AIM: To study the effect of heat shock protein (HSP) on the maturation of dendritic cells (DCs) and observe the morphological changes of DCs dynamically. METHODS: The HSP (gp96)-peptide complex was purified from the tissues of hepatocellular carcinoma. Hepatoma cells were treated by heat shock for preparation of the HSP expressed on cell surface and then marked with DiI fluorescence. Immature DCs from peripheral blood mononuclear cells were cocultured with two types of HSPs. The morphological changes of DCs were observed dynamically and the effects of HSPs on the maturation of DCs analyzed by Flowcytometer. RESULTS: The morphological changes and the processes of antigen capture of DCs cocultured with DiI marked tumor cells were well showed. Four ways to capture antigens of DCs were observed, including direct contact, besieging, forming bubbles and extending pseudopodia with bubbles on the terminals. Results also indicated that both types of HSP could promote the maturation of DCs. CONCLUSION: DiI is a good fluorescent dye suitable for the morphological studies of DCs. Four ways for DCs to capture antigens were indicated in this paper. Different types of HSP, purifed from tumor tissues or expressed on tumor cells surface, promote DC maturation, and the purified HSP is more effective. [

Objective:The expression patterns of TLR4,9,10 in the rat spleen were compared between the rat model of acute skin-transplant rejection and physiologically normal rats ,and their physiological significance were accessed.Methods:6 Wistar and 6 SD rats were used as donors ,and another 24 SD rats were used as recipients which were divided into 4 groups of 6.The same back skin slices were transplanted from donor to recipient , Group A:allograft ( Wistar to SD );Group B:homograft ( SD to SD );Group C:autograft;and Group D:normal SD rats as control.Rat spleens were collected at 1,4,7,10,14,and 21 days after surgery ,and mRNA levels of TLR4,9,10 in splenic mononuclear cells were determined by real-time PCR and corresponding protein expression was accessed by immunohistochemistry.Results:TLR4,9,10 mRNA levels of Group A were significantly higher than that of Group B and C ( P<0.05);TLR4,9,10 mRNA levels showed no significant difference between Group B and C (P>0.05).TLR4,9,10 expressions were moderate (++) to strong (+++) in Group A,and generally weak (+) in Group B,C and D.Conclusion:The patterns of TLR4,9,10 mRNA and protein expression in the rat model of acute skin-transplant rejection indicate that the three genes are involved in acute transplant rejection;the three genes may be expressed coordinately;inhibition of the Toll-like receptors may provide therapeutic targets for acute transplant rejection.

Objective To observe the effect of somatostatin (SST) on the expression of metalloproteinase-2(MMP-2) and tissue inhibitor matrix metalloproteinase-2(TIMP-2) of implanted tumor in nude mice after partial hepatectomy.Method Nude mice were divided into group A(n=10) implanted by human hepatocellular carcinoma(HCC),group B(n=10, partial hepatectomy) and C(n=10,HCC implantation after liver resection). SST(250 ?g/kg,b.i.d) was given intraperitoneally in group C. Mice were sacrificed on 35th d, tumor was measured, the expression of MVD.MMP-2 and TIMP-2 was detected by immunochemical staining and quantitative image computer-analysis. Results In group B, the weight and volume and expression of MVD.MMP-2 of tumor tissue was markedly incressed than in group A(P

Objective:To summarize the perioperative nutrition management,improve the successful rate in liver transplantation patients and reduce the complications after operation.Methods:A retrospective analysis of the perioperative nutrition treatment was made in 71 cases with liver transplantation.The principle of enteral nutrition before operation was appropriate energy,protein and rich vitamin,and the branched-chain amino acid(BCAA) and glutamine(Gln) were supplied.Intravenous nutrition,early enteral nutrition and total enteral nutrition support were applied during the postoperation period.Results: Except 5 cases that died from respiratory failure and 2 died from hemorrhagic shock respectively,other 64 cases recovered gradually in liver function,and their nutrition indices were enhanced significantly.Conclusion:The perioperative nutrition management is very necessary for liver transplantation patients,and the appropriate nutrition support is helpful to rehabilitate the function of graft organ and the nutritional status of the recipients as possible as early.

Objective To analyze the surgical procedure and effect of living-related small bowel transplantation(LR-SBTx) on intestinal function failure caused by short bowel syndrome.Methods A boy, 15 years of age with short gut syndrome, who had only 8 cm of residual small intestine, associated with serious malnutrition and poor D-xylase absorption test (0.226/5h). The donor was the boy's mother. They had a match of 4 loci in HLA. In the first stage of the surgical procedure, 120 cm of ileum from the patient′s mother was transplanted into the recipient. Both ends of the transplanted intestine were exteriorized as stomas on the patient′s abdominal wall. The second stage of reconstruction of the intestine was carried out 6 months after his first operation. The residual small bowel of the recipient was transected, and both of its ends were respectively anastomosed end-to-side to the proximal and distal segments of the graft. The stomas of the graft were left in place. Results The donor and recipient operation went on smoothly. Acute rejection and infection of CMV developed postoperatively and were cured after treatment. The patient was followed-up for 8 months, the graft function recovered gradually postoperatively with increase of body weight. He can ingest a semifluid diet and take care of himself independently. Conclusions LR-SBTx is an effective way to treat short bowel syndrome. The reconstruction of the intestine in two stages for LR-SBTx decreased the risk of complications. Rejection and infection are important risk factors of LR-SBTx.

Objective To explore the monitoring methods for pancreatic graft function after upper abdominal cluster transplantation.Methods Analysis of the clinical data of 5 cases of successful upper abdominal(cluster) transplantation in our center.Results The patients recovered well after the operation.Endocrine and exocrine functions of all the pancreas graft returned to normal without any rejection.Conclusions Dynamic monitoring of blood glucose,C-peptide,blood insulin,blood amylase,urine amylase,amylase in abdominal drainage and duodenal tube decompression drainage,in addition to Doppler color ultrasound examination,can effectively detect the endocrine and exocrine function of the pancreas graft.

Objective To investigate the methods and effectiveness of heterotopic reconstruetion of hepatic artery in orthotopic liver transplantation. Methods The methods of heterotopic hepatic artery reconstruction and postoperative management of 36 cases of recipient vascular anomalies among 440 cases of liver transplantation performed in our hospital over a ten year period,were retospectively analysed. Results In 10 of 36 recipients the donor hepatic artery was anastomosed to recipient infrarenal aorta ,10 to the suprarenal aorta ,4 to the left gastric artery and 2 to the splenic artery. Five patients died perioperatively with patency of hepatic artery, and 31 recipients have survived for 3 to 48 months without hepatic artery complications; 1 patient had to receive liver retransplantation because of ischemic necrosis of bile duct. Conclusions In cases of disease or anomaly of recipient hepatic artery during liver transplantation,the heterotopic reconstruction of donor hepatic artery to the infarenal or suprarenal aorta,splenic artery or left gastric artery of the reeipient is indicated,and the results are satisfactory.