To summarize the evolution of spleen surgery and prospects the future. The knowledge on the splenic function (anti-infection, cancer and certain blood effects)gradually promotes the reform of spleen surgery in clinical practical, resulting all kinds of spleen-preserving surgery when splenic injury. However,there is still controversy about spleen removal or reservation under the condition of portal hypertension in liver cirrhosis patients, because advantages and disadvantages between these different operations. Laparoscopic splenectomy is a major progress in recent years,the standard operation need to be further explored. Spleen transplantation in the treatment of hemophilia A is one of the characteristics of the spleen surgery in China, and this is the leading position in the world, now we will focus on how to prevent chronic spleen graft dysfunction. To keep the advanced international level, Chinese teams on spleen surgery are still required to deepen the related research and strengthen the academic communication in the future.

Objective To investigate the effect of T cell vaccination(TCV)on the survival time of cardiac allograft in rat.Methods Rat heterotopic cardiac transplantation was performed,Donor antigenprimed recipients' spleen cells were obtained bv 1/3 splenectomy for the preparation of TCV.TCV was then intraperitoneally into the abdominal cavity again.The survival time of cardiac allograft was observed.Results TCV could markedly prolonged rat cardiac allograft survival.T cell proliferation was increased and B cell proliferation was not affected in the vaccinated rats.The mixed lymphocyte reaction(MLR)was inhibited,The analysis of phenotypes on T cells showed that the number of CD8+ clones in vaccine cells and vaccinated rat spleen cells were increased.The antibody-mediated cytotoxicity was not affected by TCV.Conclusions TCV enhances the recipients' T cell-mediated immune response.The TCV-induced hyporeactivity to specific donor antigen is related to the induction of anti-idiotypic response and is not associated with humoral mechanisms.

Wistar rats randomly divided into groups A,B and C were killed at 2、3 and 12 days after transplantation,respectively.The pathological changes of the donor livers were observed by light microscope and electron microscope.The findings demonstrated that:(1)in the group A there was hepatocellular regeneration including hypertrophy of nuclei and nucleoli,and hyperplasia of mitochondrions and endoplasmic reticula;(2)in the group B the morphologic changes of the allografts involved in distinet fatty degencration and mitochondrial swelling of hepatic cells and peripheral vesscl wall infiltration by monocytes and lymphocytes;(3)in the group C hepatocellular loss with the massive tissue necrosis and fibroplasia occurred in the gratfs.From the above it was concluded that hepatocellular necrosis or loss related to the rejection 12 days after the transplantation might lead to the liver failure in the rats.

In order to determine the relationship between hyperacute xenograft rejection and oxygen free radical(OFR)formation,in the model of guinea pig to SD rat cardiac xenotransplantation guinea pig heart specimens were obtained at harvesting,after stored in Ringer's lactate solution(4℃)for 1 hour,and at 60 min after transplantation to assess histological changes and OFR production by light microscopy,electromicroscopy and luminol-enhanced chemiluminescence (LC).OFR formation increased significantlly in hyperacute rejection.These findings suggests that OFR may play important role in the pathogenesis of discordant xenograft rejection.

In an in vivo guinea pig-to-rat cardiac xenotransplantation model,the effect of complement depletion by using Chinese Cobra venom(CCV)on hyperacute rejection(HAR) was evaluated.A single low dose of 0.25～0.5mg/kg CCV given i.P.to SD significantly reduced hemolytic C activity for up to 24 hours.Rats receiving GP cardiac xenografts with CCV therapy min in control rat,P<0.01).Combination therapy using CCV,splenectomy and prostaglandin E1 induced 20~40 hours graft survival.Histologic analysis of GP cardiac xenograft taken from CCV-treated rats revealed monocyte infiltration,extensive hemorrhage and areas of myocardial necrosis 12～40 hours after transplantation.The histologic findings suggested that the monocyte may be involved in delayed xenograft rejection.Our study showed that the complement system plays an important mediating role in the hyperacute rejection in guinea pigs.

Objective To manufacture rapamycin (RPM)-a new type immunosuppressant made in our country and investigate its immunosuppressive mechanism.Methods The effect of RPM on mouse splenocyte (Tc) proliferation induced by ConA,splenocyte (Bc) proliferation induced by LPS,DTH induced by DNCB and rat GVHR were studied.Results RPM obviously restrained the proliferation of Tc with IC50=1 nmol/L,significantly lower than IC50(10 nmol/L) of CsA (P＜0.05).RPM evidently repressed the proliferation of Bc with IC50=1 nmol/L significantly lower than IC50＞10 nmol/L of CsA(P＜0.05).RPM inhibited murine DTH to DNCB with ED50:1.8 mg/kg,significantly lower than ED50＞30mg/kg of CsA(P＜0.05).RPM controlled rat's GVHR with ED50=3 mg/kg,significantly lower than ED50≥30 mg/kg of CsA(P＜0.05).Conclusions RPM can inhibit lymphocytic proliferation and DTH,GVHR more markedly than CsA and they have combined efforts.

Objective To develop an advanced three-cuff-technique orthotopic liver transplantation model in rats. Methods The recipient's liver was not resected when the donor's liver was set in position, but was gradually resected during the process of vascular anastomoses. Results This method greatly shortened the anhepatic phase (11.8 min for the mean time), simplified the manipulation. The operative successful rate was 92 % . Conclusion This model could be used as an effective measure for the study of liver transplantation in rats.

Objective To elucidate the effect of postoperative early enteral nutrition support (ENS) on cellular immunity function and nutritional status of gastrointestinal (GI) cancer patients.Methods Twenty patients with GI cancer were at random divided into two groups: enteral nutrition group (EN-group, 10 cases), parental nutrition group (PN-group, 10 cases). PN-group was given total parental nutrition (TPN).In EN-group,Since the 1st postoperative day Neutrinos(r) was infused, the infused volume was increasingly added from 500 ml/d to 1 500 ml/d, the infused rate was step-by-step increased from 21 ml/h to 63ml/h. T-cell subgroup, NK cell, IL-2, PA, RBP were measured in the day before operation and on the 2nd ?4th ?8th postoperative day.Results ① The serum RBP,PA levels were obviously decreased postoperatively (P

Objective To investigate the influence of HLA immunogenic mismatching (IM) on acute rejection of renal transplants.Methods The function recovery time of renal allograft and the rate of acute rejection of 196 cases after cadaveric renal transplantation wereanalyzed. Results IM of HLA locus did not influence the function recovery time of the renal allograft. The IM of HLA-A locus did not increase the rate of allograft acute rejection whereas the HLA-B locus did and the HLA-DR increased the acute rejection rate significantly. Conclusion IM should not be ignored in HLA typing. HLA-B locus is related to the allograft acute rejection, while the IM of DR locus increasesthe allograft acute rejection rate significantly.

Objective To explore the cause and treatment strategy of chronic graft rejection characteristic of jaundice in patients with liver transplantation. MethodsPrimary disease, immunosuppressive protocol were reviewed in nine cases surviving more than 1 year after liver transplantation. The pathology examination, choledochoscopy and ultrasound examination were performed. The dosage of immunosuppressive agent was adjusted. Four cases underwent operation. Results Chronic rejection was well controlled in 6 out of the 9 cases with total bilirubin level decreased from 200 ?mol/L to less than 100 ?mol/L. Bile flocculus and bile slush became less obvious or disappeared after flushing and dilataltion of the common bile duct. Three cases died in spite of aggressive therapy. ConclusionsInsufficient immunosuppressive strength is one of the most important causes for chronic rejection. Immunological injury results in hepatocellular damage, bile slush, inflamed thick bile duct.