Objective To investigate the surgical technique of establishing a reliable rat model of orthotopic liver transplantation and prevention of operational complication. Methods The model was established with modified cuff technique.The donor was perfused through the abdominal aorta with 20ml cold perfusate.The anastomosis of the suprahepatic vena cave(VC)was sutured end-to-end with 8-0 nylon line,and the continuity of infrahepatic VC and portal vein (PV)were established by means of cuff method respectively.The bile duct anastomosis was performed by internal stent. Results Three hundred and sixty case of rat orthotopic liver transplantation were performed and the successful rate of the mode was 91.3%.In non-intervention group,the survival rat was satisfactory,with a 86.5%of 1 week survival and a 80.7% of long-term survival (longer than 3 months). Conclusions The sophisticated microsurgical technique and the delicate surgical manipulation is the prerequisite of preventing operational complication,and shortening the anhepatic phase of recipient as soon as possible is the key to animal survival.

14 d).Compared with 1 h CI,TNF-? expressions in whole liver grafts with 8 h and 16 h CI were markedly increased at 90 min after reperfusion(P

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 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 explore the effect of controlled premature delivery and its termination method of pregnancy.Methods The clinical data of 151 cascs of controlled premature delivery were retrospectively analyzed.Results The incidence of premature delivery was 7.5% and the incidence of controlled premature delivery was 44.8%.The cesaran section rate of controlled premature delivery Was 93.4%.Pregnancy induced hypertension(PIH)was the first place reason of controlled premature delivery.The second was antepartum hemorrhage,intrauterine fatal diatress and placenta previa,pregnancy associated with cardiac disease.The complications and mortality of premature infants were reduced if antenatal care is regularly and glucocorticoids could be used.Conclusion Antenatal care and proper treatment can increase the survival rate of premature infants in the inevitable controlled delivery.

Objective To evaluate the efficacy and safety of concomitant docetaxal (DTX) and nedaplatin (NDP) therapy for recurrent epithelial ovarian cancer in elderly women.Methods Totally 42 elderly patients with histologically confirmed recurrent epithelial ovarian cancer received chemotherapy with DTX combined with NDP.DTX with the dose of 60-70 mg/m2 was administered intravenously on day 1,followed by NDP with the dose of 70-80 mg/m2 given intravenously on day 2.The treatment was repeated every 3 weeks.The efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) and serum CA125 level.Adverse reactions were assessed according to performance and standard criteria in toxicity of anticancer agents of WTO.Results 4 patients were switched to other chemotherapy strategies due to progression of disease after 2 courses of treament,and the other patients completed 4 to 6 courses.Among 42 patients,18 cases (42.9％)showed complete remission,10 cases (23.8％) showed partial remission,6 cases (14.3％) were in stable conditions,and 8 cases (19.0％) progressed to severe disease.The median progression-free survival (PFS) time was 7 months,and the efficacy rate (complete and partial remission) was 66.7％(28/42).The main adverse effects were alopecia,nausea and vomit,and leucopenia.Patients could get remission by receiving drug therapy.Conclusions Docetaxel plus nedaplatin therapy has a good therapeutic effect with low incidence of adverse reactions,high safety and well tolerance in elderly platinum-sensitive women and in those with platinum-resistant recurrent epithelial ovarian cancer.

Objective To find out whether the benefits entitled to peasants have increased since NRCM is in place in Beijing, and to analyze the extent of such benefit increase if any. Methods The first is to calculate changes to the reimbursement ratio of hospitalization charges for the peasants covered by NRCM; the second is to calculate the role played by NRCM for alleviating the catastrophic health expenditure of peasants. Results The reimbursement ratio of hospitalization charges for peasants covered by NRCM rose from 32.4% in 2004 to 45.4% in 2007. Survey data from districts and counties in the sampling test indicate that NRCM has gained an ever growing power in alleviating the catastrophic expenditure of peasants. Conclusion Recent years have witnessed a marked growth in medical charges, peasants' income, and peasants' demand for medical services. Against such a background, NRCM can still sharply downsize their catastrophic health expenditure, and its role keeps intensifying. This proves that the fund raising speed of NRCM has greatly outpaced the growth of medical charges and peasants' demand for medical services, and NRCM is playing a more effective role in alleviating the peasants from poverty caused by diseases.

Objective To study the molecular mechanism involved in early liver regeneration following cold ischemia after rat orthotopic liver transplantation(OLT). Methods Syngeneic(Lewis to Lewis)rat OLT with hepatic artery reconstruction was performed.Graft survival and liver regeneration following 1 h and 16 h cold ischemic injury were evaluated.Specimen were collected at predetermined intervals from 0,1,2,4,16,24,48,72 h post-reperfusion.The patterns of IL-6 and TNF-α expression,STAT3 activation,and upregulation of immediately early genes(IEGs)including c-fos,c-myc,and c-jun were determined in liver grafts with 1 h and 16 h cold ischemia times.Quantitative analysis of IL-6 at 2 h after reperfusion was performed for grafts preserved for 1 h and 16 h.Progression of hepatocyte replication was confirmed by bromodeoxyuridine(BrdU)immunohistochemistry.Positively BrdU-stained nuclei were quantitated and analyzed between the two groups at 48 h after reperfusion. Results Survival rate in the two groups was 100%.Compared to 1 h cold ischemia group,IL-6 and TNF-α expression and STAT3 activation in 16 h cold ischemia group were markedly increased.Extensive hepatocyte replication was present.Upregulation of immediate early genes of c-fos,c-myc,and c-jun was also observed.Grafts with 1 h ischemic iniury had lower levels of IL-6 than that when grafts suffering from ischemia for 16 h(t=27.7,P＜0.05).Number of positively stained nuclei in 16 h group were more than that in 1 h group at 48 h after transplantation(t=13.4,P＜0.05). Conclusions Severe cold ischemia initiated liver regeneration after rat OLT.TNF-α and IL-6 are important factors in early liver regeneration.IL-6/STA3 pathway in liver regeneration is an important part in the recovery of grafts following cold ischemia injury.

Objective To observe recipient survival time and liver graft regeneration in an orthotopic liver transplantation model using IL-6 knockout mice as a donor.Methods A model of liver transplantation in C57BL/6 WT and IL-6 KO mice with C57BL/6 background was established.Thirty eight mice were divided into three groups:C57BL/6 wild type→C57BL/6 wild type control group(n=10),IL-6 KO→IL-6 KO group(n=14)and IL-6 KO→C57BL/6 WT group(n=14).Hepatocyte replication with BrdU uptake after liver transplantation was examined by immunohistochemistry.Resuits The survival time in the control group was＞16 days.and that was 2 days and 1.6 days in the IL-6 KO→IL-6 KO and IL-6KO→C57BL/6 WT,respectively.The difierence in survival time in all three groups was statistically significant(F=190.09,P＜0.01).The liver grafts in control group showed minimal injury and no necrosis and mild increase of BrdU uptake at 48 hours.Patchy areas of necrosis and hepatocyte ballooning were observed in the two groups using IL-6 KO mice as donors,there was minimum increase in BrdU uptake at 48 hours post transplantation.Conclusion IL-6 KO liver grafts fail to regenerate after liver transplantation.IL-6 is an important factor in liver regerative response.