OBJECTIVESTo investigate the energy metabolism and post transplantation survival of liver graft under different warm ischemia times (WIT) in rats and determine the maximum limitation of liver graft to warm ischemia.

METHODSAccording to WIT, the rats were randomized into 7 groups, and WIT were 0, 10, 15, 20, 30, 45, 60 minutes respectively. The indexes of energy metabolism were measured by reversed-phase high performance liquid chromatography (HPLC) and all liver graft specimens were subjected to ultrastructural observation. After orthotopic liver transplantation (OLTx), the recovery of energy metabolism of liver graft after 24, 48 hours and the rats' survival were observed.

RESULTSThe levels of adenosine triphosphate (ATP) and energy charge (EC) decreased gradually after different WIT in a time-dependent manner, and especially significant within 30 minutes. The levels of ATP and EC of liver grafts were largely recovered after 24 hours of OLT within 30 minutes of warm ischemia, partially recovered after 48 hours of OLT with 45 minutes of warm ischemia and hardly recovered even after 48 hours of OLT with 60 minutes of warm ischemia. The rat survival time after OLT was not significantly different within 30 minutes of WIT, while the long-term survival was insulted with 45 and 60 minutes of WIT.

CONCLUSIONSThe levels of ATP and EC after OLT may be the important criteria to evaluate the quality of liver graft. WIT of liver graft is closely related to both the recovery of hepatic energy metabolism and the liver graft survival.

Adenosine Triphosphate ; metabolism ; Animals ; Energy Metabolism ; Graft Survival ; Liver ; blood supply ; Liver Transplantation ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; Time Factors

Objective To summarize the experience of endovascular embolization for the treatment of posterior circulation aneurysms. Methods The clinical and follow-up data of 65 patients with posterior circulation aneurysm treated with endovascular embolization in Jiangmen Central Hospital, Guangdong Province were analyzed retrospectively. Results A total of 65 patients with posterior circulation aneurysm received endovascular embolization in Jiangmen Central Hospital, including 30 females (46.2％) and 35 males (53.8％). Their age ranged from 37 to 76 years old(mean 57.3 ± 10.25).Ruptured aneurysms were found in 57 cases (87.7％) and unruptured aneurysms were found in 8 cases (12.3％). Parent arteries:22 (33.8％) in vertebral artery,23 (35.4％) in basilar artery,3 (9.2％) in posterior cerebral artery,2 (3.1％) in superior cerebellar artery, 2 (3.1％) in anterior inferior cerebellar artery, and 10 (15.4％) in posterior inferior cerebellar artery. Hunt-Hess grade:gradeⅠin 15 cases,gradeⅡin 29 cases,gradeⅢin 11 cases, grade Ⅳ in 6 cases, and grade Ⅴ in 4 cases. Twenty-one patients (32.3％) were treated with coil embolization alone,29 (44.6％) were treated with stent-assisted coil embolization, 6 (9.2％) were treated with stenting alone, and 9 (13.8％) were treated with parent artery embolization. Immediate angiography after surgery revealed that 54 patients (83.1％) were completely embolized, and 11 (16.9％) were not embolized completely. Three patients (4.6％) complicated with cerebral infarction, 2 (3.1％) had intraoperative rupture,2 had respiratory disturbance(3.1％),1 (1.5％) had hoarseness, and 1 had vitreous hemorrhage (1.5％).At discharge,the modified Glasgow outcome scale assessment showed that 53 patients (81.5％) had excellent outcome,5 (7.7％) had good outcome, and 7 (10.8％) had poor outcome. Of the patients with poor outcome, 2 (3.1％) died. Thirty-four patients (52.3％) were followed up by angiography, of whom 6 (17.6％) recurred, and 1 died of complicated cerebral infarction. Conclusion Although endovascular treatment of posterior circulation aneurysms is difficult, flexible selection of endovascular treatment may achieve good therapeutic effect.