the average score of each index was calculated. RESULTS AND CONCLUSION: Forty-eight patients from the intervention group and 44 patients from the control group accomplished the study. After intervention, the scores of the two subscales, confronce and avoidance, were significantly higher than those in the control group (P < 0.05). However, some scores were significantly lower than those in the control group, including the score of acceptance/resignation subscale of MCMQ, total average score of SCL-90, the score of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety and additional items, and the score of four clinical indices related to adherence to fluid restrictions (the ratio of interdialysis weight gain to dry weight, mean systolic blood pressure, mean diastolic blood pressure, and mean ultrafiltration volume prior to hemodialysis)  (P < 0.05). All these findings suggest that rational-emotive therapy can effectively amend the coping modes and the mental states of the patients, and then improve their adherence to fluid restrictions. Related Articles | Metrics

Select

Improved latissimus dorsi flap free grafting based on perforator flap conception for repairing soft tissue defects in the lower extremity Zhang Pi-hong, Lü Chun-liu, Long Jian-hong, Zeng Ji-zhang, Ren Li-cheng, Fan Peng-ju, Huang Xiao-yuan 2010, 14 (31):  5873-5877.  doi: 10.3969/j.issn.1673-8225.2010.31.043 Abstract ( 358 )   PDF (645KB) ( 565 )   Save BACKGROUND: Thoracodorsal artery perforator flap can relieve damage to donor site and avoid bulk in the recipient site, but dissociation of perforating branch took time. Some one believed that it should be done by very experienced physicians and some muscle tissues should be reserved. OBJECTIVE: To investigate the method, effectiveness and clinical application of improved latissimus dorsi flap based on perforator flap conception for reconstruction of soft tissue defects of lower extremity. METHODS: A total of 17 patients needing skin flap transplantation were selected. 12 latissimus dorsi musculocutaneous/ muscle flaps, 3 latissimus dorsi flaps with a few muscle and 2 double-leaf segmental latissimus dorsi compound flaps were designed based on perforator flap conception. According to the territory of latissimus dorsi musculocutaneous flap, a skin paddle in which anterior underlying muscle and main perforator was designed, extend about to the anterior edge of the latissimus dorsi muscle. An additional latissimus dorsi muscle flap was selected for soft tissue enlargement if necessary. Sometimes, double-leaf segmental latissimus dorsi musculocutaneous/muscle flap, including one muscle-sparing latissimus dorsi musculocutaneous flap and the other segmental latissimus dorsi muscle flap nourished by the lateral branches of the thoracodorsal vessels was selected to repair two adjacent defects. The harvested tissue area ranged from 12 cm×8 cm to    28 cm×17 cm. Survival state of skin flap, together with shape and function of donor site and recipient site of skin flap were observed. RESULTS AND CONCLUSION: Following skin flap transplantation, one case developed vascular crisis that was relieved following re-exploration for vessel anastomosis. All skin flap survived. Second-stage skin grafting was done on one muscle flap wound. All donor sites were sutured directly. After a follow-up of 3 to 18 months in 15 cases, only two cases received two-stage plastic operation because bulky flaps brought some trouble in wearing shoes. Improved latissimus dorsi flap based on perforator flap conception can reduce damage to the donor site and the receipt area bulk. Double-leaf segmental latissimus dorsi compound flaps can repair both heel and toe wound. The versatile latissimus dorsi flap designed using thoracodorsal artery perforator flap conception is an ideal flap for repairing widespread soft tissue defects in the lower extremity. Related Articles | Metrics

Select

HLA-peptide tetramers and adoptive immunotherapy in prevention of cytomegalovirus disease　 Ruan Guang-ping, Yao Xiang, Pan Xing-hua, Pang Rong-qing, Deng Yong-li 2010, 14 (31):  5878-5882.  doi: 10.3969/j.issn.1673-8225.2010.31.044 Abstract ( 327 )   Save BACKGROUND: Antiviral drugs can reduce the incidence of early-onset cytomegalovirus (CMV) disease, but are associated with strong toxicity and the development of late-onset CMV disease. In order to prevent CMV disease better, cytotoxic T lymphocytes (CTL) may play a critical role in controlling CMV reactivation. Fluorescent HLA-peptide tetramers are used to monitor the recovery of CMV CTL in recipients of allogeneic transplants. OBJECTIVE: To explore the effect of HLA-peptide tetramers and adoptive immunotherapy in treating CMV disease. METHODS: A computer-based online search of Pubmed and Wanfang databases was performed for articles related to CTL detection, application of antiviral drugs and HLA-peptide tetramers, and adoptive immunotherapy with key words “HLA-peptide tetramers, cytomegalovirus, specific CTL, adoptive immunotherapy” in English and Chinese. Repetitive articles were excluded and 29 articles were included. RESULTS AND CONCLUSION: Adoptive immunotherapy with CMVs cytotoxic T cells as preemptive therapy is a very elegant strategy; however, generation of these cells is costly and time-consuming, and therefore the therapy is not available at every transplantation center. Magnetic selection of CMVs CD8+ T cells from peripheral blood of CMV-seropositive donors by using HLA-peptide tetramers may be very hopeful, which simplifies adoptive immunotherapy. Related Articles | Metrics

Select

Improvement of cervical heterotopic heart transplantation in mice using Tail-Cuff technique Zhang Song-lin, Sun Zong-quan 2010, 14 (31):  5883-5886.  doi: 10.3969/j.issn.1673-8225.2010.31.045 Abstract ( 424 )   PDF (291KB) ( 421 )   Save BACKGROUND: The mouse model of cervical heart transplantation is an ideal medical research tool for study of transplant-induced ischemia/reperfusion injury and immunological rejection. However, technical problems have limited the widespread use of mouse cervical vascularized heart transplantation. OBJECTIVE: To improve the cervical heterotopic heart transplantation in mice using the tail-cuff technique. METHODS: Isogeneic transplantation was performed from Balb/c to BALB/c mice, and allogeneic transplantation from C57BL/6 to BALB/c mice. The right common carotid artery and the external jugular vein of the recipient were equipped with a tail cuff made from 24 G and 22 G intravenous catheter, and everted over the cuff, and then connected with the aorta and the pulonary artery of donor heart, respectively. RESULTS AND CONCLUSION: A total of 36 transplants for formal experiment, 12 for isogeneic transplantation, and 24 for allogeneic transplantation, were performed with a surgical successful rate of 100%. The total surgical procedure was (49.6±7.4) minutes and total ischemic time of the grafts was (28.8±4.2) minutes. In particular, the average time for vascular everting and for the reconnection of both vessels was obviously shortened. This improved tail-cuff technique shows its superiority, and can serve as an ideal method for establishing cervical heterotopic heart transplantation model in mice. Related Articles | Metrics

Select

Genetic polymorphism of cytochrome P450 2C19 in Xinjiang Uigur population versus Han population Alimu Kadeer, Munila Anwar, Niu Chun-yan, Luo Jin-yan 2010, 14 (31):  5887-5890.  doi: 10.3969/j.issn.1673-8225.2010.31.046 Abstract ( 432 )   PDF (273KB) ( 440 )   Save BACKGROUND: Previous studies demonstrated that, metabolic phenotype of cytochrome P450 2C19 has genetic polymorphism, which presents with extensive or poor metabolisms and has great differences in races and individuals. OBJECTIVE: To study the genotype distribution of cytochrome P450 2C19 in Xinjiang Uigur population. METHODS: In total 144 unrelated Uigur and 156 unrelated Han subjects were genotyped for cytochrome P450 2C19 by polymerase chain reaction-restriction fragment length polymorphism. The differences of gene phenotype and gene frequency were compared between Uigur and Han populations. RESULTS AND CONCLUSION: The frequency of extensive metabolism wt/wt, wt/m and wt/m1+wt/m2 of Uigur was notably higher than that of Han population (P < 0.05), but the frequency of poor metabolism m1/m1 was obviously lower than that of Han population (P < 0.05). There were significant differences between Uigur and Han populations in allele frequency wt, m1 and m2  (P < 0.05), especially m1, which was 58-fold of m2 (P < 0.01). The results revealed that, distribution frequency m1/m1 of poor metabolism of Uigur is obviously lower than that in Han population, and m1 frequency is higher than that of Han population, accordingly, m1 is the main gene mutation of cytochrome P450 2C19 in Uigur population. Related Articles | Metrics