Objective To investigate the expression of CD2 in peripheral blood T lymphocytes in acute rejection after small bowel transplantation (SBT) in rats.Methods Three groups were set up: Group A (n=18), receiving sham operation and feeding of common feedstuff; Group B (n=18) receiving SD rat to SD rat iso-series SBT and the treatment of routine liquid infusion and antibiotics after operation; Group C (n=18) receiving SD rat to Wistar rat taniso-series SBT and the same post- operation treatments as in group B. Samples of grafts and peripheral blood in the three groups were collected on the day 3, 5 and 7 respectively after SBT for detection of flow cytometry. The intestinal grafts were obtained for pathological examination.Results The survival time of rats in group C, group B and group A was 7.0? 2.1, 33.3? 2.3 and more than 90 days, respectively. There was significant difference between group C and groups A, B (P

Objective To summarize the practical experience of 2 cases of anemia following living related intestinal transplantation.Methods The clinical data of 2 cases of anemia following living related intestinal transplantation were studied retrospectively. After the surgical procedure regiments of blood transfusion, hemostasia, to cut down the dosage of some drug, to fill up raw material of hematopoientic system and requisite nutrition support were used to treat the patients. Results Four weeks later, the diseased conditions of the two patients became better and better. The index of hemoglobin were increased remarkably, to normal level 100 to 120?g/L.Conclusion Anemia is one of the common syndrome in living related intestinal transplantation. The correction of anemia is very important in treating such patients.

Objective To establish the model of abdominal heterotopic heart transplantation and grope steady operation methods.Methods The heart transplantation was performed in the control group(group A) and experiment group(group B) with 30 rats in each group.Another 30 animals not performed the operation were as the blank group(group C).During the procurement of the donor heart saline solution containing heparitin was injected into the inferior vena cava of liver.At the same time abdominal aorta was transected.Then heart was perfused until it stopped.The activity of superoxide dismutase(SOD) and content of malondialdehyde(MDA) in blood was measured after transplantation.Results The total perfusion time of the graft was shortened within 2 min and hot ischemia time was shortened within 25 s in the group B.The activity of SOD and content of MDA between two groups was significantly different(P<0.05).Conclusion The perfusing method improved with new technique is quicker and more effective than the traditional one and results in the successful rate improvement.

Objective To investigate the protective effects of reducing average radiation dose and increasing protective weight on the auditory system (tympanic cavity,the bony portion of eustachian tube,vestibule,and cochlea) during intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods The planning system (ADAC Pinnacle3 8.0m) with direct machine parameter optimization was used to optimize the IMRT planning for 40 patients with NPC (stage Ⅰ + Ⅱ:20 patients ;stage Ⅲ + Ⅳ:20 patients).Without reducing the radiation dose for target volume,the IMRT planning was optimized by limiting the average dose administered to the auditory system or increasing the protective weight for the protected organs in auditory system.The protective effects were assessed by analyzing the average dose received by the auditory system.Results After limiting the average dose administered to the auditory system without reducing the radiation dose for target volume,the average dose received by the auditory system was significantly reduced (3855.5-5391.3 Gy vs 2960.3-4559.6 Gy,P =0.000 for all) ; when the protective weight for the auditory system was increased,the average dose received by the auditory system was even more reduced (3855.5-5391.3 Gy vs 2725.4-4271.4 Gy,P =0.000 for all).For all three regimens,the average dose was significantly higher in stage Ⅲ + Ⅳ patients than in stage Ⅰ + Ⅱ patients (P =0.000 for all).Conclusions For the IMRT planning for NPC,limiting the average dose administered to the auditory system can greatly reduce the average dose received by the auditory system,and increasing the protective weight for the auditory system can further reduce the average dose received by the auditory system.However,the protective effect on the auditory system may be reduced as the stage of NPC increases.

BACKGROUND: A latest research indicates that γ~δ T cells following touching with microbe products show characteristics as dendritic cells and antigen-presenting cells (APC) and induce intensive immune response of CD4~+ CD8~+ γ~δ T cells.OBJECTIVE: To verify APC-like functions of γ~δ T cells during transplantation rejection, investigate a simple and effective method to amplify γ~δ T cells in vitro, and to infect γ~δ T cells with FasL retrovirus system.DESIGN, TIME AND SETTING: An animal experiment was performed at Central Laboratory of the First Affiliated Hospital of the Fourth Military Medical University of Chinese PLA from August 2007 to August 2008. MATERIALS: A total of 60 healthy adult Wistar rats of clean grade and weighing 200-320 g were used to establish donor and receptor models with segmental heterotopic small intestine transplantation.METHODS: Models of segmental heterotopic small intestine transplantation were established using three sleevelet vascular anastomosis. γ~δ T cells were obtained using flow cytometry and its function was demonstrated. Mononuclear cells were routinely separated and amplified with Mtb-Ag. MAIN OUTCOME MEASURES: Cell proliferation was observed; percentage of γ~δ T cells for lymphocytes was detected using TCRγ~δ magnetic beads kit; γ~δ T cells following transfection were detected using pLXSN FasL retrovirus system. RESULTS: Activated γ~δ T cells showed dendritic cell-like adhesion function and APC-like functions during transplantation rejection. γ~δ T cells accounted 4.5% for mononuclear cells, the purification of γ~δ T cells was up to 72.2% on the 10~(th) day after activated by Mtb-Ag, and the purification of γ~δ T cells was up to 99.1% through positive magnetic sorting. 285 bp FasL fragment demonstrated that the gene integration was observed in PA317 cells. The ration of FasL+ cells was 97.3% after infected by pLXSN FasL retrovirus system.CONCLUSION: This study demonstrated APC-like functions of γ~δ T cells during transplantation rejection. γ~δ T cells were successfully amplified in vitro. PA317/ pLXSN2FasL+ retrovirus system was successfully constructed and γ~δ T cells were modified by FasL retrovirus system.

Objective To explore the value f high sensitive c-reactive protein (hs-CRP) and CD4/CD8 ratio for monitoring of lung infection in elderly patients with esophageal cancer through detecting hs-CRP ,white blood cell (WBC)parameters and CD4 /CD8 ratio .Methods A total of 89 lung infection elderly patients with esophageal cancer after surgery from August 2012 to Decem-ber 2014 were collected as observation group ,special protein instrument ,blood cell analyzer and flow cytometry instrument were used to detect the hs-CRP ,WBC parameters ,CD4/CD8 ratio ,and compared with 82 cases of retired veteran cadres physical exami-nation for the same period in the control group .Results The hs-CRP ,WBC parameters ,CD4/CD8 in the preoperative group and the control group had no significant difference (P> 0 .05) .The three indicators in the preoperative group ,infection group and 3 days group had significant differences (P < 0 .05) ,although CD4/CD8 ratio in the cure group improved ,had not been completely im-proved .Conclusion Hs-CRP in diagnosis and monitoring of therapeutic efficacy is better than WBC parameters ,in the treatment of lung infection in elderly patients with esophageal cancer ,besides use the anti-infection treatment ,promote immune function recovery should not be ignored .

Objective To investigate the feasibility and results of the application of both expanded cutaneous flap and temporoparietal fascia flap in total ear reconstruction with Medpor framework.Methods The main procedures consisted of three stages:stage Ⅰ-skin expansion,stage Ⅱ auricle formation that consisted of orientation of Medpor implant and creation of coverage for the implant by both expaned skin flap and temporoparietal fascia flap,and stage Ⅲ-treatment of residual ear and recontruction of auricular lobule. Results Twenty-two ears in 22 unilateral microtia patients were constructed using Medpor implants covered with both expanded cutaneous flap and temporoparietal fascia flap over the last three years,and they were accepted as pleasing by the patients.Conclusions Application of both expanded cutaneous flap and temporoparietal fascia flap can assure no extrusion of Medpor implant in ear reconstruction.Further more,the two layers of transferred tissues will not affect the profile details of the reconstructed ear.And because the skin covering the framework and fascia is derived from frommastoid region,the appearance and profile of the reconstructed auricle is true to nature and close to that of the opposite one.

Objective To study the prevention and treatment of chylous leakage after Whipple operation.Methods Clinical data of 381 patients underwent Whipple operation from Jan 2010 to march 2013 were retrospectively analyzed.Results Among 381 patients,23 patients had chylous leakage,the incidence was 6.04％.While in 89 patients,in which intraoperative precautionary physical ligation or mattress suturing of the lymphatic vessels were undertaken,no chyle leakage occurred ; Most of chyle leakage occurred in malignant tumor after radical resection(21 patients),most chylous leakage was found 5-8 days after surgery,with daily volume of 260-450 ml.All patients of chylous leakage were cured by conservative treatment.Conclusions Chylous leakage are common in PD.Intraoperative preventive measures such as lymphatic duct ligation or safe suturing can effectively prevent chyle leakage.Conservative therapy heals most chylous leakage after Whipple operation.

Objective To investigate the efficacy of concurrent interventional cisplatin,leucovorin,fluorouracil,hydroxy camptothecin chemotherapy plus radiotherapy in patients with Ⅳ stage middle-lower section esophageal cancer.Methods The subjects were all the patients with Ⅳ stage middle-lower section esophageal cancer.Among of them,42 patients,via artery,had been enrolled for concurrent interventional cisplatin,leucovorin,fluorouracil,hydroxy camptothecin chemotherapy plus radiotherapy.40 patients were given irradiation.Results The incidence rate of Ⅰ grade esophageal X-ray in the former group was 57.1%,and that in the later group was 25.0%,and the parameters had significant difference(?0.05).Conclusion Concurrent interventional cisplatin,leucovorin,fluorouracil,hydroxy camptothecin chemotherapy plus radiotherapy may be attributed to progression of Ⅳ stage middle-lower section esophageal cancer.

Objective:To investigate appropriate accommodation of nutrition after living-related small bowel transplantation.Methods: According to the function of allograft and general body state,TPN was used and gradually transferred to PN+EN,finally to TEN.The clinical and laboratory nutrition markers in 4 recipients were observed.Results: 2 recipients survived over 4 years,various kinds of nutrition markers were normal,and the health status was good.One recipient died of acute pulmonary infarction at 19 days.Another recipient died of multiple system organ infection at 5 months.Conclusion: EN cand promote restoration of allograft function.