AIM: To explore the molecular mechanism of anti-shock effect of Shenmai (SM) injection and to observe its influence on TLR4 and I?B mRNA expression in hemorrhagic shock (HS) plus LPS rat lung. METHODS: Rats were divided into HS, HS+LPS, HS+LPS+ dexamethasone (DEX), HS+LPS+SM group, respectively. HS+LPS injury model of rats were induced by hemorrhagic shock (MAP 40 mmHg for 10 min) followed by intravenous administration of lipopolysaccharide (LPS, 1.5 mg/kg). Four hours later, the TNF-? contents in lung tissue were measured by ELISA, TLR4 mRNA and I?B? mRNA expression were assayed by RT-PCR, ultrastructural changes of the type Ⅱ alveolar cell were observed by electron microscope. RESULTS: The TLR4 mRNA expression level in HS+LPS+SM group was significantly decreased as compared to HS+LPS group (P

Objective To analyze the surgical procedure and effect of living-related small bowel transplantation(LR-SBTx) on intestinal function failure caused by short bowel syndrome.Methods A boy, 15 years of age with short gut syndrome, who had only 8 cm of residual small intestine, associated with serious malnutrition and poor D-xylase absorption test (0.226/5h). The donor was the boy's mother. They had a match of 4 loci in HLA. In the first stage of the surgical procedure, 120 cm of ileum from the patient′s mother was transplanted into the recipient. Both ends of the transplanted intestine were exteriorized as stomas on the patient′s abdominal wall. The second stage of reconstruction of the intestine was carried out 6 months after his first operation. The residual small bowel of the recipient was transected, and both of its ends were respectively anastomosed end-to-side to the proximal and distal segments of the graft. The stomas of the graft were left in place. Results The donor and recipient operation went on smoothly. Acute rejection and infection of CMV developed postoperatively and were cured after treatment. The patient was followed-up for 8 months, the graft function recovered gradually postoperatively with increase of body weight. He can ingest a semifluid diet and take care of himself independently. Conclusions LR-SBTx is an effective way to treat short bowel syndrome. The reconstruction of the intestine in two stages for LR-SBTx decreased the risk of complications. Rejection and infection are important risk factors of LR-SBTx.