This study was disigned to determine the effect of nutritional status on the energy metabolism of liver. Rat liver of four nutritional groups (Group Ⅰ： fasting; Group Ⅱ: surgar feeding diet; Group Ⅲ: normal feeding diet; Group Ⅳ: group Ⅰ and group Ⅱ accepted patenteral nutrition) were removed for study. The adenosine triphosphate (ATP) level, total addenosine nucleotides (TAN) level, and adenylaty energy charge (EC) of liver decreased in group Ⅰ and group Ⅱ in contrasted with group Ⅲ (Plt;0.001), result of group Ⅳ was similar to that of group Ⅲ when the liver specimens were collected. The rusults indicate that a short period of starvation and low sugar intake will result in the malnutrition of liver and derangement of hapatic energy metabolism and material metabolism. But this status can be corrected by a short perios of parenteral nutrition.
随着对肝脏解剖认识的深入，CT、MRI等影像学技术的发展、新的断肝器械的应用以及外科技术的进步，肝切除的并发症和死亡率都明显下降; 随着腹腔镜技术在肝脏外科的应用，肝切除技术又有了新的发展空间，现仅就肝切除技术现状作简要回顾。
ObjectiveTo summarize the diagnosis and treatment of thoracoomphalopagus conjoined twins according to successful separation of two cases of conjoined twins. MethodsA retrospectives study was performed on two pairs of thoracoomphalopagus twins. One case was omphalopagus with complex congenital heart disease (transposition of the great arteries and single cardiac ventricle), and the other was sternoxiphopagus with single pericardium and complex congenital heart disease (single cardiac ventricle and cardiac atrium). All the two cases of conjoined twins shared the common livers. The separation surgery was performed at one month after birth. Results All the two cases of conjoined twins were successfully separated. These conjoined twins were connected by a liver bridge, and shared a pericardium or had a contact pericardium, respectively. The coloboma of peritoneum, diaphragm， and mediastinum were repaired by Gore-Tex patch. Each patient, to varying degrees, had a wound infection after surgery, and healed by taking out the Gore-Tex, debridement or drainage. The first two infants were discharged on 37 d after operation, but one died of pneumonia after 6 months. The two other infants were discharged on 40 d and 93 d after operation, respectively. ConclusionsDetailed information about the twins’ general and conjoined condition, especially on cardiovascular system and the joined liver, shall be understood by the imagination examinations before the operation. Adequate preoperative preparation, elaborate liver separation and rational reconstruction for thoracic and abdominal wall are the key to successful operation.
Objective To elucidate the role of the transcription factor liver activator protein (LAP, a member of the C/EBP family) in the expression of α1(I) collagen gene in activated hepatic stellate cells (HSCs). Methods Rat HSCs were prepared from SD rats by in situ perfusion and singlestep density Nycodenz gradient. Two chimeric luciferase reporter gene plasmids containing the human collagen α1(I) gene promoter fragments (-804～+1 452 or -804～+222) were constructed. Culture-activated HSCs were co-transfected with the reporter gene contructs and mammalian vector expressing LAP using the cationic-liposome mediated method, and the promoter activity was determined by measuring luciferase activity. Results The luciferase reporter gene construct containing the first intron of α1(I) collagen gene (-804～+1 452, was called as PGL3-col) had a higher level of gene expression, as compared with the construct lacking the first intron 〔was called as PGL3-col (△intron)-in activated HSCs (315±45 U/mg protein vs 220±70 U/mg protein, Ｐ＜0.05). Transient transfection of the vector expressing LAP significantly increased basal transcription from PGL3-col and PGL3-col (△intron) reporter gene vectors (587±62 U/mg protein vs 315±45 U/mg protein and 326±52 U/mg protein vs 220±70 U/mg protein respectively, both Ｐ＜0.05). Conclusion The transcription factor LAP transactivates collagen α1(I) gene in activated HSCs, and the first intron is important for α1(I) collagen gene transcription activity in activated HSCs.
目的 探讨异氟醚通过抑制细胞间黏附分子（ICAM-1）表达参与减轻肝脏缺血-再灌注（IR）损伤的可能调节机制。 方法 32只雌性SD大鼠分为4组。A组大鼠行腹腔注射1%戊巴比妥钠40 mg/kg麻醉，进行手术但不阻断入肝血流；B组1%戊巴比妥钠麻醉后行部分肝脏IR；C组大鼠仅接受1.0 MAC异氟醚吸入麻醉，不阻断血流；D组采用1.0 MAC异氟醚麻醉，建立肝脏IR模型。肝脏缺血60 min，再灌注3 h后取肝组织和血液标本，检测血清丙氨酸转氨酶（ALT）和天冬门氨酸转氨酶（AST）、肝组织ICAM-1和肝组织还原型谷胱甘肽（GSH）、脂质过氧化物丙二醛（MDA）和超氧化物歧化酶（SOD）含量。 结果 与戊巴比妥钠麻醉比较，采用异氟醚处理后明显降低血清ALT和AST的水平，再灌注肝组织内GSH、SOD含量明显高于而MDA含量降低，同时抑制肝组织ICAM-1的表达。 结论 异氟醚麻醉能够有效减轻肝脏IR损伤，抑制氧自由基的生成和释放，具体机制可能与抑制ICAM-1表达致使细胞内GSH含量增加密切相关。
Portal vein blood flow is very important for the normal function of transplanted liver. The author reviewed the management methods of different portal vein thrombosis classification in the liver transplantation (LT). The prognosis of LT in the patients with Yerdel 1–3 thrombosis is similar to that the patients without thrombosis. The portal vein reconstruction of the patients with Yerdel 4 thrombosis can be realized by varicose vein to portal anastomosis, renoportal anastomosis or cavoportal hemitransposition. When anastomosis is made at the proximal side of a spontaneous shunt between the portal and cava system, the blood shunted from portal system can be reintroduced into the donor liver, which is crucial for the management of Yerdel 4 thrombosis. The establishments of artificial shunt by distal splenic vein, mesenteric vein or “multiple to one” anastomosis are effective attempts to drain the blood from portal system to the donor liver. For more severe diffuse thrombosis of portal vein system, multivisceral transplantation, including liver and small intestine, should be considered. The cases of LT in the patients with complex portal vein thrombosis are increasing, however the prognosis remains to be determined after accumulation of the cases.
The experimental models of chronic hepatic lesion of 40 rabbits were made by intra-abdominal injection of thioacetamide.The chronic hepatic lesion was confirmed by pathological examination and hepatectomies were performed in accordance with different measurements on each rabbit.The observations included indocyanine green retention rate,hepatic resection volume,and the outcomes of operations.The results showed that the mortality was correlative with the change of hepatic functions in the background of chronic hepatic lesion.The indocyanine green retention and the level of serum albumin are important parameters to indicate hepatic impairment.When the former was over 40% or the latter below 2.8g% the operative danger was high and the mortality was over 50%.In accordance with the classification of hepatic function,the preoperative functional state of liver were classified:grade A,B and C.the mortality of posthepatectomy were respectively 16.7%,3O%,and 72%.The multiple progressive regression equation is employed for calculating the postoperative outcome.The equation predicted the postoperative outcome with 88.9% accuracy.