Protective Effects of Epigallocatechin-3-gallate on Intestinal Ischemia Reperfusion Injury through Enhanced Activation of PI3K/Akt Pathway in Rats

Inflammation plays a critical role in intestinal ischemia reperfusion injury(IRI). Epigallocatechin-3-gallate(EGCG) has been demonstrated to possess anti-inflammatory effect. This study examined the effect of EGCG on intestinal IRI and explored the possible mechanisms. Male Wistar rats were randomly divided into three groups: sham-operated group(Sham), IRI control group(IRI) and IRI-EGCG group(EGCG). Rats in IRI-EGCG group were administered dissolved EGCG in drinking water(0.4 mg/m L) for 14 days prior to IRI induction. A rat model of intestinal IRI was established by ligating the superior mesenteric artery(SMA) for 30 min, followed by reperfusion for 1 h. Intestinal histology, pro-inflammatory cytokines and mediators were examined and the effect of EGCG on PI3K/Akt signalling was assessed. EGCG significantly alleviated the pathological changes of the intestine and suppressed the IRI-induced up-regulation of TNF-α, IL-1 and IL-6 m RNA and protein expression in the serum and intestine. The mechanism might be that EGCG enhanced the activation of PI3K/Akt signalling pathway. In conclusion, the administration of EGCG can significantly mitigate the acute intestinal IRI in rats by enhancing the activation of PI3K/Akt signalling pathway to suppress inflammatory response and might be a promising alternative for the prevention or treatment of intestinal IRI in the clinical practice.     

肾移植术后并发恶性肿瘤患者免疫抑制药方案的选择

［摘要］目的评估肾移植术后并发恶性肿瘤患者选择不同免疫抑制药方案的有效性和安全性。方法肾移植术后并发恶性肿瘤患者10例,在检查确诊恶性肿瘤后,将其免疫抑制药方案调整成以西罗莫司为基础免疫抑制的方案,观察肿瘤生长、复发情况,监测移植肾功能及排斥反应情况。结果所有患者随访至少1 a,其中9例病情稳定,1例患者因肿瘤扩散转移,于调整药物后7个月死亡;1例患者药物转换2个月后出现一次急性排斥反应,激素冲击治疗后恢复。结论对肾移植术后并发恶性肿瘤患者使用以西罗莫司为基础免疫的免疫抑制方案安全,有效。     

中国肝癌肝移植的现状与医学伦理学思考

探讨中国肝癌肝移植的现状,包括受体的选择标准、疗效以及与其他常规治疗的比较,并思考由此而带来的伦理学问题。在我国目前大力发展肝移植的同时,我国卫生资源短缺且分配不均带来了大量尖锐的伦理学冲突。对于肝癌患者,临床医生是选择常规治疗、肝移植还是放弃治疗,已不简单是一个临床决策,其背后的医学伦理学问题值得深思。     

改良门腔静脉半转位肝移植术一例

在终末期肝硬化患者中,门静脉系统的广泛血栓形成并不少见,发生率为2.1%～13.8%,曾被认为是肝移植的绝对禁忌证.近年来,对此类患者的处理多采用门腔静脉吻合半转位肝移植术.本院于2008年12月30日为1例门静脉系统广泛血栓形成的患者实施了改良门腔静脉半转位肝移植术,现报告如下.     

Hepatofugal portal flow associated with acute rejection in living-donor auxiliary partial orthotopic liver transplantation: A report of one case and literature review

We report a case of reversible hepatofugal portal flow after auxiliary partial orthotopic liver transplantation (APOLT) from a living donor in this study.On postoperative day 6,continuous hepatofugal portal flow was observed in the grafted liver without portal thrombosis and obstruction of the hepatic vein.Based on histological findings,acute rejection was the suspected cause.The normal portal venous flow was restored after steroid pulse and antithymocyte globulin (ATG) therapies.The patient was discharged on the 30th postoperative day.It was concluded that hepatofugal flow after liver transplantation is a sign of serious acute rejection,and can be successfully treated by anti-rejection therapy.     

老龄亲属活体供肾移植疗效观察

目的:探讨老龄亲属活体供肾移植的疗效. 方法:我院自2006年1月至2006年12月共施行亲属活体肾移植74例,收集该74例活体供肾移植的临床资料,按供者年龄大小分为2组:老龄组(≥55岁)11例,低龄组(＜55岁)63例.分别对两组受体术后不同时间点临床资料和两组供体术前术后的临床资料进行分析比较,探讨老龄活体供肾移植的疗效. 结果:(1)受者情况:老龄组有1例术后发生移植肾功能延迟恢复,低龄组有7例,组间比较无差别(P>0.05),两组受者移植术后肾功能恢复情况比较无差异,1年人/肾存活率均为100%.供者情况:两组供者术后一周血肌酐均明显升高,老龄组术前血肌酐(85.6±13.7)μmol/L,术后1周升高至(106.4±15.6)μmol/L,而低龄供者术前血肌酐(73.7±6.8)μmol/L,术后1周升高至(101.8±13.1)μmol/L.但术后1年随访,两组供者血肌酐恢复术前水平. 结论:在严格供体筛查的前提下,老龄供肾(55～65岁)对供者是安全的;而对受者,接受老龄供肾术后近期肾功能恢复情况良好,远期效果有待进一步观察.华中科技大学同济医学院附属同济医院器官移植研究所,教育部/卫生部器官移植重点实验室 (武汉,430030)     

结缔组织生长因子诱导人肾小管上皮细胞向间充质细胞转化的实验研究

Objective To investigate the role of connective tissue growth factor ( CTGF) in epithelial mesenchymal transition of HK-2 cells in vitro.Methods HK-2 cells were randomly divided into two groups; (1) control group including cells cultured in DMEM medium supplemented with 10% fetal bovine serum only; and (2) experimental group including cells cultured in DMEM medium supplemented with 10% fetal bovine serum and recombinant CTGF at a final concentration of 5 p-g/L The cells were collected at 72 h time points.Direct immunoiluorescence staining and immunohistochemistry were used to evaluate the E-cadherin,Vimentin,α-SMA and ERK2 in cells.Western-blotting was used to detect the E-cadherin,Vimentin and ERK2 protein expression.Boyden Chamber was used to detect the migration of tubular endothelium at 1 d,3 d and S d.Results There were less E-cadherin but more Vimentin expressed in cells of the experimental group.The presence of α-SMA was detected at 48 h with peak at 72 h in the cells of the experimental group.On the first day,the cellular migration in the two groups showed no difference.However,after 3 days,the transformed cells migrated surpassed the control group with peak at the 5th day [ (45.0±1.1) : (14.0±1.2),P < 0.05 ) ].Conclusion Connective tissue growth factor induces mesenchymal transformation of HK-2 cells,in which the ERK2 signaling pathway may play an important role.     

桥式背驮式肝移植治疗布加综合征:附六例次临床病例分析

目的探讨肝移植治疗布加综合征的外科新技术。方法1999年以来笔者共为6例布加综合征病人施行了桥式背驮式肝移植,通过血管架桥将供肝的肝上下腔静脉与受者的右心房吻合,供肝的肝下下腔静脉与受者的下腔静脉吻合。结果6例次肝移植术均获成功,未发生手术技术并发症。其中1例术后3个月死于多器官功能衰竭,其他5例仍在随访中,1例已存活近7年,术后均未出现布加综合征复发。结论桥式背驮式肝移植为临床治疗布加综合征提供了一种新的技术途径,减少了技术并发症和布加综合征复发可能。     

老年患者肾移植围手术期的处理体会

目的总结老年患者肾移植围手术期处理的经验及教训。方法对１４例年龄为６０～７６岁的老年患者肾移植的资料进行回顾性分析。结果术后患者肾功能恢复正常的时间为３～３０天，平均（８．９±７．５）天；无移植肾功能丧失；术后未发生排斥反应；术后并发症有环孢素Ａ肝毒性、尿瘘、急性肾小管坏死、白细胞减少等。结论针对老年患者的特点做好围手术期各项工作，老年患者肾移植是可以取得较好效果的