To summarize the evolution of spleen surgery and prospects the future. The knowledge on the splenic function (anti-infection, cancer and certain blood effects)gradually promotes the reform of spleen surgery in clinical practical, resulting all kinds of spleen-preserving surgery when splenic injury. However,there is still controversy about spleen removal or reservation under the condition of portal hypertension in liver cirrhosis patients, because advantages and disadvantages between these different operations. Laparoscopic splenectomy is a major progress in recent years,the standard operation need to be further explored. Spleen transplantation in the treatment of hemophilia A is one of the characteristics of the spleen surgery in China, and this is the leading position in the world, now we will focus on how to prevent chronic spleen graft dysfunction. To keep the advanced international level, Chinese teams on spleen surgery are still required to deepen the related research and strengthen the academic communication in the future.

Summary: In this study we tried to investigate the effect of fructose-1,6-diphosphate and HTK solution on protecting primary cardiac muscle cells of rat with cold preservation. The primary cardiac muscle cells of rat were cultured in vitro with four preservation solutions respectively: 0.9 % sodium chloride solution (group A), FDP (group B), HTK solution (group C) and a mixture of FDP and HTK solution (group D). The cells were preserved for 6, 8 and 10 h at 0-4 ℃. The values of AST and LDH-L and the Na+-K+ ATPase activity in cardiac muscle cells were detected, and the survival rate of cardiac muscle cells was detected with trypan blue staining. The values of AST and LDH-L in group C and group D were remarkable lower those in group A and group B (P<0.001), while the Na+-K+ ATPase activity and the survival rate of cells in group C and group D were much higher than those in group A and group B (P<0.001). The values of AST and LDH-L after 6 hours in group D decreased much more than those in group C (P<0.01), while the Na+-K+ ATPase activity and the survival rate of cells in group D improved more than those in group C (P<0.01). Both of the HTK solution and the mixture of HTK and FDP solution have an evident effect on protecting the primary cardiac muscle cells of rat in vitro with cold preservation, Compared with the HTK solution, the mixture solution has a better short-term protective effect.

Objective To investigate the influence of HLA immunogenic mismatching (IM) on acute rejection of renal transplants.Methods The function recovery time of renal allograft and the rate of acute rejection of 196 cases after cadaveric renal transplantation wereanalyzed. Results IM of HLA locus did not influence the function recovery time of the renal allograft. The IM of HLA-A locus did not increase the rate of allograft acute rejection whereas the HLA-B locus did and the HLA-DR increased the acute rejection rate significantly. Conclusion IM should not be ignored in HLA typing. HLA-B locus is related to the allograft acute rejection, while the IM of DR locus increasesthe allograft acute rejection rate significantly.

Objective To elucidate the effect of postoperative early enteral nutrition support (ENS) on cellular immunity function and nutritional status of gastrointestinal (GI) cancer patients.Methods Twenty patients with GI cancer were at random divided into two groups: enteral nutrition group (EN-group, 10 cases), parental nutrition group (PN-group, 10 cases). PN-group was given total parental nutrition (TPN).In EN-group,Since the 1st postoperative day Neutrinos(r) was infused, the infused volume was increasingly added from 500 ml/d to 1 500 ml/d, the infused rate was step-by-step increased from 21 ml/h to 63ml/h. T-cell subgroup, NK cell, IL-2, PA, RBP were measured in the day before operation and on the 2nd ?4th ?8th postoperative day.Results ① The serum RBP,PA levels were obviously decreased postoperatively (P

Objective To explore the prophylaxis and treatment strategies for psychic syndrome in patients after piggyback liver transplantation.Methods The data on the etiology,treatment outcome and prognosis of psychic syndrome occurring in 45 of 235 patients who had piggyback liver transplantation were retrospectively analyzed.Results The incidence of psychic syndrome complication was 19.1%(45/235),22 cases presented as mania(48.9%),5 cases as tristimania(11.1%),3 cases as hallucinosis(6.7%),1 case as suicidal tendency(2.2%),1 case as metamorphopsia(2.2%),8 cases as angst insomnia(17.8%),2 cases as maladjusted disturbance(4.4%),3 cases as affective disturbance(6.7%),and the majority presented as delirious alienation.All the cases were cured,except 1 case of coma,who was confirmed by CT to have intracranial hemorrage,died after failure of resuscitation.Conclusions The incidence of psychic syndrome in patients after piggyback liver transplantation is relatively high.However,most cases have mild symptoms and the prognosis is fine.When the patients have psychogenic symptoms,the prognosis of patients can be improved by some symptomatic treatment strategies directed to their different clinical manifestations.

Objective To explore the cause and treatment strategy of chronic graft rejection characteristic of jaundice in patients with liver transplantation. MethodsPrimary disease, immunosuppressive protocol were reviewed in nine cases surviving more than 1 year after liver transplantation. The pathology examination, choledochoscopy and ultrasound examination were performed. The dosage of immunosuppressive agent was adjusted. Four cases underwent operation. Results Chronic rejection was well controlled in 6 out of the 9 cases with total bilirubin level decreased from 200 ?mol/L to less than 100 ?mol/L. Bile flocculus and bile slush became less obvious or disappeared after flushing and dilataltion of the common bile duct. Three cases died in spite of aggressive therapy. ConclusionsInsufficient immunosuppressive strength is one of the most important causes for chronic rejection. Immunological injury results in hepatocellular damage, bile slush, inflamed thick bile duct.

Objective To investigate the effect of T cell vaccination(TCV)on the survival time of cardiac allograft in rat.Methods Rat heterotopic cardiac transplantation was performed,Donor antigenprimed recipients' spleen cells were obtained bv 1/3 splenectomy for the preparation of TCV.TCV was then intraperitoneally into the abdominal cavity again.The survival time of cardiac allograft was observed.Results TCV could markedly prolonged rat cardiac allograft survival.T cell proliferation was increased and B cell proliferation was not affected in the vaccinated rats.The mixed lymphocyte reaction(MLR)was inhibited,The analysis of phenotypes on T cells showed that the number of CD8+ clones in vaccine cells and vaccinated rat spleen cells were increased.The antibody-mediated cytotoxicity was not affected by TCV.Conclusions TCV enhances the recipients' T cell-mediated immune response.The TCV-induced hyporeactivity to specific donor antigen is related to the induction of anti-idiotypic response and is not associated with humoral mechanisms.

Objective To manufacture rapamycin (RPM)-a new type immunosuppressant made in our country and investigate its immunosuppressive mechanism.Methods The effect of RPM on mouse splenocyte (Tc) proliferation induced by ConA,splenocyte (Bc) proliferation induced by LPS,DTH induced by DNCB and rat GVHR were studied.Results RPM obviously restrained the proliferation of Tc with IC50=1 nmol/L,significantly lower than IC50(10 nmol/L) of CsA (P＜0.05).RPM evidently repressed the proliferation of Bc with IC50=1 nmol/L significantly lower than IC50＞10 nmol/L of CsA(P＜0.05).RPM inhibited murine DTH to DNCB with ED50:1.8 mg/kg,significantly lower than ED50＞30mg/kg of CsA(P＜0.05).RPM controlled rat's GVHR with ED50=3 mg/kg,significantly lower than ED50≥30 mg/kg of CsA(P＜0.05).Conclusions RPM can inhibit lymphocytic proliferation and DTH,GVHR more markedly than CsA and they have combined efforts.

Objective To develop an advanced three-cuff-technique orthotopic liver transplantation model in rats. Methods The recipient's liver was not resected when the donor's liver was set in position, but was gradually resected during the process of vascular anastomoses. Results This method greatly shortened the anhepatic phase (11.8 min for the mean time), simplified the manipulation. The operative successful rate was 92 % . Conclusion This model could be used as an effective measure for the study of liver transplantation in rats.

objective From April 1994 to April 1997, the authors anatomized and studied 40 cadaveric Livers, Which included the character, Length and diameter of the vessels and bile ducts of the first, second and third hepatic portis. This article put the emphasis on the anatomic structures and its clinical applilation. The results of the 40 cadaveric liver anatomy will play important roles on the resection and transplantation of the liver, especially the Piggy back Liver transplantation.