The MDA contents of platelet, plasma and lung tissue in rat endotoxemia were measured by TBA fluorescent method. It was showed that the lipid peroxidation of platelet and plasma was significantly increased, but there was no notable change of the lung tissue.

The endotoxemia model was established by intraabdominal injection of endotoxin Coli B. (E. Coli O55B5,8 mg/kg weight)in albino rats. Two hours before administration of endotoxin, the ejiao recovery-pulse decoction was perfused into the stomach tube of the rats in the experimental group (10mg/kg weight), and 12h later, the platelets were counted, kaolin activated partial thromboplastin time (KPTT), prothrombin time (PT) and thrombin time (TT) were measured, and malondialdehyed (MDA) levels in plasma and platelet were determined by thiobarituric acid (TBA) fluorometry. The results demonstrate that the ejiao recovery-pulse decoction could prevent from peripheral platelet dropping, KPTT and TT prolonging and MDA level rising which were caused by endotoxin.

5 cm and portal vein tumor thrombus significantly affect the tumor-free survival of the patients.

Objective To study the early diagnosis and management of the patients with acute respiratory distress syndrome (ARDS) caused by cytomegalovirus (CMV) pneumonia after liver transplantation.Methods The clinical data of 8 patients with ARDS caused by CMV pneumonia after liver transplantation in our hospital from April 2001 to May 2004 was retrospectively analyzed. All cases were treated with intravenous infusion of gancyclovir, reduced dosage of cyclosporine A or tacrolimus to 1/3~1/2 of baseline and withdrawal of MMF and prednisone. The patients were subjected to breathing machine assist ventilation and nutrition supply.Results Five patients recovered and 3 died. No one developed acute rejection. Conclusions The key of early diagnosis lies in combining chest X-ray or CT scan with clinical presentation. Administration with anti-viral drugs, adjustment of immunosuppressive agents, management with breathing machine assist ventilation and effective nutrition supply are important for the treatment of patients with ARDS caused by CMV pneumonia after liver transplantation.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

With the increasing demand for liver transplantation,some previously abandoned donors,called marginal donor,started to be involved in clinical liver transplantation,which raises higher requirement on the organ preservation methods.Normothermic perfusion is regarded to be superior to the currently adopted hypothermic perfusion,and plays an important role in the organ preservation of marginal donors.This review will summarize the clinical applications of liver normothermic perfusion in transplantation and repair,as well as its roles in basic research.

Objective To study the clinical application of Multi-slice spiral CT angiography (MSCTA) in renal arterial stenosis. Methods 36 patients clinically suspected of renovascular hypertension were examined by 16 slice or 64 slice spiral CT angiography. After scanning , three dimensional reconstruction of the blood vessels were operated. 28 cases were detected diseases of renal vessels and perivascular, and then compared with DSA. Results In the 36 cases, MSCTA showed 19 renal areterial stenosis, 3 adrenal gland neoplasms, 2 adrenal hyperplasia, 1 polycystic kidney disease. In 19 cases with MSCTA , there were 2 double renal areterial stenosis and 2 renal areterial anatomical variants. DSA showed 21 renal areterial stenosis with various degree, the accordant rate of MSCTA and DSA exceeded 90%. Conclusion MSCTA play an important role in clinical application in diagnosis of renal arterial stenosis.

BACKGROUND:At present, there are a number of articles about hypothermic machine perfusion versus static cold storage of kidney alografts; however, the conclusions are various. Furthermore, due to the limitation of single sample size, there is a lack of objective evaluation on the merits and demerits of hypothermic machine perfusion. OBJECTIVE: To compare the prognostic outcomes of hypothermic machine perfusion and static cold storage of kidney alografts. METHODS: A computer-based search of PubMed, sinoMed, EMbase, Web of Science, the Cochrane Central Register of Controled Trials (CENTRAL), Wanfang and CNKI databases were searched from their establishment to March 4, 2015 to screen the randomized controled trials (RCTs) about hypothermic machine perfusion versus static cold storage for kidney transplantation. Meanwhile, the references of included RCTs were also searched by hand. After study selection, RCTs screening, data extraction and quality assessment were conducted by two reviewers independently. Meta-analyses were performed by using the RevMan5.3.0 software. The quality of evidence was assessed by using the GRADEpro3.6 software. RESULTS AND CONCLUSION: Six articles were included, involving 619 cases undergoing hypothermic machine perfusion and 620 cases undergoing static cold storage. The results of Meta-analyses showed that the incidence of primary graft non-function, incidence of delayed graft function of functional kidney alografts, and incidence of delayed graft function were significantly lower in the hypothermic machine perfusion group than the static cold storage group (P < 0.05 or 0.01). There were no differences in the 1-year recipient survival rate and 1-year alograft survival rate between the two groups (P > 0.05). These findings indicate that the hypothermic machine perfusion only can reduce the incidence of postoperative complications to maintain the function of kidney, but cannot improve the 1-year recipient survival rate and 1-year alograft survival rate. Hypothermic machine perfusion has no advantage on the long-term preservation of donor organ compared with the static cold storage.

Objective To introduce the application and assess the outcome of ProPlan CMF software in virtual surgery of mandibular resection and reconstruction with vascularized fibular graft.Methods Nineteen patients were performed mandibular resection,and immediate reconstruction with free fibular graft by application of ProPlan CMF software between March 1,2013 and January 31,2014,including 7 cases of osteoradionecrosis,6 cases of adamantoblastoma,4 cases of carcinoma of gingiva,2 cases of intra-osseous carcinoma of mandible.There were 12 males and 7 females,with an age range of 21-73 years (median,54 years).In each case,three-dimensional spiral CT scan of mandible and fibula was obtained before operation.The CT data were imported into the ProPlan CMF software and the virtual surgical planning was performed.After that,the mandibular rapid prototyping and surgical guide plates were made according to customized design.The segmental resection of mandible,titanium plate bending,fibular molding,insetting and fixing were then carried out by using these surgical guide plates.Results Operations were undertaken successfully according to preoperative design in all nineteen patients and negative margin was detected by intraoperative frozen section.The fibula was cut,shaped and fixed accurately.The operations took 4.5-7.0 hours (mean,5.5 hours).Primary healing of incision was obtained without complications except fistula in 2 cases of osteoradionecrosis,which were resolved with local wound care after 4 weeks.19 patients were followed up between 3 months to 1 year and all patients were alive with disease free.All patients were satisfactory with their maxillofacial appearance,occlusion and function.The ranges of mouth opening was 2.0-4.0 cm.The postoperative panoramic radiographs or CT scan showed perfect situation and contour of fibular graft.Healing of the donor site occurred without significant complications.All patients started early postoperative ambulation,and walked normally after 2 or 3 months.Conclusion The application of ProPlan CMF software in virtual surgical design and guide plates creation can simplify the operation,and improve the accuracy of mandibular resection and reconstruction,especially the spatial relationship of the mandible and the fibula graft.It is worth promotion widely in clinical practice.

Objective To study the effect of extracorporeal membrane oxygenation (ECMO) in donor preservation and organ procurement of donation after citizens' death.Method From 2013 to 2014,according to the ECMO indications,we used ECMO to provide circulation and breathing support for circulatory or respiratory function failure donation after brain death (DBD) donor and uncontrolled donation after cardiac death(DCD) donors.Through percutaneous liver puncture and living tissue rapid frozen section,the liver steatosis and fibrosis degree was determined.ECMO indications,ECMO related parameters and the result of blood gas analysis were recorded.alanine aminotransferase(ALT),aspartate aminotransferase(AST) and creatinine(Cr) before and after ECMO intervention were detected to evaluate liver and kidney function and damage.Whether the liver and kidney reached the requirements of the organ transplantation was assessed.Result The ECMO was used in 6 donors.Five cases of DBD were assisted through V-A ECMO because of circulatory or respiratory function failure.In one case of uncontrolled DCD recirculation was established through the thoracic aorta-blocked V-A ECMO.Four livers and 8 kidneys,from 4 donors,were retrieved and transplanted.Two donors' organs were discarded for damage beyond the standard.Conclusion For DBD donor with circulatory or respiratory function failure and uncontrolled DCD donors,the use of ECMO to assist circulatory and respiratory function or establish DCD recirculation can avoid liver and kidney injuries from vascular active drugs and DCD warm ischemia injury,thus,reduce the organ discarding rate of donation after citizens' death.