Objective To evaluate graft regeneration and influencing factors after right lobe adult living donor liver transplantation (LDLT) using MSCT.Method Sixty-three living recipients were included in this study.We measured graft volume periodically by using MSCT and IQQA-Liver workstation.The liver regenerative ratio (LRR) of different stages of recipients after LDLT was calculated and compared,and stepwise regression analysis was done to set up the regression equation.Result Within 0.5 month after LDLT,graft volume was increased rapidly,and LRR reached maximum [(106.11 + 30.90)％],then decreased slowly.There was significant difference in LRR among 0.5,1 month and 3,6 months after LDLT (P＜0.05).The following factors,including whether the graft containing middle hepatic vein or not,age and sex of recipients,had no significant influence on LRR after LDLT (P＞0.05).The status of liver function of recipients preoperatively had significant influence on LRR 0.5 month after LDLT (P＜0.05).There was significantly negative correlation between the graft volume and LRRs of recipients at different stages after LDLT (P ＜ 0.05).Regression equation could be derived.Conclusion Most evident graft regeneration occurs in early stage after adult LDLT.There are many and different factors influencing graft regeneration at the different stages after LDLT.Graft volumetric measurement by using MSCT is a valid modality to evaluate graft regeneration after LDLT.

Objective To evaluate the impact of donor age on early remnant liver function and regeneration after right lobe adult living donor liver transplantation (LDLT) donation.Methods 43 living donors were divided into 2 groups:donor age ＞ 50,n =8,and donor age ＜ 30,n =35.Alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TB) and liver regenerative ratio (LRR) of donors between the 2 groups were compared.Results There were no significantly different in ALT,AST and TB on days 1,2,3,5 after LDLT between the 2 groups (respectively t =0.147,1.030,-0.903,0.013,0.043,1.362,0.817,0.003,1.121,0.241,1.061 and 0.943,all P＞0.05).There was significant difference between LRR on day 7 (t =-0.965,P =0.042),but the difference was not statistically significant in LRR when evaluated on day 15 after LDLT (t =0.585,P =0.385).Conclusions Remnant liver regeneration on the first week is reversely affected by donor's age after hepatectomy,while the influence of age decreases significantly after 2 weeks.

Objective To evaluate and compare liver regeneration between normal donors and recipients at the different stages after right lobe adult living donor liver transplantation (LDLT) using MSCT.Method Sixty-eight living donors and 63 recipients without complications were included in this study.We did CT volumetric measurement of the liver by using IQQA-Liver workstation.The relationship between graft volume measured by preoperative MSCT and intraoperative actual graft volume was evaluated.The liver regenerative ratio at different stages of donors and recipients after LDLT was calculated and compared.Result Preoperative measurement of total liver and grafts resulted in a mean volume of (1366.99 ± 234.75) cm3 (standard deviation) and (862.73 175.94) cm3 (VCT-right),respectively.Intraoperative volume of the grafts was (654.46 ± 151.23) ml (Vintraop).Corresponding pre-and intraoperative data were correlated significantly each other (r =0.795,P=0.000).Vintraop can be calculated with the equation:Vintraop =64.949 + 0.683 VCT-right.There was significantly difference in LRR between donors and recipients at 0.5,1,3 and 6 months after LDLT (P＜ 0.05).Conclusion The patterns of normal liver regeneration between donors and recipients after LDLT are different.The liver of donors regenerates more significantly and quickly than recipients.Liver volumetric measurement by using MSCT is a valid modality to evaluate liver regeneration after LDLT.

Objective To evaluate the impact of donor age on graft short-term outcome after right lobe adult living donor liver transplantation (LDLT).Method Thirty living recipients were divided into 2 groups according to donor age:older donor group (O group,donor age ＞50,n =5) and younger donor group (Y group,donor age ＜30,n =25).Alanine transarninase (ALT),aspartate transaminase (AST),total bilirubin (TB),prothrombin time (PT) on the postoperative day 1 to 5 and graft liver regenerative ratio (LRR) on the postoperative month 0.5,1,3,and 6 between 2 groups were determined and compared.Result TB on postoperative day 1,2,3,4 and 5 was significantly higher in O group than in Y group there were significant differences between two groups (P＜0.01).There was no significant difference of other liver function parameters 2 groups (P ＞ 0.05).There was no significant difference in LRRs on the postoperative month 0.5,1,3 and 6 months postoperatively between 2 groups after LDLT (P＞0.05).Conclusion Although allografts from older donors in LDLT have prolonged jaundice than those of their younger counterparts,after strictly preoperative evaluation,donor age has little effect on short-term outcomes of graft after LDLT.

Objective To investigate the possible influence of immunosuppressive therapy,including sirolimus (SRL) and calcineurin inhibitors (CNI, tacrolimus), on level of Treg in the liver allo-graft recipients, Methods Forty-seven liver transplant recipients with stable liver function were assessed for at least 2 years, and divided into two groups: one composed of 15 patients receiving SRL,and another, of those receiving CNI (32 patients with tacrolimus). Thirty-eight age-matched healthy subjects (HS) were used as normal controls. We examined the expression of CD4, CD25, and Foxp3 in peripheral blood monouclear cells. Treg of every group was analyzed using Cell Quest software.Results SRL significantly increased the prevalence of CD4+ CD25high T cells, compared with HS and CNI group. The prevalence of CD4+ CD25high T cells of CNIs group was significantly lower than that of HS. The percentage of CD4+ CD25high T cells in the total CD4+ T cells was 1.88 % (1.56 %-2. 60 %), 1. 15 % (0. 57 %-l. 48 %) and 0. 84 % (0. 46 %-1. 45 %) in SRL, NS and CNI group,respectively (P<0. 01 or P<0. 05). Foxp3 was expressed in more than 95 % of CD4 + CD25high T cells and less than 20 % of CD4+ CD25low T cells, whereas not expressed in CD4+ CD25- T cells.Conclusion Different immunosuppressive therapy (SRL or CNI) might have different roles in tolerance induction in liver transplant recipients. Namely, SRL promoted the induction of allo-antigen tolerance, but CNI hampered the progression.

Objective To evaluate donor remnant liver regeneration and influencing factors at different stages after right lobe adult living donor liver transplantation (LDLT) using multi-slice spiral computed tomography (MSCT).Methods 68 living donors were included in this study,We did CT volumetric measurement of the liver by using IQQA-Liver workstation.Liver regenerative ratio (LRR) at different stages of donors after LDLT were calculated and compared,correlation coefficient and stepwise regression analysis were calculated.Results The difference between LRRs at different stages after LDLT were significant (F =3.323,P =0.009),there were significant difference between LRR of 7-day and 1-month,3-month (respectively t =-2.065,-2.214,all P ＜ 0.05).The inclusion of middle hepatic vein and donor gender had no influence on LRR (respectively t =0.600,-0.622,1.464,0.926,-1.228,0.624,-0.688,0.131,all P ＞ 0.05).There were negative correlation between the remnant liver volume and LRRs (P ＜ 0.05).Conclusions MSCT is a valid modality to evaluate remnant liver regeneration after LDLT.Most evident remnant liver regeneration occurs in early stage after adult LDLT.

Objective To establish animal model of prolactinoma with Fischer 344 (F344) rats.MethodsFemale F344 rats were injected with estradiol benzoate-treated and 0.9% sodium chloride respectively. After 50 days of treatment, MRI scan was performed and animal's living status was observed, and pituitary weight, serum prolactin level, pathological and PRL immunohistochemistry changes were also detected.ResultsAll estradiol benzoate-treated rats formed the prolactinoma after treatment for 50 days and the growth of body weight was retarded obviously. Pituitary weight and serum PRL increased significantly in estradiol benzoate-treated animals compared with those treated with 0.9% sodium chloride. Pituitary adenomas were found in MRI scan and HE stain was positive. The forming rate of tumor was 100%.ConclusionThe animal model of pituitary adenoma established with F344 rat has more characters such as having a short tumor forming period, easy and stable, and coincided with features of prolactinoma.

Objective To investigate the applied value of 3.0T blood oxygen level dependent(BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury (WIRI) in rabbits.Method Twenty healthy adult New Zealand white rabbits were randomly divided into two groups by using the stochastic indicator method.In 10 rabbits enrolled in the treatment group,the model of hepatic WIRI after ischemia for 30 min followed by 6-h reperfusion was established,and the remaining 10 rabbits were chosen as the normal control group and were not subjected to any surgery.All the experimental rabbits were scanned by 3.0T MRI and BOLD MRI.T2* values were separatelymeasured by 2 considered radiologists and the R2* values were calculated (R2* =1/T2*).Thereafter,the intra-class correlation coefficient (ICC) was used to check the consistency.All rabbits were killed after MR examination and routine assays were performed for testing the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and lactate dehydrogenase (LDH) in the ear vein blood serum.The contents of total superoxide dismutase (SOD),malondialdehyde (MDA) and myeloperoxidase (MPO) in liver tissues were determined,and histopathological changes were examined.The correlation between R2 * value and clinical test index was evaluated by Spearman correlation analysis.The R2* value was evaluated by ROC curve.Result ICC =0.87 ＞ 0.75,suggesting that the repeatability of the outcome is good.Compared to the normal control group,R2*value of the warm ischemia-reperfusion injury group was increased (P =0.000).The differences in ALT,AST,LDH,total SOD,MDA and MPO between the two groups were statistically significant (P＜0.01).R2* values were significantly positively correlated with ALT,AST,LDH,MDA and MPO (r＞0.6,P＜0.05),and there was a significantly negative correlation between R2* and total SOD (r=-0.663,P=0.001).The R2* value could efficiently diagnose rabbit hepatic WIRI (AUC =0.99) with the best diagnostic threshold being 116.40 Hz.Conclusion 3.0T BOLD MRI can accurately and non-invasively assess the pathophysiologic changes caused by WIRI.It is of great importance for 3.0T BOLD MRI in dynamically monitoring and evaluating hepatic WIRI.

Objective To detect the volume changes of cerebral gray and white matter in patients with maintaining hemodialysis using voxel-based morphometry(VBM) and to correlate these changes with cognitive function. Methods Forty-two patients with maintaining hemodialysis and 41 age and sex matched normal subjects were recruited in this study. MMSE was obtained to evaluate their neuropsychiatric conditions. Whole brain high-resolution T1WI was performed on 3.0 T MR scanner in both patients and normal controls. The data were analyzed by VBM based on SPM8, using analysis of functional neuroimages (AFNI) software package with the Monte Carlo simulation method(AlphaSim method) for multiple cluster level comparisons correction. Independent sample t test analysis was used to compare the volume of gray and white matter between the patients and normal controls. In addition, Stepwise multiple linear regression analysis was performed to explore the correlation between the voxel value of cerebral volume changes area and dialysis duration and clinical laboratory examination, and Spearman correlation analysis was used for the correlation between the left insula voxel values and neuropsychological test scores. Results Compared with normal controls, patients showed significantly decreased volume in the grey matter of the right putamen, the left putamen, the left insula (numbers of voxel in clusters were 455, 561, 162, t=-9.5681,-5.9516,-5.7185,P<0.001, AlphaSim-corrected). There was negative correlation between decreased grey matter volume of the right putamen[(0.53 ± 0.12)mm3]and the left putamen[(0.48 ± 0.12)mm3] and dialysis duration [19.0(1.5-114.0)months] (r=-0.330,-0.307,P<0.05). MMSE score of patients[29(21-30)score] was significantly lower than normal controls[30(28-30)score] (Z=-30.58,P<0.01). Decreased grey matter volume of the left insula [(0.39 ± 0.12) mm3] was positively correlated with MMSE(r=0.320, P<0.05). Conclusions The patients with maintaining hemodialysis show grey matter atrophy which is associated with neurocognitive dysfunction. Dialysis duration may be an important risk factor for decreased gray matter in patients with maintaining hemodialysis.

Objective To observe the effect of low level infrasound on neuropathic pain and explore its underlying mechanism. Methods Rats were divided into experimental and control groups after their L5 spinal nerves had been ligated to create a neuropathic pain model. The experimental group was subjected to 40 to 80 dB infra sound. The control group received no infrasound treatment. Paw withdrawal latency in response to heat radiation was measured and the average gray scale of the microglia in a slice of the L5 spinal cord was compared. Results The experimental group expressed significantly lengthened paw withdrawal latency on the 12th and 14th day. The average gray scale showed significantly weakened activation of spinal microglia in the 2nd week of infrasound treatment compared with the control group. Conclusion Low level infrasound can ameliorate neuropathic pain to a certain extent,which might be related with inhibition of spinal microglia.