Objective Ｔo summarize the advancement of ABO-incompatible liver transplantation. Methods Relevant literatures about ABO-incompatible liver transplantation, which were published recently domestic and abroad were reviewed and analyzed. Results Owing to various treatments recent years, outcomes of ABO-incompatible liver transplantation have been improved dramatically. Conclusion With effective immnosuppressive protocols and effective perioperative management, ABO-incompatible liver transplantation is feasible.
Objective To summarize the significance of CYP3A5 in individualized immunosuppressive treatment with tacrolimus (FK506) after liver transplantation. Methods Relevant literatures about the effect of CYP3A5 polymorphisms on the pharmacokinetics of tacrolimus in liver transplant recipients, which were published recently domestic and abroad, were reviewed and analyzed. Results Tacrolimus was used effectively to prevent allograft rejection after liver transplantation. Narrow therapeutic range and individual variation in pharmacokinetics made it difficultly to establish a fixed dosage for all patients. Genetic polymorphism in drug metabolizing enzymes and in transporters influenced the plasma concentration of tacrolimus. CYP3A5 genotype had an effect on the tacrolimus dose requirement in liver transplant recipients.Conclusion Genotyping for CYP3A5 may help optimal individualization of immunosuppressive drug therapy for patients undergoing liver transplantation
Objective To establish model of thymectomy in adult rats. Methods The animal models were built by resection of the thymus and simultaneously emptying the air under xiphoid in the rats underwent thoracotomy. Results Of 30 rats, 1 died of postoperative atelectasis, 1 died of excessive bleeding because of puncturing the pulmonary vein by mistake during the operation. Twenty-eight rats survived more than 30 days. A successful rate of 93.3% was achieved in the making of thymectomy model. Conclusion The results show that the model is easy to operate and the success rate is very high, and can be used in the experiment of thymectomy in the rats.
目的总结胆囊切除术致医源性胆管损伤的原因、诊断、治疗及预防的经验。方法回顾性分析昆明市第一人民医院2006年5月至2011年5月期间经治的17例胆囊切除术致医源性胆管损伤患者的临床资料。结果损伤部位包括隆突2例，肝总管3例，胆囊管汇入胆总管部7例，胆总管4例，副肝管1例。1例一期术中端端吻合，2例一期吻合并留置T管支撑，1例行胆囊管结扎，2例内镜下留置鼻胆管引流，4例术后内镜下留置胆管支架，6例术后行胆肠Roux-en-Y吻合，1例行脱细胞基质材料修补。随访0.3～5年，平均2.3年，效果良好16例，1例反复发生胆管炎。结论医源性胆管损伤重在预防，精细解剖胆囊三角、严格遵循“确认-剪断-确认”三步骤是防止医源性胆管损伤的关键; 及时发现和正确的处理方法是降低其死亡率及改善预后的关键。