In guinea pig to rat cardiac xenotransplantation model,plasmapheresis,splenectomy and cyclophosphamide were used to reduce the content of the plasmatic natural antibodies.The survival time of the grafts was observed.It was found that plasmapheresis could lead to a dramatic drop of the natural antibodies in the plasma.Plasma IgM and IgG was significantly reduced to 167 mg/dl and 693.3mg/dl after plasmapheresis from 936.0mg/dl and 2 424.3mg/dl before plasmapheresis.Survival time of the control group was 13.2 min,while survival time of the plasmapheresis group was 537.0 min.The combined use of plasmapheresis,splenectomy and cyclophos-phamide could further prolong the survival time of the xenografts(760.0min).

MicroRNA(miRNA)is a kind of 22 nt endogenous small non-coding single strand RNA and is universally present in animals and plants.It can suppress the expression of target genes at post-transcription al level by complementary biding to the 3'UTR of target mRNAs.Recent studies indicate that microRNA is closely associated with tumorigenesis,differentiation,metastasis and relapse.MicroRNA might act as a new biomarker of tumor diagnosis and a new target of tumor gene therapy.

Objective To investigate the effect of clinical pathway in health education for preventing post partum urinary retention. Methods 883 women who performed vaginal delivery in our department before implementation of clinical pathway from July to December, 2007 were set as the control group, 1172 women who performed vaginal delivery after implementation of clinical pathway were selected as the experimental group from January to June, 2008. Then the first micturition condition was compared between the two groups. Results The rate of autonomic micturition was 95.9% in the experimental group, and 91.6% in the control group, The rate of autonomic micturition was higher than that of the control group. Conclusions Application of clinical pathway to prevent post partmn urinary retention can improve obstetrical nursing quality.

Objective　To study the effect of the combined use of aminoguanidine (AG) and cyclosporine A (CsA) on acute rejection following cardiac allograft. Methods　Except the control group, all other three groups were respectively treated by AG 600mg/kg every day subcutaneously 0 to 7 days after transplantation, low-dose CsA 2mg/kg every day i.m 0 to 7 days after transplantation, and low-dose CsA plus AG. Inducible nitric oxide synthase (iNOS) expression and nitric oxide (NO) production during acute allograft rejection were detected at 4th day after operation, and the graft survival was observed.Results　Compared with the control group, iNOS expression and NO production were significantly inhibited in the AG-treated group (P＜0.05)，the progression of acute rejection was slightly attenuated and allografted heart survival prolonged. The inhibitory effects of iNOS activity and NO production in the recipients receiving the combined treatment of low-dose CsA plus AG were higher than those receiving low-dose CsA alone. Compared with the low-dose CsA group, low-dose CsA plus AG could significantly reduce the histologic grade of acute rejection (P＜0.01) and prolong the graft survival (P＜0.05). Conclusion　The combined use of low-dose CsA and AG could synergistically suppress iNOS activity and NO production, and significantly prolong allografted heart survival.

Objective To observe the effects of intrathymic islet transplantation or renal subcapsule islet transplantation on the graft survival.Methods C57BL/6 mice were used as recipients and BALB/c as donors The recipients receiving intrathymic or renal subcapsule islet transplantation were divided into simple transplantation groups and the group intraperitoneally receiving rabbit antithymocyte serum(ATS) at the time of islet transplantation.Results The median survival time (MST) of simple intrathymic allografts were 19.5 days,longer than that of allografts implanted beneath the renal capsule.Administration of ATS at the time of islet transplantation delayed rejection of islets transplanted to the renal subcapsute(MST,43.0 days),and intrathymic allografts were superior(MST,93.8 days).Six of 8 intrathymic grafts with administration of ATS survived permanently.especially a state of donor-specific unresponsiveness was induced.Conclusion The thymus may be an immunoprivileged site for islet transplantation and may play an important role during the induction of immune tolerance.

Objective To study the molecular mechanisms of hepatoeyte regeneration following different cold preservation (CP) durations after rat partial liver transplantation. Methods Mate inbred Lewis rats were used as donors and recipients. Donor liver was kept in 4℃ UW solution for 1 h (coldisehemia 1 h group, CI 1 h group), 8 h (CI 8 h group) and 16 h (CI 16 h group) and then implantedorthotopieally. 50% liver graft transplantation model was established by ligating the left portion ofmedian lobe, left lateral lobe and caudate lobe with 3-O silk suture prior to reperfusion. Survival rate ofeach group and hepatoeyte regeneration were recorded after grafting. Reverse transcription-polymerasechain reaction was used to detect the expression of IL-6 and TNF-α in the liver tissues. Western blotanalysis was done to measure STAT3 activation in the liver. Immunohistoehemistry was conducted toanalyze the expression of cyclin D1 and hepatocyte replication with BrdU uptake in the graft. ResultsOperative success rate in all groups was 100%. Compared with CI 1 h group, the TNF-α and IL-6expression (F=67.45 for TNF-a comparison, P<0.05 and F=287.73 for IL-6 comparison,P<0.05 respectively) in 8 h CI and 16 h CI groups was markedly increased after partial grafttransplantation. STAT3 activity in 8 h C1 and 16 h C1 groups was also significantly increased ascompared with that in 1 h CI group. Cyclin D1 expression in 8 CI group was demonstrated withcytoplasmic and nuclear staining at 24 h after transplantation. Grafts in 16 h CI group showed largeareas with no cyclin D1 expression. Number of hepatocytes with BrdU positively stained neclei in 8 hCI group was more than that in 16 h C1 group at 24 h after transplantation (t=19.40, P<0.05).Conclusion Hepatocytes regeneration was present following rat partial transplantation in the graftspreserved for limited time, which may be regulated by TNF-α/IL-6' STAT3/ Cyelin D1/DNAsynthesis pathways; Hepatocytes could not respond to early signals for liver graft regeneration when50%liver graft preserved for 16 h.

Objective To explore the microsurgical techniques in establishing an orthotopic rat liver transplantation model of 20% small-for-size graft. Methods A rat liver transplantation model of 20% small-for-size liver graft was orthotopically performed. Forty male Lewis rats were used as 20 donors and 20 recipients. Donor liver was perfused with 4℃ UW solution via donor portal vein. Su-prahepatic inferior vena cava was anastomosed end-to-end with running suture. Infrahepatic inferior vena cava and portal vein were reconstructed by cuff technique. A sleeve anastomosis for hepatic artery was used. Continuity of the bile duct was established with an end-to-end intraluminal stent. Survival rate of the recipients was recorded and immunohistochemical analysis of hepatocyte replication con-firmed by bromodeoxyuridine (BrdU) uptake. Results Totally 20 liver transplantations of 20% par-tial liver graft were successfully performed. The successful rate of the operation was 100%. Survival rate of the recipients with 20% liver grafts was 93.8% (＞14 d). Histological examination showed normal liver structure with limited injury after transplantation. The number of positively stained nuclei was significantly increased at 72 h after transplantation. Conclusion The 20Z% small-for-size liver grafts initiate and complete the process of liver regeneration after transplantation. Skillful microsur-gery is the key to success of the transplantation model. The stable model is suitable for basic research in partial liver transplantation.

Objective To study the effect of simultaneously combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases. Methods Thirteen cases subject to SLKT from 1996 to 2004 were reviewed in The First Affiliated Hospital of Sun Yat-sen University. Among them, there were 4 cases of polycystic liver and kidney, 4 cases of hepatic cirrhosis and renal failure, and 5 cases of fulminant heptic failure and hepatorenal syndrome. Ten were males and 3 females with an average age of 45.5 years old.Results Four cases of polycystic liver and kidney have all survived for more than one year after SLKT, and one of them has survived for 4 years. The 3 of 4 patients with hepatic cirrhosis and renal failure have survived more than one year, and one of them died perioperatively. The 2 of 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for one year, and 3 of them died perioperatively.Conclusion SLKT has been the effective therapy for end-stage liver and kindney diseases; The indications of SLKT for hepato-renal syndrome were discussed. SLKT may immunologically protect the renal graft.

Hepatic ischemia/reperfusion injury (HIRI) exists in lots of process of clinical pathology and operation. Apoptosis is an active process controlled by some gene and factors such as Fas/FasL, Caspases and Bcl-2 families. More and more studies suggest that HIRI is associated with apoptosis. This article summarized the mechanisms and gene modulation of apoptosis during HIRI and the significance of suppressing apoptosis in preventing HIRI.

Objective To study the effect of systematic prenatal education on the outcome of childbirth. Methods Pregnant women (200 cases) were randomly divided into 2 groups, 100 pregnant women who were willing to attend the maternity club to accept the systematic prenatal education were set as the experimental group, while 100 pregnant women who only accepted the regular prenatal health education as the control group. The experimental group not only received regular prenatal health education, but also had classes about prenatal gymnastics training exercise, the simulant delivery process, Lamaze pain relieving delivery, various postures of 3 delivery processes, the knowledge of husband assistance, the physical and psychological change and relevant coping method during gestation and postpartum, etc. The control group only accepted the regular prenatal health education, which was watching breastfecding VCD, having classes about the basic health knowledge and the physical process of pregnant period, delivery period, and puerperal period, the breasffecding knowledge, etc. Results The cesarean section rate and the total stage of labor of the experimental group was significantly less and shorter than that of the control group(P<0.05 and P<0.01). Conclusions The systematic prenatal e-ducation can improve pregnant women's knowledge of pregnancy and parturition, improve pregnant women's confidence of natural delivery, help to regulate nerve and the function of different organs, shorten the childbirth process, and reduce the cesarean section rate.