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30 July 2011, Volume 15 Issue 31 Previous Issue    Next Issue

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Correlation of tumor necrosis factor-alpha and interleukin-10 expression to acute rejection in complex tissue and serum of rats after laryngeal transplantation Yuan Mu, Chen Gang, Zhao Hua, Jing Jian-jun 2011, 15 (31):  5701-5706.  doi: 10.3969/j.issn.1673-8225.2011.31.001 Abstract ( 101 )   PDF (451KB) ( 311 )   Save BACKGROUND: It remains unclear whether proinflammatory factor, such as tumor necrosis factor-α (TNF-α), γ-interferon and anti-inflammatory cytokine, such as interleukin-10 (IL-10), interleukin-4 (IL-4) levels can change after laryngeal transplantation. OBJECTIVE: To explore the expression of TNF-α and IL-10 in different expressive tissue layers and its relationship during the acute rejection episodes, and to evaluate the role of TNF-α and IL-10 levels in serum for prediction of early acute rejection after laryngeal transplantation. METHODS: Laryngeal heterotopic transplantations were performed in Wistar and Sprague-Dawley rats. According to different dosages of immunodepressant, all recipients were divided into three groups: Group 0 mg, Group 5 mg, and Group 10 mg. Untreated Sprague-Dawley rats served as normal control group. RESULTS AND CONCLUSION: Changes in serum TNF-α and IL-10 levels at postoperation days 3, 7 and 11 were positively correlated with these expressions in the epithelium mucosa and submucosa at various time points after transplantation. These indicate that the high-antigenicity of graft mainly concentrates on the layers of mucosa and submucosa. TNF-α and IL-10 concentrations can serve as indexes for predicting acute rejection after laryngeal transplantation. Related Articles | Metrics

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Analysis of liver function test and screening of early warning indicators for biliary cast group after orthotopic liver transplantation Yang Yu-long, Liu Zhen-wen, Lin Mei-ju, Zhang Hong-wei, Shi Li-jun 2011, 15 (31):  5707-5712.  doi: 10.3969/j.issn.1673-8225.2011.31.002 Abstract ( 129 )   PDF (784KB) ( 370 )   Save BACKGROUND: When biliary cast syndrome in liver transplantation is identified, the transplanted liver has been injured to different extents because of obstruction of biliary tract and repeated infection, therefore, it is extremely important to detect biliary cast syndrome. OBJECTIVE: To detect the liver function of patients who underwent orthotopic liver transplantation and exhibited biliary cast complications and to screen the warning indicators for early diagnosis of biliary casts. METHODS: We retrospectively analyzed the liver function indices of 25 patients with biliary tract complications after liver transplantation, which have been confirmed by endoscopic or radiographic cholangiography. The 25 patients were assigned to four groups according to the syndromes: biliary cast (n =7), biliary duct anastomotic stricture (n = 5), biliary cast + anastomotic biliary stricture (n = 13) and normal biliary duct (n = 18). RESULTS AND CONCLUSION: At 1 week after liver transplantation, there was no significant difference in liver function indices between normal biliary duct and other groups (P > 0.05). At 1 months after liver transplantation, serumγ-glutamyl transpeptidase was significantly higher in the biliary cast group, biliary cast + anastomotic biliary stricture group than in the normal biliary duct group (P< 0.01), and it was significantly lower in the biliary duct anastomotic stricture group than in the biliary cast group (P < 0.05). The results showed that biliary cast is the potential complication of orthotopic liver transplantation; serumγ-glutamyl transpeptidase can be used as an warning indicator of biliary cast group after orthotopic liver transplantation and it is also an important reference indicator for identification of jaundice causes following surgery and an indication for choledochoscopy and surgical treatment. Related Articles | Metrics

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MRI evaluation of vascular and biliary complications before and after orthotopic liver transplantation Long Kai-lin, Zou Pan 2011, 15 (31):  5713-5716.  doi: 10.3969/j.issn.1673-8225.2011.31.003 Abstract ( 124 )   PDF (536KB) ( 418 )   Save BACKGROUND: MRI scanning technology have been improved and achieved a “one-stop” MR comprehensive examination, that is, an inspection process using a variety of sequences to get the image assessment of liver blood vessels, pancreatic duct system and abdominal organs. It is characterized by convenient, fast and simple. OBJECTIVE: To evaluate the MRI examination before and after liver transplantation in clinical application. METHODS: Totally 38 patients with liver cirrhosis and liver cancer received treatment in Transplantation Center, the Third Xiangya Hospital, Central South University, were selected, including 27 males and 11 females, aged 23-68 years. They underwent 1.5T MRI and 2-slice spiral CT inspections pre- and post- orthotopic liver transplantation, and finally be confirmed by surgical and pathological findings. The observation effects were compared with two scanning methods. RESULTS AND CONCLUSION: All patients with end-stage liver disease examined by pre- and post- MRI can accurately describe the case of liver lesions, abnormal blood vessels and biliary tract anatomy, as well as emboli and stones. The result is better than 2-slice spiral CT. That MRI assessment has a very important value in evaluation pre- orthotopic liver transplantation and early detection of complications after transplantation. Related Articles | Metrics

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Influence of ABCB1 polymorphisms on tacrolimus dosage requirements in patients following liver transplantation Liu Qi-yu, Li Li, Li Xiao-yan, Chen Gang, Zhao Ying-peng, Bai Jian-hua, Zhu Xin-feng 2011, 15 (31):  5717-5721.  doi: 10.3969/j.issn.1673-8225.2011.31.004 Abstract ( 170 )   PDF (829KB) ( 561 )   Save BACKGROUND: The calcineurin inhibitor tacrolimus is widely used to prevent allograft rejection after liver transplantation. It has a narrow therapeutic index and shows considerable interindividual differences in its pharmacokinetics. OBJECTIVE: To evaluate retrospectively the effect of genetic polymorphisms of ABCB1 on tacrolimus dosage and dosage adjusted trough blood concentration during the early period after liver transplantation in patients. METHODS: Sixty-seven liver transplantation recipients were genotyped by DNA sequencing for ABCB1. Tacrolimus whole blood levels were measured by enzyme-linked immunospecific assay. Dose-adjusted trough blood concentrations (C) were determined and compared among different genotype groups. RESULTS AND CONCLUSION: The tacrolimus dosage had great variation between individuals. A synonymous single nucleotide polymorphism (SNP) of ABCB1 in various exons was different. Furthermore, ABCB1 3435C>T polymorphisms was significantly correlated with tacrolimus dose-adjusted pre-dose concentrations at various time points. The present study shows that genetic polymorphisms in ABCB1 may be responsible, in part, for the large interindividual variability of tacrolimus pharmacokinetics during the early period after liver transplantation in patients. Patients in ABCB1 3435C>T wild-type expressors require a high dose of tacrolimus to reach target levels compared with mutator expressors. Genotyping future transplant recipients for ABCB1 polymorphisms, therefore, could have the potential to individualize better tacrolimus immunosuppressive therapy and enhance drug safety. Related Articles | Metrics

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Effects of Danshen on heme oxygenase-1 expression in rat transplanted liver Gao Chuan-chang, Li Dong-sheng, Wang Kai, Zou Shu-bing 2011, 15 (31):  5722-5725.  doi: 10.3969/j.issn.1673-8225.2011.31.005 Abstract ( 174 )   PDF (1371KB) ( 286 )   Save BACKGROUND: Danshen pretreatment before organ transplantation can protect tissue from ischemia-reperfusion injury and improve the survival rate of grafts OBJECTIVE: To investigate the effects of Danshen-containing cold perfusion solution on heme oxygenase-1 (HO-1) expression in rat liver allograft and the protective effects on donor liver from ischemia-reperfusion injury. METHODS: Sprague-Dawley male rats were randomly divided into University of Wisconsin solution (UW) solution group (UW group, preservation using UW solution during transplantation), Danshen+UW solution group (DS+UW group, preservation with Danshen+UW solution during transplantation), ZnPP (HO-1 inhibitor) pretreatment group (ZnPP group, intraperitoneal injection of ZnPP 24 hours before transplantation, and preservation with Danshen+UW solution during transplantation). Reliable rat models of liver allografting were established. Ten normal rats were selected as normal controls. RESULTS AND CONCLUSION: Serum total bilirubin, alanine aminotransferase, and aspartate aminotransferase levels were significantly lower in the DS+UW group, UW group than in the ZnPP group (P < 0.01). HO-1 mRNA and protein expressions were greater in the DS+UW group than in the UW group, but the expressions were obviously inhibited in the ZnPP group (P < 0.05). Suzuki scores were significantly lower in the DS+UW group than in the ZnPP group and UW group. These findings suggest that Danshen can upregulate HO-1 mRNA and protein expressions in rat liver allograft, alleviate ischemia-reperfusion injury of donor liver, and protect the transplanted liver. Related Articles | Metrics

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Effects of omega-3 fish oil emulsion on changes in serum cytokines after liver transplantation Jiang Tao, Wang Xuan, Yang Ai-zhen, Lu Lei, Zhang Dong-hua, Zhang Rong-sheng 2011, 15 (31):  5726-5730.  doi: 10.3969/j.issn.1673-8225.2011.31.006 Abstract ( 128 )   PDF (1638KB) ( 374 )   Save BACKGROUND: Omega-3 fish oil emulsion can adjust systemic inflammatory response after liver transplantation. OBJECTIVE: To investigate the effects of omega-3 fish oil emulsion on the changes of cytokines and the prognosis of patients undergoing liver transplantation. METHODS: All 36 orthotopic liver transplantation patients were prospectively randomized into two groups: experimental and control. After liver transplantation, two group patients received isocaloric and isonitrogenous nutritional support and the same immunosuppressive regimen. From day 2 after liver transplantation, the experimental group patients received omega-3 fish oil emulsion for successive 6 days while the control group patients did not. RESULTS AND CONCLUSION: Compared with the control group, on days 5, 8 after liver transplantation, interleukin (IL)-1β, IL-2, IL-6, tumor necrosis factor (TNF)-α, prostaglandin E2, and leucotriene B4 were downregulated to different degrees, IL-4, IL-10, TNF-β and leukotriene were upregulated to different degrees in the experimental group. On day 8 after liver transplantation, the ratio of IL-6/IL-10 was significantly decreased and the ratio of IL-10/ TNF-α was significantly increased (P < 0.01). There was no significant difference in perioperative mortality and acute rejection incidence between experimental and control groups. However, The postoperative ICU stay time and hospital stay time were significantly shorter in the experimental group than in the control group (P < 0.05). These results showed that additional omega-3 fish oil emulsion in liver transplantation patients can effectively decline the levels of proinflammatory cytokines and retrieve the extra inflammatory response, modulate the balance of pro-/anti-inflammation, and improve prognosis. Related Articles | Metrics

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Effect of laser drilling before vitrified cryopreservation on transplantation of frozen-thawed blastocyts Fang Jian-ye, Yang Jing, Yin Tai-lang, Cheng Yan, Zhao Qing-hong, Zou Yu-jie, Huang Wei 2011, 15 (31):  5731-5734.  doi: 10.3969/j.issn.1673-8225.2011.31.007 Abstract ( 137 )   PDF (1269KB) ( 450 )   Save BACKGROUND: A series of studies have demonstrated that artificially reduced blastocoelic cavity can greatly increase the vitrified frozen-thawed effects of blastocytes, but different physical methods and materials used during the process of reduction can lead to mechanical injury to blastocytes. OBJECTIVE: To investigate the effects of laser drilling before vitrified cryopreservation of transplantation of frozen-thawed blastocyts. METHODS: Blastocytes from three dysgenesia patients who averaged 30 years old were subjected to laser drilling before vitrified cryopreservation to reduce the blastocoelic cavity for 1 year on average. Before transplantation, these blastocytes were thawed. RESULTS AND CONCLUSION: Two patients acquired satisfactory pregnancy and one patient did not get pregnancy. The results showed that laser drilling before vitrified cryopreservation reduces blastocoelic cavity and transplantation of frozen-thawed blastocytes is safe and effective. Related Articles | Metrics

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Chemically acellularized nerve allografts for repair of rat S1 nerve defects    Li Hang-xu, Zou Lian, Liu De-zhong, Zhang Xiao-yi, Zhang Zi-liang 2011, 15 (31):  5735-5738.  doi: 10.3969/j.issn.1673-8225.2011.31.008 Abstract ( 116 )   PDF (1255KB) ( 397 )   Save BACKGROUND: Autologous nerve transplantation is the most common method for repair of peripheral nerve injury. OBJECTIVE: To investigate the efficacy of chemically acellularized nerve allografts for repair of rat S1 nerve defects and to search the ideal methods and materials for repair of peripheral nerve injury. METHODS: SD rat S1 nerve was taken and chemically acellularized to remove the immunogenic component. 1 cm long incision was made on the right S1 in SD rats and bridged with the nerve allograft. RESULTS AND CONCLUSION: Compared with prior to surgery, the urinary leakage site of the detrusor muscle was lowered, the maximum volume and compliance of the bladder were significantly increased (P < 0.05) at 8 weeks after surgery. Neurofilament staining showed that on the experimental (right) side, neural anastomotic stoma was stained green, nerve fibers were orderly distributed, and regenerated axons grew towards distal nerve; on the left side, nerve morphology was normal, nerve fibers were orderly arranged, and axons did not grow toward distal nerve. These findings suggest that chemically acellularized nerve allografts with obviously decreased antigenicity can repair peripheral nerve injury in high grade mammals. Related Articles | Metrics

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Safety and efficacy of cyclosporine A trough level monitoring and 2 hours level post-administration monitoring in organ transplantation recipients: A Meta analysis Li Hai-ju, Ping Wei-wei 2011, 15 (31):  5736-5760.  doi: 10.3969/j.issn.1673-8225.2011.31.013 Abstract ( 102 )   PDF (586KB) ( 501 )   Save BACKGROUND: Cyclosporine microemulsion (CsA-ME) is a drug with a narrow therapeutic window and highly variable pharmacokinetics. Therapeutic drug monitoring is essential and has been conventionally guided by trough levels (C0). Recent evidence indicates that a single blood concentration monitoring 2 hours after CsA administration (C2) is a more accurate predictor of the occurrence of the acute reject reaction and harmful reaction than monitoring of C0. OBJECTIVE: To analyze the clinical benefits of cyclosporine C2-level monitoring and C0-level monitoring in solid organ transplantation recipients. METHODS: Case-control studies and cohort studies were collected by searching the electronic bibliographic databases such as CBMdisc (1979 to 2010), Chinese Sci-tech Periodical Full-text Database (1989 to 2010), Wanfang (1982 to 2010), Chinese Journals Full-text Database (since 1994), China Master’s Theses Full-text Database (since 1999), and China Doctor Dissertations Full-text Database (since 1999). All the relevant studies were identified and the quality of the included studies was assessed. The RevMan 4.2 software was used for meta-analysis. RESULTS AND CONCLUSION: Eight studies with 1 148 patients were included. Result of Meta analysis showed: the rate of acute rejection episodes in C2 was lower than that in C0 [OR = 1.64, 95%CI(1.15, 2.35)]; mean C0 level in the rejection group was lower than that in the no rejection group [SMD = -0.40, 95%CI(-0.68, -0.13)]; mean C2 level in the rejection group was lower than that in the no rejection group [SMD = -1.11, 95%CI(-1.64, -0.58)]; the difference between C2 group and C0 group in terms of the rate of harmful reaction was not significant [OR = 0.92, 95%CI(0.52,1.62)]; the difference between harmful reaction group and no harmful reaction group in terms of mean C0 level was not significant [SMD = 0.14, 95%CI(-0.28, 0.55)]; mean C2 level in the harmful reaction group was higher than that in the no harmful reaction group [SMD = 0.94, 95%CI(0.05,1.83)]; the current domestic evidence proves that both C2 and C0 monitoring can predict acute rejection episodes, C2 monitoring is better than C0 monitoring. C2 monitoring can predict harmful reaction. In conclusion, C2 is a more accurate predictor of the occurrence of the acute reject reaction and harmful reaction than C0. Related Articles | Metrics

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Analysis of clinical outcomes for embryo transfer and blastocyst transfer Hao Gui-qin, Li Rong, Geng Lan, Xu Jin-bei, Yang Wei-hong 2011, 15 (31):  5739-5742.  doi: 10.3969/j.issn.1673-8225.2011.31.009 Abstract ( 105 )   PDF (521KB) ( 948 )   Save BACKGROUND: It is less reported in China about the clinical outcome of cleavage-stage embryo transfer and blastocyst transfer. OBJECTIVE: To compare the clinical outcome of the cleavage stage transfer and blastocyst transfer. METHODS: 1 612 IVF/ICSI cycles treated in Peking University Shenzhen Hospital between January 2008 and December 2009 were included in the study. It was compared between D2/D3 cleavage stage transfer and D5 blastocyst transfer about clinical pregnancy rate, implantation rate, abortion rate, multiples and sex ratio of neonatal. RESULTS AND CONCLUSION: The cycle number of D2/D3/D5 group was 195, 1162 and 255. The clinical pregnancy rate was 33.33%, 38.04%, 44.71% respectively for three groups. The implantation rate was 21.37%, 24.70%, 31.96%. The clinical pregnancy rate and implantation rate were higher in D5 group than in D2/3 group (P < 0.05). For ectopic pregnancy, the risk estimate was higher in D2 group than in D3 group. No statistically differences existed in regard to abortion, monozygotic twin, multiples, preterm birth and sex ratio of neonatal among three groups. It was demonstrated a higher pregnancy rate and implantation rate after blastocyst transfer than after cleavage stage transfer. At the same time, the risk of abortion, monozygotic twin, multiples, preterm birth had not increased. It had no adverse effect on the sex ratio of neonatal. Related Articles | Metrics

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Hamstring tendon autograft versus tendon allograft for reconstruction of anterior cruciate ligament Zhang Yi-long, Li Ning, Li Zhi-huai, Song You-xin, Liu Jian-feng, Li Zhe, Sun Zhi-jie 2011, 15 (31):  5743-5746.  doi: 10.3969/j.issn.1673-8225.2011.31.010 Abstract ( 122 )   PDF (622KB) ( 612 )   Save BACKGROUND: There are mostly three kinds of grafts used in ansterior cruciate ligament reconstruction, such as autografts, allograft and artificial ligaments, each of which has its own advantages and disadvantages. There are a lot of debates on selections of grafts. OBJECTIVE: To evaluate the therapeutic effects of hamstring tendon autograft and tendon allograft used in reconstruction of anterior cruciate ligament (ACL). METHODS: Seventy knees with ACL tear in 70 patients, verified by arthroscopy at the Department of Orthopedics in the Affiiliated Hospital of Chengde Medical College from January 2007 to January 2009, were divided into two groups, and all the damaged ansterior cruciate ligaments were reconstructed under arthroscopy with hamstring tendon autograft or tendon allograft respectively. The value of KT-1000 and the Lysholm scores were recorded before operations and during follow-ups. RESULTS AND CONCLUSION: All of them were followed up for 18 to 24 months with an average of 20.1 months except two were missing. No severe complication, such as vascular nerve injury, infection and rupture of graft occurred in early stage after operations in the patients followed. Wound around canal orifice of drainage tube exuded continuely in two cases of allograft group, which were cured successfully by changing dressings after half a month. Lysholm scores of both groups increased, side-side difference of the postoperative anterior laxity decreased significantly, and there was no statistical significance in the above-mentioned data between these two group (P > 0.05). These findings suggest that the therapeutic effects in the two groups are satisfactory equally. Related Articles | Metrics

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Endoscopic posterior cruciate ligament reconstruction using achilles tendon allografts: single-bundle versus double-bundle Zhang Qi-liang, Teng Xue-ren 2011, 15 (31):  5747-5750.  doi: 10.3969/j.issn.1673-8225.2011.31.011 Abstract ( 116 )   PDF (486KB) ( 328 )   Save BACKGROUND: Endoscopic posterior cruciate ligament reconstruction using achilles tendon allografts has been primarily performed by single-bundle and double-bundle types. OBJECTIVE: To compare the clinical outcome of single-bundle and double-bundle endoscopic posterior cruciate ligament reconstruction using achilles tendon allograft. METHODS: A total of 70 patients with single posterior cruciate ligament injury who received treatment at the Department of Orthopedics, Qingdao Municipal Hospital between January 2006 and January 2009 were included in this study. All patients were randomly divided into two groups: single-bundle group and double-bundle group. The single-bundle group had single-bundle reconstruction using achilles tendon allograft, and the double-bundle group had double-bundle reconstruction. RESULTS AND CONCLUSION: After surgery, 52 patients were successfully healed and followed up. The surgery time and the number of patients who need joint puncture were greater in the double-bundle group than in the single-bundle group (P < 0.05). At 18 months after surgery, the stability and range of motion of the knee joint, Lysholm and IKDC scores were improved in each group compared with prior to surgery (P < 0.05). The tibial backward distance tested by KNEELAX3 when the knee joint flexed at 30° and 90° was significantly improved compared with prior to surgery (P < 0.05). There was no significant difference in the range of motion of the knee joint, Lysholm and IKDC scores, and the tibial backward distance tested by KNEELAX3 when the knee joint flexed at 30° and 90° between the single-bundle and double-bundle groups (P > 0.05). Compared with single-bundle reconstruction, double-bundle reconstruction resulted in poor improvement in early clinical curative effects and greater surgical trauma, required long surgery time, and lead to swelling of the knee joint. Therefore, double-bundle reconstruction should not be the preferred protocol for posterior cruciate ligament reconstruction and its long-term effects need to be further investigated. Related Articles | Metrics

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Platelet-rich plasma fibrin glue in the early stage for survival rate of autogeneic fat graft Li Hong-mian, Liu Da-lie, Wu Tao, Zhao Pei-ran, Liang Shuang-wu 2011, 15 (31):  5751-5755.  doi: 10.3969/j.issn.1673-8225.2011.31.012 Abstract ( 141 )   PDF (822KB) ( 793 )   Save BACKGROUND: Autogeneic fat is the ideal filling material in aesthetic and reconstructive surgery. However, the autogeneic fat graft produces serious impact on long-term effect because much fat would be absorbed after transplantation. Accordingly, difficulties in this field are how to increase the survival rate of autogeneic fat graft. OBJECTIVE: To investigate the effect of platelet-rich plasma (PRP) on the survival rate of autogeneic free grain fat grafts. METHODS: The fat was harvested from abdominal region of healthy adults and purified. At the same time, venous blood was taken from concurrent patients and PRP was prepared by centrifugation. The grafts were made using fibrin glue combined with PRP according to the physical characteristics of fibrin glue. A subdermal pocket was created in each side of the dorsal midline, the grafts which carried fat particle and PRP fibrin glue were randomly implanted below the deep fascia of the pocket as an experimental group, and simple fat particles were grafted into another pocket as a control group. RESULTS AND CONCLUSION: At 1 and 3 months after implantation, compared with the control group, angiogenesis surrounding the implanted fat particles was significantly obvious (P < 0.05), the maintenance rate of free fat graft was significantly high (P < 0.05), and fibrous proliferation and steatonecrosis rate was significantly low (P < 0.05) in the experimental group. Results showed that PRP fibrin glue can increase angiogenesis and weight maintenance rate of the free fat grafts in the early stage, and at the same time, it can also decrease the fibrous proliferation and steatonecrosis rate of the free fat grafts. Related Articles | Metrics

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Gene expression detection in kidney tissue allograft transplantation for improvement of renal anemia Liu Rong-yao, Liu Bai-cheng, Wang Wang-long, Zhang Hong-yu, Guo Jian-zhong, Liu Jing 2011, 15 (31):  5761-5764.  doi: 10.3969/j.issn.1673-8225.2011.31.014 Abstract ( 104 )   PDF (596KB) ( 307 )   Save BACKGROUND: Erythropoietin (EPO) deficiency is difficult to improve renal anemia caused by chronic renal failure. OBJECTIVE: To investigate the effects of kidney tissue allograft transplantation on EPO gene expression in rats with renal anemia. METHODS: A total of 80 Wistar rats were randomly divided into four groups: normal control, case control, recombinant human EPO, and kidney tissue allograft. Rats in the kidney tissue graft group were developed into models of renal failure. RESULTS AND CONCLUSION: At 60 days after renal transplantation, hemoglobin level and serum level of EPO were significantly higher in the kidney tissue allograft group than in the case control group (P < 0.05), and there were no significant difference in these two indices between the kidney tissue allograft group and recombinant human EPO group (P > 0.05). EPO mRNA expression was significantly higher in the kidney tissue allograft group than in the case control group (P< 0.05). These findings suggest that the mechanism underlying kidney tissue allograft for improvement is that increased EPO mRNA expression in the kidney tissue increases EPO expression in the kidney and thereby increases hemoglobin level. Related Articles | Metrics

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Application of urine IP-10 and Fractalkine in early diagnosis of acute rejection following renal transplantation Wang Min, Tian Pu-xun, Ding Chen-guang, Jin Zhan-kui, Ge Guan-qun, Jia Li-ning, Ruan Dong-li, Hao Jun-jun 2011, 15 (31):  5765-5768.  doi: 10.3969/j.issn.1673-8225.2011.31.015 Abstract ( 140 )   PDF (595KB) ( 305 )   Save BACKGROUND: Studies have confirmed that urine IP-10 and Fractalkine play an important role in acute rejection following organ transplantation. OBJECTIVE: To investigate early diagnosis and post-treatment expression of urine IP-10 and Fractalkine in the acute rejection after renal transplantation, through detecting the association of the urine IP-10 and Fractalkine variation according to some cases of nephridial tissue biopsy. METHODS: According to the postoperative clinical manifestation, laboratory examination and renal biopsy histopathological examination results, we divided 106 patients with renal transplantation allograft patients into acute rejection group (n  = 16) and the stable group (n  = 90). Healthy volunteers were chosen as normal control group (n = 10). IP-10 and Fractalkine concentration changes were measured by double antibody sandwich enzyme-linked immunosorbent adsorption. RESULTS AND CONCLUSION: The urine level of IP-10 and Fractalkine in patients with renal transplantation post-operation was significantly higher than pre-operation group. But one week post-operative, the urine level of IP-10 and Fractalkine was declined in the stable group and to preoperative level after 11 days, and acute rejection group continued high expression. IP-10 with first day postoperative and Fractalkine with third day postoperative compared with stable group showed significant difference  (P < 0.05). It is confirmed that to detect the urine levels of IP-10 and Fractalkine in patients with renal transplantation pre-operation and post-operation has certain clinical significance to early diagnose and treat acute rejection. Related Articles | Metrics

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Effects of tacrolimus and cyclosporine A on inflammatory cytokines and blood lipid after renal transplantation Liu Ke-pu, Yi Xiao-min, Ma Shuai-jun, Li Zhi-bin, Zhang Geng, Yuan Jian-lin 2011, 15 (31):  5769-5772.  doi: 10.3969/j.issn.1673-8225.2011.31.016 Abstract ( 150 )   PDF (524KB) ( 364 )   Save BACKGROUND: Tacrolimus (FK506) and cyclosporine A (CsA) are widely used immunosuppressive agents after renal transplantation in the clinic. OBJECTIVE: To investigate the effects of FK506 and CsA on inflammatory cytokines and blood lipid after renal transplantation. METHODS: Totally 112 patients who received renal allograft for the first time were randomly divided into two groups. The CsA group received a triple therapy of CsA, mycophenolate mofetil and glucocorticoid. The FK506 group received a triple therapy of FK506, mycophenolate mofetil and glucocorticoid. 1-year survival rate, reversing rate, serum concentrations of interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, fasting plasma glucose and blood lipid were measured in the FK50 and CsA groups. RESULTS AND CONCLUSION: In the FK506 group, 1-year survival rate and reversing rate were significantly higher, while acute rejection rate was significantly lower, compared with the CsA group (P < 0.05). In the FK506 group, serum concentrations of IL-2, IL-6, IL-8 and fasting plasma glucose at 1 month and 1 year after transplantation were significantly higher compared with before transplantation (P < 0.05) and CsA group (P < 0.05). In the FK506 group, serum concentrations of IL-4 and IL-10 at 1 month and 1 year after transplantation were significantly lower compared with before transplantation (P < 0.05), but significantly higher compared with the CsA group (P < 0.05). In the FK506 group, total cholesterol, triacylglycerol and low density lipoprotein cholesterol at 1 month after transplantation were significantly higher compared with before transplantation (P < 0.05), but were significantly lower compared with the CsA group (P < 0.05). In the FK506 group, total cholesterol and low density lipoprotein cholesterol at 1 year after transplantation were significantly lower compared with CsA group (P < 0.05). These findings suggest that FK506 may reduce acute rejection and increase survival rate of renal transplantation via inhibiting the release of cytokines and improving glucose and lipid metabolisms. Related Articles | Metrics

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Safety of combined spinal-epidural anesthesia during kidney transplantation in patients with uremia and heart failure Zhang Cai-qin, Wu Ya-hui, Qiao Hui 2011, 15 (31):  5773-5776.  doi: 10.3969/j.issn.1673-8225.2011.31.017 Abstract ( 98 )   PDF (607KB) ( 335 )   Save BACKGROUND: Uremia combined with heart failure is not the contraindication of kidney transplantation, but anesthesia management is very difficult. OBJECTIVE: To investigate the safety of combined spinal-epidural anesthesia during kidney transplantation in patients with uremia and heart failure. METHODS: Under combined spinal-epidural anesthesia, 16 patients with heart failure underwent allogenic corpse kidney transplantation. Before and 10 minutes after anesthesia, before and after reperfusion of kidney transplant, and after kidney transplantation, systolic pressure, diastolic pressure, heart rate, and saturation of blood oxygen were determined. RESULTS AND CONCLUSION: Compared with prior to anesthesia, systolic pressure, diastolic pressure and heart rate were significantly decreased (P < 0.05) and heart failure symptoms were obviously alleviated at 10 minutes after anesthesia. During the time period from transplantation initiation to transplantation termination, hemodynamical changes were stable, and patients’ heart failure symptoms were completely relieved. All 16 patients were safe during the period of anesthesia. These findings suggest that combined spinal-epidural anesthesia for kidney transplantation in patients with acute left heart failure can produce good anesthetic effects if anesthetic dose and administration speed are proper; in addition, it also can decrease cardiac afterload, improve heart and lung function, and maintain stable hemodynamics, without influence on blood perfusion of kidney transplant. Related Articles | Metrics

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Living unrelated donor kidney transplantation between spouses and living related donor kidney transplantation Shen Bei-li，Qu Qing-shan, Yang Lei, Liang Shao-feng, Li Ming 2011, 15 (31):  5777-5780.  doi: 10.3969/j.issn.1673-8225.2011.31.018 Abstract ( 112 )   PDF (528KB) ( 385 )   Save BACKGROUND: Living unrelated donor kidney transplantation between spouses is poorer than living related donor kidney transplantation in tissue matching, but clinical practice shows that there is no obvious difference in short-term curative effects between these two types of kidney transplantation. OBJECTIVE: To compare the clinical curative effects between living unrelated donor kidney transplantation between spouses and living related donor kidney transplantation and summarize the clinical experience of kidney transplantation between spouses. METHODS: A retrospective clinical data analysis was made regarding 18 patients who received kidney transplantation between spouses and 100 patients who received living related donor kidney transplantation. The clinical curative effects were compared between these two types of kidney transplantation by analyzing some indices including tissue matching before transplantation and renal function recovery, acute rejection and infection incidence at 1, 3, and 6 months. RESULTS AND CONCLUSION: Tissue matching before transplantation was poorer in 18 patients undergoing kidney transplantation between spouses than in 100 patients undergoing living related donor kidney transplantation. Under the same transplantation proposal and immunosuppressive therapy, there was no significant difference in serum creatinine level, renal function recovery, acute rejection, and infection incidence within 6 months after transplantation between kidney transplantation between spouses and living related donor kidney transplantation (P > 0.05). These findings suggest that the clinical curative effects are similar between living unrelated donor kidney transplantation between spouses and living related donor kidney transplantation. Related Articles | Metrics

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Evaluation of donor’s renal function during living-related donor kidney transplantation Zhao Yu-bo, Shi Bin-yi, Fang Jia-li, Chen Zheng, Pan Guang-hui, Chen Jian-bing, Wang Ke, Gao Zhen-li 2011, 15 (31):  5781-5784.  doi: 10.3969/j.issn.1673-8225.2011.31.019 Abstract ( 124 )   PDF (588KB) ( 453 )   Save BACKGROUND: Proper effective evaluation of bilateral renal function before kidney transplantation is of importance for the safety of donors and recipients during living-related donor kidney transplantation. OBJECTIVE: To investigate the suitable indexes for evaluating living donor’s renal function in living-related donor kidney transplantation. METHODS: A total of 173 cases of living-related donor kidney transplantation were analyzed retrospectively. The donor grafts were divided into two groups: elderly group (≥ 55 years) and young- and middle-aged group (< 55 years). Before kidney transplantation, there was no significant difference in the indexes which reflect renal function, including serum creatinine, total glomerular filtration rate (GFR), remaining renal GFR, endogenous creatinine clearance rate, and blood urea nitrogen. Change in each index of renal function was compared before and after kidney transplantation. RESULTS AND CONCLUSION: Compared with before transplantation, serum creatinine and blood urea nitrogen levels were increased while renal total GFR was decreased at 10 days after transplantation (P < 0.01). At 1 month after transplantation, remaining renal total GFR was increased (P = 0.0000), but it increased compared with before transplantation. These findings suggest the renal total GFR can be used as a main index for evaluating the donor’s renal function during living-related donor kidney transplantation, but it would provide more reliable information if combining with serum creatinine and endogenous creatinine clearance rate. Related Articles | Metrics

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Pre-transplant frequency of donor-specific, interferon-gamma-producing T lymphocytes as a tool for forecasting acute rejections following kidney transplantation Chen Wei-guo, Wang Qing-tang, Wang Liang, Yang Hang, Zhou Peng, Cao Wen-feng, Liu Xiang-dan, Li Sha-dan 2011, 15 (31):  5785-5788.  doi: 10.3969/j.issn.1673-8225.2011.31.020 Abstract ( 94 )   PDF (742KB) ( 356 )   Save BACKGROUND: Increasing the accuracy of rejection risk forecast post-transplant can provide reference for individualized use of immunosuppressive agent post-transplant. OBJECTIVE: To investigate an immunological assay for donor-specific alloreactivity to identify patients at risk for future acute rejection. METHODS: The pre-transplant frequency of donor-specific, interferon-γ-producing T lymphocytes in 115 patients who received kidney allograft was tested prospectively by ELISPOT-assay. Acute rejection and pneumonitis were observed within the period of follow-up. The relationship between HLA mismatching and acute rejection was also observed.  RESULTS AND CONCLUSION: 25 patients who experienced acute rejection had significantly higher frequency of primed donor-specific T cells prior to transplantation compared with 90 patients without acute rejection (78.75±32.81 vs. 14.85±14.66,  P < 0.01). The sensitivity and specificity of the test were 84.0% and 94.4%. No significant difference was observed in HLA mismatches between patients who experienced acute rejection and patients who were free from acute rejection (P > 0.05). The rate of pneumonitis was higher in patients who experienced acute rejection than those who did not experience (44.0% vs. 14.4%, P < 0.05). The pre-transplant frequency of donor-specific memory cells correlated with the post-transplant risk of developing acute rejection episodes, may allow improved pairing of recipients with donors, and could identify high risk recipients for prophylactic, aggressive immunosuppression. Related Articles | Metrics

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Safety analysis on kidney transplantation in hepatitis C virus-positive patients  Bi Wen-hao, Chen Zheng, Ma Jun-jie, Fang Jia-li, Li Guang-hui, Xu Lu, Zhang Lei, Ai Wei, Li De-sheng, Pan Guang-hui 2011, 15 (31):  5789-5792.  doi: 10.3969/j.issn.1673-8225.2011.31.021 Abstract ( 76 )   PDF (532KB) ( 376 )   Save BACKGROUND: Safety of kidney transplantation in hepatitis C virus (HCV)-positive patients has been paid increasing attention. OBJECTIVE: To study the clinical observation and treatment strategy in HCV RNA-positive patients after kidney transplantation. METHODS: A total of 22 HCV RNA-positive patients were involved in this study, of which 14 patients had mild liver dysfunction. The patients' liver and kidney function were detected regularly and corresponding doses and types of the anti-immune rejection drug were adjusted in time to prevent possible immunological rejections. RESULTS AND CONCLUSION: During the postoperative follow-up period of 6-36 months, 20 patients presented with different degrees of liver dysfunction at 4 weeks-6 months. After drug treatment, liver function recovered to normal level. At 1.5 years after kidney transplantation, one patient died of severe liver failure due to changing his anti-rejection program by himself. Four patients presented with HCV RNA-negative symptoms after using interferon combined with ribavirin after kidney transplantation, while the remaining 18 patients remained to present HCV RNA-positive symptoms and required long-term liver treatment. These findings suggest that HCV-positive recipients should be strictly followed up after kidney transplantation to ensure that appropriate managements would be taken in time when their liver function appeared abnormal. Related Articles | Metrics

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12/378 cases of kidney transplantation complicated with pneumocystis carinii pneumonia in the same institution within 10 years Chen Tong-qing, Lin Min-wa, Kong Yao-zhong, Lu Jie-wen, Wen Zhen-ying 2011, 15 (31):  5793-5796.  doi: 10.3969/j.issn.1673-8225.2011.31.022 Abstract ( 101 )   PDF (484KB) ( 361 )   Save BACKGROUND: The immunity of patients can be obviously suppressed since a large amount of immunosuppressor is used in the early stage after kidney transplantation, therefore pneumocystis carinii pneumonia (PCP) tends to have a high incidence during this period. OBJECTIVE: To explore the clinical features, diagnosis, treatment, and prevention of PCP after kidney transplantation. METHODS: Twelve cases complicated with PCP were collected from 378 cases of kidney transplantation patients from the Nephrology Department of the First People’s Hospital of Foshan from November 2000 to July 2010. And then the time of onsets, predisposing factors, diagnostic methods, clinical manifestations, therapeutic schedule and prophylactic efficiency were retrospectively analyzed. RESULTS AND CONCLUSION: The time of onsets was 5.3 (3-11) months after kidney transplantation. Twelve cases of patients presented with polypnea and cyanosis with a high fever of 38.0-40.2 ℃. Nine cases experienced slight cough. Five cases coughed with a small amount of white sputum and one case with red frothy sputum. Five cases were complicated with bacterial infection, two with fungal infection, two with cytomegalovirus infection and one with tuberculosis. The infection rate was 7.8% (7/89) in patients administrated with Tacrolimus, while1.7% (5/289) in those administrated with cyclosporine A. Ventilators were applied in nine cases and two cases were treated with bi-level positive airway pressure (BIPAP) for assisted respiration. Eight cases fully recovered. However, two cases died of cerebral hemorrhage due to thrombocytopenia during the treatment, one case died of fungal infection and one case died of hemopneumothorax. No exclusive reaction was found during the treatment. These indicated that the key to raising the curative rate of PCP was early diagnosis, drug combination and decreased immunosuppressor dosage. Related Articles | Metrics

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Effects of a new immunodepressant J2 on lymphocytic secretion of interleukin 10 and interferon gamma in mice after corneal allograft Wang Da-jiang, Guo Hui-ling, Huang Yi-fei, Chen Guo-jiang, Zhang Han, Li Yan 2011, 15 (31):  5797-5800.  doi: 10.3969/j.issn.1673-8225.2011.31.023 Abstract ( 145 )   PDF (664KB) ( 378 )   Save BACKGROUND: J2 is a new immunodepressant targeting CD4, and previous studies have verified the effect of J2 on spleen cells of normal mice or mice undergoing corneal transplantation. OBJECTIVE: To investigate the effects of J2 on the lymphocytic secretion of interferon gamma (IFN-γ) and interleukin 10 (IL-10) of mice with allogeneic corneal transplantation. METHODS: Corneal transplantation models were created in the right eyes of 36 clean BalB/c(H2d) mice (receiptors) and 17 clean C57BL/6(H2b) mice (donors). The models were randomly divided into four groups according to the different intervene methods. Corneal opacification and neovascularization were scored. The proliferation of spleen cells of mice was detected by ATPase method, and secretion of IL-10 and IFN- γ in cytosupernatant before and after ConA stimulated were assessed by ELISA.  RESULTS AND CONCLUSION: J2 arrest the occurrence of corneal rejection by inhibiting the activation of CD4+ T cells and suppress the proliferation and ConA-stimulated Th1 cytokine production of spleen cells. Related Articles | Metrics

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HLA-A, B and DR high-resolution gene polymorphism of Henan Stem Cell Registry  Wang Zhao-fu, Zhang Bo-wei, Ma Ru, Du Juan, Kong Da-wei 2011, 15 (31):  5801-5804.  doi: 10.3969/j.issn.1673-8225.2011.31.024 Abstract ( 348 )   PDF (491KB) ( 554 )   Save BACKGROUND: Since 2009, Chinese Marrow Donor Program takes more efforts in high resolution HLA typing, shortens typing retrieval time and increases the success rate of HLA typing. OBJECTIVE: To statistically analyze HLA-A, B, DRB1 high-resolution gene polymorphism in bone marrow donors from Henan Province, China. METHODS: A total of 3 874 venous blood samples were collected from the volunteer donors and subjected to ethylenediamine tetraacetic acid anticoagulation. The blood samples were detected using PCR-SSO HD high-resolution HLA typing method (LABType ® HD, Onelambda USA). The SSP and SBT detection tests were performed to solve ambiguity. Allele frequency was calculated with the direct count method. RESULTS AND CONCLUSION: A total of 168 alleles were detected, 34 of which were for HLA-A, 84 for B, and 50 for DRB1. The top five loci for each was A*0201(0.160 9), A*1101 (0.162 7), A*2402(0.160 2), A*3001(0.080 8), A*3303 (0.078 9); B*1302(0.077 7), B*4001(0.072 2), B*5101(0.062 8), B*4601(0.061 2), B*0702(0.050 7); DRB1*1501(0.146 9), DRB1*0901(0.131 8 ), DRB1*0701(0.121 1), DRB1*1202(0.061 2), DRB1*0405(0.058 2). Related Articles | Metrics

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Tacrolimus application dose in limb allograft transplantation Shang Jian, Liu Wei, Han Xin-guang, Ling Xiao-dong, Su Jian 2011, 15 (31):  5805-5808.  doi: 10.3969/j.issn.1673-8225.2011.31.025 Abstract ( 351 )   PDF (780KB) ( 319 )   Save BACKGROUND: Tacrolimus (FK506) is widely used in human organ transplantation and prolongs allograft survival in several animal models, yet there is still no consistent standard in current clinical application. OBJECTIVE: To investigate the optimal application dose of FK506 in limb allograft rats. METHODS: Sixty rat models of hind limb allograft were randomly divided into three groups (A, B and C) and daily received FK506 0.5, 1, and 2 mg/kg respectively. Twenty untreated allograft rats served as the control group. Gross observation, morphological change observation and T lymphocyte subsets analysis were performed to evaluate the efficiency of FK506. RESULTS AND CONCLUSION: The occurrence time of rejection was assessed as follows: control group (3.43±0.79) days, A group (5.68±0.97) days, B group (9.13±1.17) days, and C group (9.61±2.38) days. The skin pathological grade of limb allograft rejection was grade (2.61±0.38) in the control group, grade (1.57±0.43) in the A group, grade (0.85±0.24) in the B group, and grade (0.71±0.19) in the C group. In the FK 506-treated allograft groups, the value of CD4+ and CD8+ was significantly decreased and CD4/CD8 slightly increased or kept normal condition. In the control group, CD4+ and CD8+ remained unchanged and CD4/CD8 increased significantly. FK 506 prolonged hind limb allograft survival and prevented rejection compared with untreated controls. A dose of 1 mg/kg per day could achieve the ideal effect; however, increasing the dose did not improve effect significantly. Related Articles | Metrics

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Protective effects of St. Thomas No.2 solution supplemented with levocarnitine on preservation of hypothermic heart ex vivo Zhou Tao, Zhang Da-guo, Xiang Dao-kang 2011, 15 (31):  5809-5812.  doi: 10.3969/j.issn.1673-8225.2011.31.026 Abstract ( 419 )   PDF (600KB) ( 461 )   Save BACKGROUND: On-pump beating-heart technique has been promoted as better systemic protection compared with the technique of cardioplegic arrest, and the attenuated inflammatory reaction may play an important role in the protective effect of the on-pump beating-heart technique. OBJECTIVE: To observe the protective effects of St. Thomas No.2 solution supplemented with levocarnitine on preservation of hypothermic rat hearts ex vivo. METHODS: Isolated rat heart Langendorff model and working model were established. Thirty-two Sprague-Dawley rats were randomized to four groups with eight rats in each group. In two groups, the hearts were arrested with St.Thomas No.2 solution and preserved in the same solution for 4 hours or 6 hours, while in the other two groups, the hearts were arrested with St.Thomas No.2 solution supplemented with levocarnitine (12 g/L) and preserved in the same solution for 4 hours or 6 hours. RESULTS AND CONCLUSION: Compared with St. Thomas No.2 solution group, after the hearts were preserved for 4 hours, there were no differences in heart rate, coronary artery flow, left ventricular systolic pressure peak, +dp/dt max, water content in myocardium, and adenosine triphosphate (P > 0.05), but creatine kinase release was significantly reduced (P < 0.05) in the St.Thomas No.2 solution supplemented with levocarnitine group. After the hearts were preserved for 6 hours, the measurement results above-mentioned were superior in the St.Thomas No.2 solution supplemented with levocarnitine group than in the St.Thomas No.2 solution group (P < 0.05). These results suggest that St.Thomas No.2 solution supplemented with levocarnitine provides better effects on preservation of hypothermic rat hearts ex vivo. Related Articles | Metrics

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Effects of self-made multi-organ preservation solution on nitric oxide synthase in cryopreserved rat testicle Sun Wen, Zhang Jin-ping, Jie Fang, Xu Chao-chao, Jin Rong-pan, Fan Qi-qi, Qian Shen-lun, Ye Bo 2011, 15 (31):  5813-5816.  doi: 10.3969/j.issn.1673-8225.2011.31.027 Abstract ( 300 )   PDF (723KB) ( 402 )   Save BACKGROUND: During testis transplantation, cryopreservation and ischemia can lead to production of oxygen free radicals by testis, which damages testis tissue. OBJECTIVE: To investigate the effects of self-made multi-organ preservation solution on nitric oxide synthase (NOS) in cryopreserved rat testicle. METHODS: Rat testicle was cryopreserved by self-made multi-organ preservation solution and UW solution. At 24, 48, and 72 hours after cryopreservation, testicular tissue was taken to determine total antioxidant capacity and NOS activity. RESULTS AND CONCLUSION: There was no significant difference in total antioxidant capacity and NOS activity in rat testicular tissue cryopreserved in the self-made multi-organ preservation solution versus UW solution (P > 0.05). These findings suggest that self-made multi-organ preservation solution can obviously reduce oxygen free radical damage in cryopreserved rat testicular tissue and its effects are equivalent to US solution.  Related Articles | Metrics

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Malnutrition-inflammation score for evaluation of nutritional status in artificial kidney hemodialysis patients Chen Wan-xin, Zhang Zhi-min, Xing Li, Cai Chun-hua, Tang Jing, Feng Xin-shu 2011, 15 (31):  5817-5821.  doi: 10.3969/j.issn.1673-8225.2011.31.028 Abstract ( 409 )   PDF (1604KB) ( 506 )   Save BACKGROUND: Malnutrition is commonly found in artificial kidney hemodialysis patients, but which is the best method for assessing nutritional status remains unclear. OBJECTIVE: To compare the three methods including subjective global assessment (SGA), modified quantitative subjective global assessment (MQSGA) and malnutrition-inflammation score (MIS) used for the evaluation of nutritional status in artificial kidney hemodialysis patients. METHODS: The nutritional status of 62 artificial kidney hemodialysis patients was evaluated by SGA, MQSGA and MIS separately. The anthropometric indices and serum biochemical parameters were measured. According to the levels of high sensitivity C-reactive protein (hs-CRP), all patients were divided into elevated CRP group and normal CRP group. The objective nutritional parameters and the malnutrition scores were compared between these two groups. Pearson’s correlation analysis was utilized to assess the relationship of hs-CRP and SGA, MQSGA, MIS and some other objective nutritional parameters. At the same time, the partial correlation analysis was utilized to assess the relationship of SGA, MQSGA and MIS and some other objective nutritional parameters. RESULTS AND CONCLUSION: The degree of nutritional status in the elevated CRP group was much worse than that in the normal CRP group, but the mean values in the two methods show that all patients had different degrees of nutritional status. But the difference of MIS in the two groups was magnificent, indicating that MIS is better in evaluating the nutritional status of typeⅡ malnutrition. MIS is more relative to the objective or subjective nutritional indices than SGA and MQSGA by Pearson correlation analysis or partial correlation analysis in terms of excepting age, body height and weight. As a quantitative evaluation method of malnutrition, MIS is more accurate in evaluating the inflammatory level and nutritional status in artificial kidney hemodialysis patients compared with SGA and MQSGA. Related Articles | Metrics

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Expressions of CD34，Delta-like-1 protein in hepatic regeneration tissue of rats after partial hepatectomy Yang Zhi-yun, Hou Yi-xin, Wang Xian-bo　 2011, 15 (31):  5822-5826.  doi: 10.3969/j.issn.1673-8225.2011.31.029 Abstract ( 352 )   PDF (416KB) ( 292 )   Save BACKGROUND: When the liver affected severe damage or excalation, liver stem cells rapidly proliferated and differentiated into mature liver cells to repair liver tissue. However, liver regeneration is a complicated multiple signal molecular regulatory process and related genes and proteins that participated in regulation remain unclear. OBJECTIVE: To investigate the expressions of CD34 and Delta-like-1 protein in rat liver regenerated tissues after partial hepatectomy. METHODS: Rat hepatic regeneration models were established after hepatectomy. Expressions of ATPase, proliferating cell nuclear antigen (PCNA), CD34 and Delta-like-1 protein were detected by hematoxylin-eosin staining, enzyme-histochemistry and immunohistochemistry method at various time points. RESULTS AND CONCLUSION: At the early stage of liver regeneration, the expression of ATPase was down-regulated, and the expressions of CD34 and Delta-like-1 protein were up-regulated. At the middle stage, the expression of ATPase was increased to the normal level, and the expressions of CD34 and Delta-like-1 protein were down-regulated. The expression of PCNA protein was continuously up-regulated. These suggest that the expressions of ATPase, CD34 and Delta-like-1 protein were different at different stages of hepatic regeneration, which means that different signal molecules were cooperated during the hepatic regeneration, and Notch-Delta signal pathway takes part in the pathogenesy. Related Articles | Metrics

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Effects of orally supplied L-glutamine on hepatic regeneration in partial hepatectomic rats An Jun, Fu Wei-li, Ding Jie 2011, 15 (31):  5827-5830.  doi: 10.3969/j.issn.1673-8225.2011.31.030 Abstract ( 291 )   PDF (1136KB) ( 410 )   Save BACKGROUND: As a necessary nitrogen provider in the processes of DNA and glutathione (GSH) biosynthesis, also a nitrogen source of plasma ammonia formation, L-glutamine is considered to play important roles in hepatic cell proliferation. But the functions and the mechanisms of L-glutamine in liver regeneration are not clearly studied and still need further investigation. OBJECTIVE: To investigate the effects of dietary supplied L-glutamine on hepatic regeneration in a rat model of partial hepatectomy. METHODS: Wistar rats were randomly divided into three groups. Before partial hepatectomy, rats in the L-glutamine and L-alanine groups were orally administered 10% L-glutamine and 10% L-alanine, respectively. After partial hepatectomy, rats from these two groups were given water containing 10% L-glutamine and 10% L-alanine, respectively. The control group rats were allowed to drink water before and after partial hepatectomy. RESULTS AND CONCLUSION: At 72 hours after partial hepatectomy, restituted liver mass was significantly greater in the L-glutamine group than in the control and L-alanine groups (P < 0.05). At 24 and 72 hours after partial hepatectomy, hepatocyte proliferation was more obvious in the L-glutamine group than in the control and L-alanine groups (P < 0.01; P < 0.05). At 24 and 72 hours after partial hepatectomy, there was no significant difference in total RNA level between L-glutamine and L-alanine groups and control groups. At 72 hours after partial hepatectomy, genomic DNA content was significantly greater in the L-glutamine group than in the control and L-alanine groups (P < 0.05). These results showed that application of high concentration L-glutamine in the perioperative stage of liver injury promotes hepatic regeneration in rats after partial hepatectomy, but L-alanine does not produce this effect. Related Articles | Metrics

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Expression of spermatogenesis-related genes Dazl, Pgk2, Prm2 and apoptosis-related gene bax in testicle and epididymis tissue from ovarian graft heterosexual recipients Peng Nan-ni, Xue Li-qun, Yuan An-wen, Yan Qing, Ling Li-jun, Wu Shan, Zou Hong-yan, Wu Fang-gui 2011, 15 (31):  5831-5834.  doi: 10.3969/j.issn.1673-8225.2011.31.031 Abstract ( 292 )   PDF (1262KB) ( 502 )   Save BACKGROUND: Dazl, Pgk2, Prm2 and apoptosis-related gene bax are involved in the regulation of spermatogenesis. The abnormal expression and deletions of these genes often affect spermatogenesis, and even lead to infertility. OBJECTIVE: To investigate the effects of ovarian transplantation on the expression levels of spermatogenesis-related genes in heterosexual recipients. METHODS: Ovaries from 1-day-old mice were transplanted under the kidney capsule of male recipient mice, and recipients were treated with or without hormone. Ovarian grafts were observed 21 days after transplantation. Tissues including testis and epididymis were collected from mice with good developmental follicles. Total RNAs were extracted and expression levels of genes were determined using semi-quantitative RT-PCR. Normal male mice with the same age were used as controls. RESULTS AND CONCLUSION: Gene Prm2 expression in the transplanted group treated with gonadotrophine was significantly higher than that in the control group (P < 0.05), and there was no significant difference in expression level of other genes between all groups (P  > 0.05). These data confirmed that ovarian grafts have no effects on the expression levels of spermatogenesis-and apoptosis-related genes in the mouse model with male and female gonads. This may suggest that ovarian transplantation has no damage to the spermatogenesis of male recipient mice at the molecular level. Related Articles | Metrics

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Establishment of Diannan small-ear pig models of artificial valve replacement Huang Dong, Zhang Gui-min, Yang Hong-sheng, Sun Yi 2011, 15 (31):  5835-5838.  doi: 10.3969/j.issn.1673-8225.2011.31.032 Abstract ( 342 )   PDF (690KB) ( 413 )   Save BACKGROUND: The pig’s heart is considered most anatomically similar to the human heart, and therefore is an ideal model for studying cardiovascular diseases. OBJECTIVE: To establish Diannan small-ear pig models of mitral valve replacement and investigate the feasibility of model establishment by cardiac ultrasonography. METHODS: Ten adult pigs underwent mitral valve replacement via the left atrial appendage under cardiopulmonary bypass through three replacement models. At 2 weeks after replacement, changes in cardiac structure and function were analyzed using cardiac ultrasonography. RESULTS AND CONCLUSION: One pig died for cardiopulmonary arrest during anesthesia induction. The remaining nine pigs survived after surgery. Cardiac ultrasonography showed that at 2 weeks after transplantation, there was no significant difference in cardiac structure and function compared with prior to transplantation, artificial valve showed good hemodynamics and histocompatibility in the pig’s body, and before and after transplantation, pig’s cardiac structure and function were stable. Related Articles | Metrics

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Construction and identification of eukaryotic expression vector pIRES2-EGFP-hFasL Qiu Ming-lian, Fang Hang-rong, Chen Li-hong, Liu Jing-feng 2011, 15 (31):  5839-5842.  doi: 10.3969/j.issn.1673-8225.2011.31.033 Abstract ( 287 )   PDF (567KB) ( 329 )   Save BACKGROUND: FasL induced target cells to programmed cell death by binding with Fas, which was critically important to steady-state mechanism for the body, immune tolerance and tumor apoptosis mechanisms. OBJECTIVE: To construct the eukaryotic expression vector pIRES2-EGFP-hFasL containing enhanced green fluorescent protein report gene (EGFP) and target gene hFasL. METHODS: FasL gene was amplified from human peripheral blood lymphocytes by using real time polymerase chain reaction (RT-PCR), then plRES2-EGFP-hFasL plasmid was constructed through the XhoⅠand EcoRⅠdouble digestion and T4 DNA ligase conjunction. The plasmid concentration and purity were detected by ultraviolet spectrophotometey and identified by endonuclease digestion, PCR and sequencing. RESULTS AND CONCLUSION: The amplified hFasL gene was about 846 bp in length. After digestion of recombinant plasmid plRES2-EGFP-hFasL by restrictive enzymes, specific products with a size of 846 bp and 2000 bp were obtained. DNA sequencing indicates 100% coincidence between hFasL sequences of plRES2-EGFP-hFasL and Genebank. These finding suggest that the eukaryotic expression vector plRES2-EGFP-hFasL containing EGFP and hFasL genes was successfully constructed. Related Articles | Metrics

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Subcutaneous implantation of human liver neoplasms in BALB/c naked mice and SCID mice Bai Jian-hua, Li Li, Li Xiao-yan, Zhu Xin-feng, Chen Gang 2011, 15 (31):  5843-5845.  doi: 10.3969/j.issn.1673-8225.2011.31.034 Abstract ( 357 )   PDF (540KB) ( 646 )   Save BACKGROUND: A good model of liver neoplasms is the basic for further diagnosis and treatment of liver carcinoma. There have been many types of models, but few of them are evaluated. OBJECTIVE: To compare the tumor formation in two kinds of immune deficiency mice in which human liver neoplasms were implanted. METHODS: CD133+ liver carcinoma stem cells were sorted from Huh7 hepatoma cells by immunomagnetic beads and 1×106 cells were implanted into the back skin of BALB/c naked mice and SCID mice. Within 20 days after implantation, the tumor formation and deaths of naked mice were investigated, and the maximal diameter of liver neoplasms was measured through the use of vernier caliper, and tumor with a diameter of 0.5 cm was considered successful. RESULTS AND CONCLUSION: Among 24 BALB/c naked mice, tumor was successfully induced in 18 mice, and among 24 SCID mice, tumor was successfully induced in 16 mice. Chi-square test showed that there was no significant difference in tumor formation (P > 0.05), but significant difference in deaths exist (P < 0.05), between these two types of mice. These results showed that BALB/c mice are superior to SCID mice in establishment of subcutaneous implantation of liver carcinoma because they show low mortality and cost less. Related Articles | Metrics

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Application of color Doppler ultrasonography after liver transplantation Wang Qiong 2011, 15 (31):  5846-5849.  doi: 10.3969/j.issn.1673-8225.2011.31.035 Abstract ( 294 )   PDF (562KB) ( 433 )   Save BACKGROUND: Monitoring complications of transplanted liver is of significance for increasing the success rate of liver transplantation and prolonging patients’ survival time. OBJECTIVE: To evaluate the effects of color Doppler ultrasonography on monitoring the complications of transplanted liver. METHODS: A computer-based retrieval was performed to search papers addressing the effects of color Doppler ultrasonography on monitoring the complications of transplanted liver published between January 1990 and December 2010 in Wanfang database (http://www.wanfangdata.com.cn/) and Medline database (http://www.ncbi.nlm.nih.gov/pubmed/) using key words “color Doppler ultrasonography, liver transplantation, complications post-transplantation. Finally, more than 60 papers were retrieved. By reading title, abstract, and full-text, review and Meta analysis papers and those with repetitive contents were excluded, and 22 papers were included in the final analysis. RESULTS AND CONCLUSION: Color Doppler ultrasonography is noninvasive, easy to operate, and can precisely locate the foci and dynamically observe the foci. It can effectively determine the size and morphology of transplanted liver and provide valuable information of internal echo and hemodynamics for monitoring the complications of the transplanted liver during the early stage after transplantation, which is very important for clinical early treatment and successful liver transplantation. Therefore, color Doppler ultrasonography is a preferred imaging examination for monitoring the complications after liver transplantation. Related Articles | Metrics

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Evaluation of complications after kidney transplantation by color Doppler ultrasonography Shang Jian-hua, Zhang Min 2011, 15 (31):  5850-5853.  doi: 10.3969/j.issn.1673-8225.2011.31.036 Abstract ( 283 )   PDF (588KB) ( 443 )   Save BACKGROUND: Color Doppler ultrasonography can sensitively reflect the morphological structure and hemodynamic changes of transplanted kidney and dynamically observe the survival of transplanted kidney. OBJECTIVE: To evaluate the clinical application efficacy of color Doppler ultrasonography in monitoring the complications of kidney transplantation. METHODS: A computer-based retrieval was performed using the key words “color Doppler ultrasonography, kidney transplant, postoperative complications” to search the papers addressing the clinical application effects of color Doppler ultrasonography on monitoring the complications of kidney transplantation published between January 1999 and December 2010 in Wanfang database. Finally, 20 papers were included in the final analysis. RESULTS AND CONCLUSION: Color Doppler ultrasonography is simple, rapid, non-invasive and repeatable and has been preferred to observe the clinical treatment efficacy after kidney transplantation. It can objectively and dynamically display the morphological structure of transplanted kidney, blood flow distribution, frequency spectrum, velocity, and direction in diastolic phase within transplanted kidney, as well as blood flow index. In addition, it can be used to monitor various complications of kidney transplantation, providing valuable information to avoid function loss of transplanted kidney. Related Articles | Metrics

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Kidney transplantation and physiotherapy Zhao Yan 2011, 15 (31):  5854-5857.  doi: 10.3969/j.issn.1673-8225.2011.31.037 Abstract ( 431 )   PDF (638KB) ( 512 )   Save BACKGROUND: Proper protocol for prevention and treatment of complications of kidney transplantation helps increase the short-and long-term survival after kidney transplantation. OBJECTIVE: To investigate the curative effects of physiotherapy on complications after kidney transplantation. METHODS: A computer-based retrieval was performed to search the manuscripts describing kidney transplantation and physiotherapy in Weipu database published between January 1998 and October 2010 with the key words kidney transplantation, complication, physiotherapy. Inclusion criteria: highly related manuscripts; manuscripts with repetitive contents or obsolete references were excluded. Thirty manuscripts were first reviewed and reference read, and 18 manuscripts were included in the final analysis. RESULTS AND CONCLUSION: After renal allograft transplantation, application of high dose of immunosuppressive agent decreases organism’s resistance and increases the infection factor of various diseases. Based on drug treatment, conventional acupuncture and moxibustion therapy, ultraviolet irradiation, low-intensity helium-neon laser irradiation, and high frequency electrotherapy can control infection, promote wound healing, shorten disease course, and reduce sequelae. Related Articles | Metrics

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Selection and reconstruction of anterior cruciate ligament graft Li Liang, Zhao Hui, Wu Hai-shan 2011, 15 (31):  5858-5861.  doi: 10.3969/j.issn.1673-8225.2011.31.038 Abstract ( 273 )   PDF (603KB) ( 368 )   Save BACKGROUND: Selection of anterior cruciate ligament graft is influenced by many factors and disputation exists.  OBJECTIVE: To review the selection of anterior cruciate ligament graft and research progress in recent years. METHODS: A computer-based retrieval was performed by the first author in PubMed and Weipu databases to search papers addressing single-bundle technique versus double-bundle technique for anterior cruciate ligament reconstruction, graft selection, correlation between anterior cruciate ligament injury and osteoarthritis, and the correlation between anterior cruciate ligament reconstruction and proprioceptive sensibility recovery. RESULTS AND CONCLUSION: In the reconstruction of anterior cruciate ligament, there was no significant difference in clinical effects between single-bundle and double-bundle techniques. More disputations regarding graft selection exist. Bone-patellar tendon-bone and four-strand hamstring tendon autograft are presently preferred for anterior cruciate ligament reconstruction. Quadriceps femoris tendon with or without bone, various allografts and artificial tendons are also gradually been used in the clinic. Meniscus injury, but not anterior cruciate ligament injury, is the most important risk factors for early osteoarthritis. For patients who undergo anterior cruciate ligament construction, proprioceptive sensibility recovery should be paid more attention during the process of therapy. Related Articles | Metrics

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Analysis on causes for pleural effusion early after liver transplantation Wang Shuang, Cai Ming, Li Zhou-li, Li Cong-ran, Shi Bing-yi 2011, 15 (31):  5862-5864.  doi: 10.3969/j.issn.1673-8225.2011.31.039 Abstract ( 480 )   PDF (537KB) ( 480 )   Save BACKGROUND: Plural effusion is a common complication in patients with end-stage liver disease and after liver transplantation. Inappropriate measures may increase mortality after liver transplantation. OBJECTIVE: To study the causes for pleural effusion after orthotopic liver transplantation. METHODS: The clinical data of 36 cases of orthotopic liver transplantation who received treatment in the Organ Transplantation Center of the 309 Hospital of Chinese PLA between May 2009 and May 2010 were reviewed. Risk factors and incidence of pleural effusion early after transplantation were analyzed. t test was performed. Logistic regression analysis on significant statistical indices was also performed.  RESULTS AND CONCLUSION: The rate of pleural effusion after orthotopic liver transplantation was 72.2% (26/36). Twenty-six cases (26/36, 72.2%) had pleural effusion in the right thoracic cavity and 13 cases (13/36, 1%) in bilateral thoracic cavities. Logistic regression analysis suggested that reoperation, postoperative pulmonary infection, the time of mechanical ventilation, the equilibrium after operation and the entity before operation were independent predisposing factors. Related Articles | Metrics

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Living-related donor kidney transplantation in elderly donors: A retrospective case analysis from one institute during 2 years Xie Qing-xiang, Han Cong-xiang, Zhao Li, Huang Hong-wei, He Yuang, Lin Xia-cong 2011, 15 (31):  5865-5868.  doi: 10.3969/j.issn.1673-8225.2011.31.040 Abstract ( 338 )   PDF (564KB) ( 623 )   Save BACKGROUND: The donors from “marginal” kidneys have been accepted to partly solve the problem between limited supply and increasing demand. OBJECTIVE: To investigate the safety of living-related donor kidney transplantation from donors above 65 years old and the middle- and long-term clinical efficacy. METHODS: The clinical data of seven pairs of donors and recipients who underwent living-related donor kidney transplantation from donors ≥ 65 years old and were followed up for 36-64 months.  RESULTS AND CONCLUSION: The donors and recipients recovered smoothly post-surgery with no severe complications. The function of kidney grafts recovered to normal within 1 week after surgery, the kidney function of donors was improved compared with prior to surgery, but it was within normal range. No acute rejection was found. Five recipients survived with normal kidney graft for 36-64 months, and two cases died one year after surgery. All donors survived with no proteinuria or hypertension, but with normal kidney transplantation. These findings suggest that kidney grafts from donors ≥65 years old may be allowed for living-related donor kidney transplantation after strict screening, which can expand the donor pool in the clinic. Related Articles | Metrics

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Deep venous thrombosis in the lower extremities following renal transplantation in two patients Hao Jun-wen, Song Hua, Lin Chang-sheng, Liu Shao-ge, Liu Yang-dong, Li Xiang-tie 2011, 15 (31):  5869-5872.  doi: 10.3969/j.issn.1673-8225.2011.31.041 Abstract ( 338 )   PDF (565KB) ( 408 )   Save BACKGROUND: Renal transplantation recipients are exposed to greater risks of developing deep venous thrombosis in the lower extremities (LDVT). How to effectively reduce this complication following renal transplantation and prompt diagnosis and correct treatment has an important significance.  OBJECTIVE: To investigate the diagnosis, treatment and prevention of LDVT following renal transplantation. METHODS: To retrospectively analyze the diagnosis and treatment of two renal transplantation recipients who developed LDVT and to review the relative literatures. RESULTS AND CONCLUSION: The two patients were diagnosed by color Doppler ultrasound examination and systemic medical history review. After timely and effective treatments including anticoagulation and thrombolysis, the two cases recovered at 6 and 7 days after treatment, showing evidence of establishment of efficient collateral circulation, as found in color Doppler ultrasound examination, and renal function was normal. The results demonstrated that renal transplantation recipients are exposed to greater risks of developing LDVT, for which color Doppler ultrasound provides the most effective diagnosis．The patients generally respond well to timely interventions with anticoagulation, clot removal and thrombolysis, and preventive measures are indicated in those at high risk of LDVT following transplantation. Related Articles | Metrics

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Clinical observation of enteral immunonutrition in patients undergoing liver transplantation Zhao De-fang, Zhang Ke, Lang Ren, Zhao Li-jun 2011, 15 (31):  5873-5878.  doi: 10.3969/j.issn.1673-8225.2011.31.042 Abstract ( 99 )   PDF (377KB) ( 738 )   Save BACKGROUND: Immunonutrition therapy can increase the synthesis of proteins with shorten half-life, regulate the local and whole body cytokines production, make the intestinal structure and functional integrity, up-regulate the immunity-inhibiting after operation through the improvement of cellular immune function. It has been proved that the appropriate nutritional therapy during perioperative period can improve the patients’ immune function; however, enteral immunonutrition (EIN) in patients undergoing liver transplantation is rarely reported. OBJECTIVE: To evaluate the safety and effectiveness of EIN therapy during liver transplantation. METHODS: Eighty-four patients undertaking liver transplantation were randomly divided into two groups, namely EIN group and regular enteral nutrition (EN) group (given EIN and common EN respectively). The liver function, cellular immunity, humoral immunity, infection and the incidence of rejection were monitored in order to compare the therapeutic efficacy of two kinds of nutrition therapies. RESULTS AND CONCLUSION: The serum prealbumin and cholinesterase levels were impressively higher in the EIN group at 1 day before operation than before nutritional therapy. The expressions of CD3+ and CD4+ were significantly higher in the EIN group than the EN group at 1 day before operation (P < 0.05). The recovery of cell immunity was delayed 1 week in the EN group as compared with the EIN group; at 1-28 days after operation, IgA level was higher in the EIN group than in the EN group  (P < 0.05). No increase in the incidence of infections occurred in the two groups. The results suggest that the EIN can improve the cell immunity and humoral immunity with a better effect than the EN. The EIN therapy is necessary for the rehabilitation of patients undergoing liver transplantation at the perioperative stage. Related Articles | Metrics

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Utilization of arsenious acid chemotherapy for hepatocellular carcinoma following liver transplantation Wu Lin-wei, Hu Xiao-kun, He Xiao-shun, Tai Qiang, Ju Wei-qiang, Wang Dong-ping, Ma Yi, Zhu Xiao-feng 2011, 15 (31):  5879-5882.  doi: 10.3969/j.issn.1673-8225.2011.31.043 Abstract ( 166 )   PDF (319KB) ( 385 )   Save BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. METHODS: Twenty-three patients with HCC extending Milan criterion received intravenous arsenious acid chemotherapy after orthotopic liver transplantation (OLT), that is, intravenous injection, 10 mg per day, for 7 successive days, followed by 7-day interval, and a course comprised 4 durations. Each patient treated for 1-4 courses. Other 16 patients did not received chemotherapy served as controls. The difference of patients’ survival, tumor recurrence and adverse reaction were compared.  RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria. Related Articles | Metrics

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Factors for anemia after kidney transplantation: A data analysis of 826 patients from one institute during 10 years Cao Zhi-qiang, Liu Long, Yang Hong-wei, Fan Lian-hui, Li Xin 2011, 15 (31):  5883-5887.  doi: 10.3969/j.issn.1673-8225.2011.31.044 Abstract ( 127 )   PDF (373KB) ( 302 )   Save BACKGROUND: Anemia after kidney transplantation has a clinical incidence rate of 30%-40%, is the important risk factor for cardiovascular diseases and kidney failure after kidney transplantation and is also the independent prediction index of patient’s death. OBJECTIVE: To analyze the factors related to anemia after kidney transplantation. METHODS: A total of 826 patients, including 541 males and 285 females, aged 18-71 years, who received kidney transplantation in the General Hospital of Shenyang Military Area Command of Chinese PLA from January 2000 to December 2009 were included in this study. Altogether 805 patients received cadaver donor kidney transplantation and 21 patients received living-donor kidney transplantation. All included patients were assigned to two groups: anemia and non-anemia. The possible factors for anemia after kidney transplantation were recorded. t test and chi-square test were used for one-way analysis of variance. RESULTS AND CONCLUSION: In the anemia group (n = 225, 27.2%, aged 26-65 years), the incidence rate of anemia in female and male patients was 23% and 37%, respectively (P < 0.05), 46 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 16 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 85.3% and kidney failure rate of 25.3%. In the non-anemia group (n = 601, 72.8%, 405 males, 196 females, aged 18-71 years), 35 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 14 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 92.1% and kidney failure rate of 12.6%. There was significant difference in above-mentioned indices between anemia and non-anemia groups (P < 0.05). These results suggest that gender, age, kidney function, digestive tract disease history, and drug application are closely related to anemia after kidney transplantation.  Related Articles | Metrics

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Simultaneous pancreaticoduodenectomy and liver transplantation for hilar cholangiocarcinoma in one case Huang Jian-zhao, Fan Wei, Shi Cheng-xian, Gou Xin, Tang Ke-li, Zhang Ying, Liu Jun, Yu Peng, Liu Yan 2011, 15 (31):  5888-5890.  doi: 10.3969/j.issn.1673-8225.2011.31.045 Abstract ( 313 )   PDF (320KB) ( 353 )   Save BACKGROUND: Because of the specificity and complexity of hepatic portal, carcinoma of bile duct of the hepatic portal is a difficulty in the surgical treatment. OBJECTIVE: To evaluate the safety and feasibility of simultaneous pancreaticoduodenectomy and liver transplantation for the end-stage hilar cholangiocarcinoma. METHODS: One recipient diagnosed as hilar cholangiocarcinoma (Bismuth type Ⅳ), with lymph node metastasis of hilar region and that posterior to pancreatic head, received pancreaticoduodenectomy combined with liver transplantation. During the initial period of post-operation, steroid, tacrolimus and mycophenolate mofetil were supplied, and the steroid was used with lower dose than normal and quickly retreated. The parameters of liver and pancreatic functions, and CA19-9 were observed postoperatively. RESULTS AND CONCLUSION: Pathology demonstrated a middle or low differentiation of hilar cholangiocarcinoma, and left, right hepatic duct, together with lobus quadratus were invaded. The tumor metastasized to hilar and posterior pancreatic lymphonodes, without involving the head of pancreas, duodenum and stomach. The function of transplanted liver recovered smoothly, and the endocrine and exocrine functions of pancreas were kept well. CA19-9 dropped to the normal levels. The patient recovered and discharged at 1 month after surgery, and still survived after one year follow up. These suggest that simultaneous pancreaticoduodenectomy and liver transplantation as a treatment of hilar cholangiocarcinoma are safe and feasible. References | Related Articles | Metrics