Objective To modify orthotopic liver transplantation method with two-cuff technique. Methods On the basis of cuff technique, the donor liver was perfused through the abdominal aorta with 20 ml cold perfusate. The anastomosis of the suprahepatic vena cave(SVC) was sutured end-to-end with 8/0 nylon line,and the continuity of infrahepatic vena cave(IVC) and portal vein(PV) were established by means of cuff method respectively.The bile duct anastomosis was performed by internal stent. Results Orthotopic liver transplantations were performed in 360 rats. The time for donor operation and liver preparation was (31.2±5.0) min and (12.0±3.0)min，and the recipient operative and anhepatic time was (45.0±5.5) min and (20.0±2.5) min, respectively. The two-day survival rate was 91.4%.In nonintervention group, one-week survival rate was 86.5%. Conclusion The modified model is easily available and highly reproducible which provides a practical and stable experimental model for the study of liver transplantation.
目的 研究尿标本中防腐剂盐酸对24 h尿游离皮质醇测定的影响。 方法 收集2008年7月-2009年1月正常人、库欣病患者及其他疾病患者的24 h尿液，混匀后，一部分浓盐酸防腐，一部分未加盐酸直接保存。电化学发光免疫分析法同步检测尿游离皮质醇浓度。 结果 经配对 t 检验加浓盐酸后的24 h尿游离皮质醇测值均高于未加酸者，比较有统计学意义（Plt;0.05）。加盐酸和未加盐酸所测尿游离皮质醇二者之间具有较好的相关性，相关系数 r =0.97，P lt;0.05。 结论 浓盐酸防腐的标本24 h尿游离皮质醇测值较未加酸保存的标本高。因此，为了得到相对准确的值，更好地反映肾上腺实际分泌情况，测定24 h尿游离皮质醇的标本不应使用盐酸防腐。
Objective To analyze the surgical techniques for the procurement and back-table surgery of the graft in living-related small bowel transplantation. Methods Eligible donor was chosen according to the donor selection criteria of living-related small bowel transplantation, and preoperative plan was designed. A segment of ileum of 120 cm was procured 20 cm proximal to the ileocecal valve which was preserved in the donor. The techniques for the procurement and back-table surgery of the graft were summarized, which included measurement of entire small bowel length from Treitz to ileocecal valve, palpation and transillumination to identify the distal branch of the superior mesenteric artery， and transient blockage of isolated blood vessels with vascular clamps in order to observe the influence on the blood circulation of graft and residual ileum. The detailed manipulation techniques in processing the graft blood vessels were discussed. Results The operations were successful both on the donor and the recipient. The functions of implanted segment of bowel were well. The donor had no other complications, such as mesenteric thrombi and anastomosis leakage of intestine, except for transient moderate diarrhea. She was discharged 14 days after operation. In the next 8 months of following-up, the donor has not experienced significant alteration in bowel habits or weight loss. Now she is in good appetite, without any changes in the habit and amount on diet. No changes have been found in lifestyle, work habits, or psychosocial conditions after the small bowel donation. Conclusion The procurement of a segment of ileum as graft and preservation of 20 cm proximal to the donor ileocecal valve may be ideal protocol. Using a standardized technique with attention presents little recent or long-term risks for the donor and brings satisfied effect for the recipient.