Objective:To establish an orthotopic autologous liver transplantation model with bile duct ischemia-reperfusion injury in rats,so as to make it easy for the operation.Methods: Eighty SD rats were used to establish the models.The method used for this model was the same as the one for orthotopic liver transplantation,except for the blood vessel anastomosis and the constant pressure perfusion of portal vein and abdominal aorta.The portal vein and the hepatic artery reperfusion were controlled by artery clamp.Results: The successful rate of the operation for establishing the model was 95%(76/80) and the anhepatic phase was(16?2) min.The periods of hot and cold ischemia and reperfusion could be accurately controlled and the effect of double constant pressure perfusion was good.There was no erythrocyte in the capillary of bile ductal wall under the light microscope after the reperfusion.Conclusion: This technique,simulating the whole process of liver transplantation,is simple and has high successful rate.Besides,it rules out the influence of immune agent on bile ducts impairment,and better reflects the pathophysiological process of bile ducts ischemia and reperfusion injury,providing a novel approach for investigation of bile ducts injury during liver transplantation.

Objective To explore the effect of relative warm ischemia (RWI) on bile nature and component in rats self-liver transplantation.Methods Thirty two rats were randomly divided into group Ⅰ (control group),group Ⅱ (RWI 0 min),group Ⅲ (RWI 30 min),and group Ⅳ (RWI 60 min).The levels of bile phospholipids (PL),total bile acids (TBA),and PL/TBA ratio were detected early after self-liver transplantation.The concentration changes of hydrophilic and hydrophobic bile acids were examined.Results Only PL concentration of group Ⅱ seemed to be lower than that of group Ⅰ (P ＜ 0.05),without any change for other indexes.Compared with group Ⅱ,only the PL and TBA concentrations of the group Ⅲ were decreased significantly (P ＜ 0.05),and no significant difference was found between two groups on PL/TBA ratio and mole fractions of bile acids (P ＞ 0.05).Compared to group Ⅱ,the concentrations of PL and TBA,PL/TBA ratio,and the mole fraction of taurocholic-β-mouse acid (T-β-MC) were much lower in group Ⅳ (P ＜ 0.05),and the mole fraction of taurocholic acid (TC) were higher in group Ⅳ (P ＜ 0.05).Conclusions RWI caused changes of PL/TBA ratio,hydrophilicity and hydrophobicity of bile early after liver transplantation,and the changes were directly proportional to the RWI time.The property of bile in early transplantation seemed not to be changed when the relative warm ischemia time was less than 30 min.When the RWI time was longer than 60 min,the bile component was changed obviously and the toxicity was increased.In liver transplantation,arterial anastomosis should be completed as soon as possible,and the RWI time should be less than 30 min.

Objective To compare the analgesic and side effects of patient-controlled intravenous analgesia(PCIA) with lornoxicam and morphine supplemented by continuous epidural infusion of 0.2% ropivacaine. Methods Sixty ASA I - II patients undergoing elective hysterectomy under epidural anesthesia were randomly divided into two groups: lornoxicam group (L, n = 30) and morphine group (M, n=30). For postoperative analgesia both groups received continuous epidural infusion of 0.2% ropivacaine 4 ml'h . In group L the patients received PICA with 0.008% lornoxicam and in group M 0.001% morphine. The bolus dose was 1 ml, lock-out interval 5 min and maximal amount within 1 h was 12 ml in both groups. If the patient still felt pain after pressing PCA pump 12 times, an additional epidural bolus of 0.2% ropivacaine 5 ml and morphine 0. 5mg was given. The clinical effects were assessed by (1) VAS score of pain( 0 = no pain, 10 = severe pain), (2) Bruggrmann comfort score (0 = persistent pain, 4 = no pain at coughing), (3) modified Bromage score, (4)patients satisfaction, (5) the number of pressing of PCIA pump by the patient (D1 ) at 30 min, 1,4,8,12,16,20,24h and the number of bolus dose delivered (D2), (5) the time when the patient passed gas and (7) complications such as nausea and vomiting and respiratory depression.Results The demographic data were comparable between the two groups. The amount of ropivacaine consumed was 192 mg in both groups.The amount of lornoxicam consumed was (3.4 +2.8) mg in group L and the amount of morphine consumed was (4.7 + 3.5) mg in group M. There was no statistically significant difference in VAS and Bruggrmann comfort score between the two groups. There were less side-effects in group L which were also milder as compared with those in group M.Conclusion The results suggest that continuous epidural infusion of 0.2% ropivacaine combined with lornoxicam in PCIA can provide better analgesia and reduce drug consumption in PICA. The efficacy of analgesia providedby lornoxicam is similar to morphine but lornoxicam causes less side-effects than morphine.

Objective To assess the analgesic effect of continuous infusion of 0.2% ropivacaine with epidural catheter placed at T11-12 or L2-3 after abdominal hysterectomy. Methods Eighty ASA Ⅰ -Ⅱ patients undergoing elective abdominal hysterectomy were randomly divided into 4 groups with 20 patients in each group : in group Al and A2 the epidural catheter was placed at T11-12 and in group Bl and B2 at L2-3 . After surgery two infusion pumps were used. The first pump was used for continuous epidural infusion of 0.2% ropivacaine in the 4 groups. The second pump was used for patient controlled intravenous analgesia (PCIA) with 0.08% lornoxicam in group Al and Bl or with 0.1% morphine in group A2 and B2. The PCIA bolus dose was 1 ml with a lockout time of 5 min. The analgesic effect (assessed using VAS) and the consumption of lomoxicam / morphine were compared among the four groups. Results The ropivacaine consumption was 192 mg during the 24 h after operation in the 4 groups. The lornoxicam and morphine consumption were (3.9?2.8) mg and (4.6?3.5) mg in group Al and A2 with the epidural catheter placed at T11-12 and (7.7?2.5) mg and (7.8?2.4) mg in group B2 and B2 with catheter placed at L2-3.The consumption of lomoxicam or morphine was significantly less with epidural catheter placed at T11-12 than that with epidural catheter at L2-3 (P

Objective To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.2% levobupivacaine in patients after lower abdominal surgery.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing lower abdominal gynecologic operation under epidural anesthesia were randomly divided into two groups : group L levobupivacaine (n = 30) and group R ropivacaine ( n = 30) . An epidural catheter was placed at L2-3 . After operation the catheter was connected through a 3-way Stopcock to a Graseby 9 500 infusion pump for continuous infusion of 0.2% levobupivacaine or 0.2% ropivacaine at a rate of 4 ml?h-1 and a Graseby 3300 infusion pump for PCEA with 0.01% morphine (bolus dose = 2ml, lockout interval = 10 min, total dose limit = 16 ml?4 h-1) (1) VAS score (0 = no pain, 100 = severe pain). (2) the ratio of the number of attempts calculated (D1) to the number of successfully delivered doses (D2) (D1/D2), (3) modified Bromage Motor scale score, (4) Bruggmann comfort scale (BCS), (5) Ramsay sedation score and (6) the severity of side effects were recorded 0, 2,4, 8, 12, 20 and 24h after operation.Results The demographic data (age, body weight, height) and duration of operation were comparable between the two groups. The analgesia was satisfactory in both groups. VAS scores were significantly lower in levobupivacaine group than that in ropivacaine group at 8 and 24 h after operation ( P

Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.

BACKGROUND: Studieshave shown that long time of warm ischemia or cold preservation would injury the biliary tract in liver transplantation. However, whether relative warm ischemia (RWI) of biliary tract would result in bile component changes is unclearly. OBJECTIVE: To establish auto-liver transplantation bile ducts RWI models, observe the effects of RWI on the bile salts and phospholipid concentration secreted by the donor liver, and to study the correlation between the total bile salt/phosphoUpid ratio (TBA, PL ratio) and billary tract injury. METHODS: A total of 32 SD rats were selected for auto-liver transplantation models with bile ducts RWI, and the rats were randomly divided into 4 groups (n=8). In Group Ⅰ (sham operation group), rats only received liver dissociation without any cold reperfusion. The RWI time of Group Ⅱ,Ⅲ, and Ⅳ were 0 minutes, 30 minutes and 60 minutes, respectively. The concentration of TBA in bile was measured with enzymatic cycling assay, andPL with enzymic colorimetric. Pathological observation with light microscope and ultrastructural observation with transmission electron microscope were performed on the hilar bile duct. The endothelial cell apoptosis was detected with TUNEL assay. The correlation between TBA, PL ratio and biliary injury was analyzed. RESULTS AND CONCLUSION: One rat died, the other 31 rats were included in the final analysis. RWI could change the composition of bile secreted by donor liver, raise the TBA/PL ratio, and increase the bile toxicity. These changes had a positive correlation to RWI time, and the changes were obviously with time prolonged. In addition, the changes are closely related to the biliary tract injury. This study shows an important mechanism of the biliary tract injury caused by RWI-injury.

Objective To comparatively study the ischemia-reperfusion injuries caused by heterogeneity of different positions of the biliary system and different construction patterns of the peribiliary vascular plexus. Methods Thirty rats were randomly divided into 3 groups: Group Ⅰ , sham operated; Group Ⅱ , 1h ischemia in biliary tract followed by 1h reperfusion; Group Ⅲ, 1h ischemia in biliary tract followed by 2h reperfusion. TUNEL assay, pathomorphology score determination and ultrastructural quantitative analysis were performed on epithelium of the hilar bile duct, proximal common bile duct and interlobular bile duct. Results In groupⅡ , TUNEL assay and pathomorphology score showed no statistical difference between proximal common bile duct and interlobular bile duct (P＞0.05) but showed significant differences in the hilar bile duct(P＜0.05). Mean volume (V) of mitochondria and area density of microvilli were obviously serious in the hilar bile duct but obviously slight in the proximal common bile duct(P＜0. 05). In group Ⅲ, the results of the above detections showed that the most severe was in hilar bile duct, followed by the interlobular bile duct and proximal common bile duct(P＜0. 05). Conclusion Different injuries in various parts of the biliary system are caused by heterogeneity of biliary epithelial cells and construction patterns of the peribiliary vascular plexus. It also provides the experimental basis to explain the higher incidences of hilar bile duct stricture. It could be taken as the best position when the bile duct is anastomosed.

To investigate the effects of Astragalus polysaccharide (APS) on proliferation of basal-like breast cancer cell line MDA-MB-468 cells and Akt phosphorylation in MDA-MB-468 cells.

Objective To evaluate the effect of gender matching on the outcomes of livingdonor renal transplantation.Methods A total of 419 cases of living-donor renal transplantation in our center were divided into male-donor-male-recipient (MDMR) group,male-donor-female-recipient (MDFR) group,female-donor-male-recipient (FDMR) group,female-donor-female-recipient (FDFR)group.The outcomes including graft and patient survival,acute rejection and renal function were analyzed retrospectively.Results Compared to MDMR group,MDFR group and FDFR group had lower Scr [(80.7±17.9),(87.4±21.9) μmol/L vs (120.3±72.5) μmol/L,all P ＜ 0.05] and uric acid (UA) [(318.1 ± 86.4),(303.5 ± 66.9) μmol/L vs (358.4 ± 77.8) μmol/L,P ＜ 0.05] 6 months after operation.Compared to MDFR group,FDMR group had higher Scr[(117.7±27.4) μmol/L vs (80.7±17.9) μmol/L,P ＜ 0.01],UA [(371.0±92.4) μmol/L vs (318.1±86.4) μmol/L,P ＜ 0.05] and lower glomerular filtration rate (GFR) [(70.4± 17.8) ml/min vs (79.6± 18.9) ml/min,P ＜ 0.05].Compared to FDMR group,FDFR group had lower Scr [(87.4±21.9) μmol/L vs (117.7±27.4) μmol/L,P ＜ 0.01] and UA [(303.5±66.9)μmol/L vs (371.092.4) μmol/L,P＜ 0.01].Compared to MDFR group,FDFR group showed lower GFR [(72.4±25.3) ml/min vs (82.7± 18.7) ml/min,P ＜ 0.05] 1 year after operation.Compared to MDMR group,FDFR group showed lower UA [(322.9±69.7) μmol/L vs (376.0±66.2) μmol/L,P ＜ 0.05] 2 years after operation.Compared to FDMR group,FDFR group showed lower Scr [(88.7 ±27.0) μmol/L vs (112.7±27.8) μmol/L,P ＜ 0.05] and UA [(318.3 ±61.2) μmol/L vs (396.2± 100.3) μmol/L,P ＜ 0.05] 3 years after operation.5 years after operation,there were no significant differences in above indexes,the incidence of slow graft function,acute rejection and survival of graft and patient among groups.Conclusions Male recipients of female donors have the worst renal function while female recipients have better outcomes after operation.