猪肝门静脉壁组织结构增龄性变化的定量分析

目的　探讨猪肝门静脉壁结构成分的增龄性变化 ,为猪 -人异种肝移植提供理论依据。方法　取正常不同月龄猪肝门静脉 ,HE染色 ,Weigert、Anilineblue及桔黄G分染弹性纤维、胶原纤维和平滑肌 ,光镜观察 ,计算机图像分析系统测量各结构成分的相对含量。结果　猪肝门静脉随月龄的增长胶原纤维的含量逐渐升高 ,弹性纤维的含量相对稳定 ,平滑肌的含量在 3月龄时最高 ,胶原纤维与弹性纤维含量的比值 (C/E)逐渐升高。结论　猪肝门静脉壁各结构成分的相对含量随增龄发生变化 ,在实施猪 -人异种肝移植时应选择与人肝门静脉壁结构成分含量相近的月龄猪作为供体。     

人与猪肝门静脉生物力学特性的比较研究

目的：比较研究人与猪肝门静脉生物力学特性的异同，为猪→人异种肝移植提供理论依据。方法：取人与不同月龄猪肝门静脉，利用软组织生物力学试验机测量压力一直径关系数据，推导出其弹性模量和顺应性。结果：猪肝门静脉的弹性模量随月龄的增大和血管内压力的升高而增大；顺应性则随月龄的增大而下降。与人肝门静脉相比，6月龄猪肝门静脉的弹性模量和顺应性与人相近。结论：6月龄猪肝门静脉的力学特性与成人相近，在行猪→人异种肝移植时，人与6月龄猪肝门静脉的吻合是可行的。     

人与猪肝门静脉显微结构成分的比较

目的：比较人与猪肝门静脉壁结构成分的异同，为猪一人异种肝移植提供理论依据。方法：取正常成人与不同月龄猪肝门静脉，常规石蜡包埋、切片，分染弹性纤维、胶原纤维和平滑肌，光镜观察，计算机图像分析系统测量各结构成分的相对含量。结果：随月龄的增长猪肝门静脉胶原纤维的含量逐渐升高，弹性纤维的含量相对稳定，平滑肌的含量在3月龄时最高，C厄值逐渐升高。与人相比，猪肝门静脉壁中胶原纤维和弹性纤维的含量较低，而平滑肌的含量则较高，5、6月龄时的C/E值与人相近。结论：人与猪肝门静脉壁各结构成分的含量存在差异，但从C僵值看，5、6月龄猪肝门静脉的力学特性与人相匹配，较适合用于移植。     

猪肝门静脉生物力学特性的增龄性变化

目的研究猪肝门静脉的生物力学特性与月龄间的关系，为猪→人异种肝移植提供力学资料。方法 取不同月龄猪肝门静脉，利用软组织力学试验机测量压力-直径关系数据，推导出其弹性模量和顺应性。结果 猪肝门静脉的弹性模量随猪的月龄的增大和血管内压力的升高而增大；顺应性则随猪的月龄的增大而下降。结论 猪肝门静脉的力学特性随增龄发生变化，在实施猪→人异种肝移植时应选择与人肝门静脉力学特性相匹配的月龄猪作为供体。     

人与猪胆总管几何形态和顺应性的比较

目的 探讨人与猪胆总管几何形态及顺应性的关系,为猪到人异种肝移植提供理论依据. 方法 取5例成年人尸体和50例3～12月龄湖北白猪的胆总管,在软组织生物力学实验机上测定胆总管的压力-直径关系.计算出顺应性.横断取材,冷冻切片,HE染色,用计算机图像分析系统测量其管径和管壁厚度. 结果 3～6月龄猪胆总管的管壁比成人的薄,其直径比成人的小(P<0.01),7～10月龄猪胆总管的壁厚和直径与成人的相近(P>0.05).3～6月龄及11、12月龄猪胆总管的顺应性明显小于成人(P<0.01),7～10月龄猪胆总管的顺应性与成人的相近(P>0.05). 结论 7～10月龄猪胆总管的几何形态和顺应性与成人的相近,从生物力学方面考虑,7～10月龄的猪肝作为人异种移植肝供源是可能的.     

猪肝动脉的弹性模量与性别的关系

目的探讨猪肝动脉弹性模量与性别的关系,为猪到人异种肝移植提供理论依据。方法取23例4、7月龄雌性、雄性、去势湖北白猪的肝动脉,将其按从近心端到远心端的方向分成近、中、远3段,各段置于4℃冰箱中待用。在软组织生物力学试验机上测定中段动脉的压力-直径关系,计算出增量弹性模量(Einc)、压力-应变弹性模量(Ep)和容积弹性模量(Ev)。结果 7月龄各组肝动脉的弹性模量有显著性差异(P0.01):雌性组最低,雄性组居中,去势组最高;7月龄各组与4月龄各组的弹性模量相比显著减小(P0.05)。结论 7月龄不同性别猪肝动脉弹性模量存在差异,从生物力学方面考虑,在猪到人异种肝移植时,应选择性别相匹配的猪肝脏作为供体材料,使移植材料肝动脉间的弹性模量尽可能相近,降低肝动脉并发症,有可能提高移植肝的存活率。     

肝门静脉高压症猪肝门静脉的结构重建

目的:建立猪肝门静脉高压症模型,探讨肝门静脉高压症时肝门静脉的结构重建.方法:猪以四氯化碳、苯巴比妥、乙醇配合高脂、低蛋白、低胆碱饮食进行混合饲养.通过脾静脉插管测压,取门静脉常规石蜡包埋、切片,用H-E 染色法、Weigert法、Aniline blue法、Organge G法分别染组织结构、弹性纤维、胶原纤维和平滑肌,用计算机图像分析系统定量分析肝门静脉的几何形态及显微成分.结果:实验组肝门静脉压为(4.17±1.03)kPa,而正常组为(1.51±0.79)kPa,实验组门静脉的内膜与中膜增厚,管壁增厚,管径增粗,平滑肌、胶原纤维的百分含量增加,平滑肌细胞核的数密度和面密度也在增加,C/E值增加.结论:肝门静脉高压症时,与血液动力学改变相适应,肝门静脉的几何形态与显微结构成分均发生了改变.     

人与猪胆总管的弹性模量及其在异种肝移植中的意义

目的：探讨人与猪胆总管弹性模量的关系，为猪到人异种肝移植提供理论依据。方法：获得5例成年人尸体和50例3～12月龄湖北白猪的胆总管，在软组织生物力学试验机上测定胆总管的压力-直径关系，计算出增量弹性模量（Einc）、压力．应变弹性模量（邱）和容积弹性模量（西）。横断取材，冰冻切片，HE法染色，用计算机图像分析系统测量其管径和壁厚。结果：人与各月龄组猪胆总管的Einc（F=502．08，P=0．00）、Ep（F=137．42，P=0．00）和Ev（F=134．59，P=0．00）差异有统计学意义；7～10月龄猪胆总管的弹性模量与成人的相近（P〉0．05），而3～6月龄及11、12月龄猪的弹性模量比成人的大（P〈0．01）。结论：7～10月龄猪胆总管的生物力学特性与成人的比较接近，故在猪到人异种肝移植时，选用7～10月龄猪的肝脏作为供体材料，也许能提高移植肝的存活率。     

猪活体肝脏移植的应用解剖

目的：探讨猪活性肝移植解剖学基础，方法：在10例新鲜成年猪肝大体和管道铸型标本上，观测猪肝分叶，分段，动脉，肝门静脉，胆管和肝静脉的分布和汇注规律。结果：猪肝外观由三大叶组成，即左外叶，叶叶和右后叶，尾状叶与邻叶界限不明显，中叶的中分线是左右半肝的真正分界线，此界面内无重要的管道结构，结论：猪活体肝移植是一个良好的实验动物模型，猪肝移植物应以左半肝为好。     

猪肺动脉干的形态学和生物力学特性

目的：探讨猪肺动脉干几何形态、显微结构成分与力学特性在增龄过程中的变化规律,为猪→人异种心脏移植吻合血管提供必要的资料。方法：应用组织学、计算机图像分析法以及生物软组织力学试验机,对猪肺动脉干进行计量形态学和力学试验。结果：猪肺动脉干的平均管径、壁厚、管腔面积、管壁面积与月龄间呈直线正相关关系,分别以1．08mm／月、0．09mm／月、14．4mm^2／月和7．31mm^2／月的速率增加。管壁中胶原纤维、弹性纤维、平滑肌的含量在增龄过程中未见明显变化。猪肺动脉干一维载荷下的材料常数和弹性模量随增龄虽有增加,但无统计学上的差异。结论：1～7月龄肺动脉干几何形态与月龄密切相关;显微结构成分含量和力学特性随月龄的变化不大。     

经肝动脉及经门静脉异种胰岛移植治疗1型糖尿病恒河猴

背景：经门静脉及经肝动脉是胰岛移植治疗1型糖尿病的2种途径,经门静脉途径并发症较多,经肝动脉移植创伤小,并发症少,但缺乏深入研究。 目的：对经肝动脉及经门静脉异种胰岛移植治疗糖尿病恒河猴模型的疗效进行比较。 方法：将18只恒河猴糖尿病模型分成经肝动脉组(n=6)、经门静脉组(n=9)及对照组(n=3)。经肝动脉组采用Seidinger技术肝动脉插管经导管植入处理好的新生猪胰岛(50 000胰岛当量/kg);经门静脉组在超声引导下门静脉穿刺经导管植入处理好的新生猪胰岛(50 000胰岛当量/kg);对照组2只经门静脉穿刺注入门静脉组等量生理盐水,1只经肝动脉注入肝动脉组等量生理盐水。各组均使用相同免疫抑制方案。 结果与结论：肝动脉组及门静脉组外源性胰岛素的用量较移植前分别平均减少约59.53%,48.39%,2组间外源性胰岛素减少的百分比差异无显著性意义(P > 0.05);肝动脉组及门静脉组血清猴C-肽一直保持在较低的水平,而血清猪C-肽的水平逐渐升高,2组之间血清猪C-肽浓度差异无显著性意义(P > 0.05),但门静脉组因移植后不同并发症出现4/9只糖尿病猴死亡,而肝动脉组仅因穿刺点渗血死亡1只,提示经肝动脉肝内移植途径操作较经门静脉途径更安全、简便,并发症及不良反应小,移植物均能长期成活并发挥生理功能。      

Catecholamine fluorescent, acetylcholinesterase positive and peptide immunoreactive nerve fibers in the rat hepatic portal system

Innervation of rat hepatic portal system consisting of stem (portal vein) and peripheral portions (superior mesenteric vein, inferior mesenteric vein, splenogastric vein) was investigated by catecholamine fluorescence, acetylcholinesterase and immunohistochemical methods. Catecholamine fluorescent and Neuropeptide Y (NPY) immunoreactive (ir) nerve fibers were distributed throughout the hepatic portal system. Greater density was demonstrated in the peripheral portions. Catecholamine fluorescent and NPY ir nerve fibers formed ground plexus around the hepatic portal system. Acetylcholinesterase positive and vasoactive intestinal polypeptide-ir nerve fibers were sparsely distributed and no significant difference in density was noticed in the stem and the peripheral portions. Density of substance P ir, neurokinin A ir and calcitonin gene-related peptide ir nerve fibers was greater in the peripheral than the stem portion. All these fibers reticular showed pattern.     

A study of the accessory hepatic vein to segments VI and VII with a morphological reconsideration of the human liver

Introduction The liver is supplied by the common hepatic artery from the celiac trunk and by the portal vein from the gastrointestine. This double blood supply to the liver by the hepatic artery and the portal vein produced a complicated structure in the liver. For the blood outflow, we can see right, intermediate and left hepatic veins, and irregular veins: the accessory hepatic veins. These veins drain the blood in the liver into the inferior vena cava. In this study, we studied the layout of the accessory hepatic vein draining segments 6 and 7 in the human livers and attempted to reconsider the structure of the liver by the layout of the accessory hepatic vein. Methods Sixty livers were subjected in this study. They were prepared by using forceps to trace the layout of the blood vessels inside the livers. We carefully examined the relation between the layouts of the accessory vein to the segments 6 and 7 and of the portal vein. The confluence patterns of the accessory hepatic vein into the inferior vena cava were also examined to find the character of the vein. The relation between the accessory hepatic vein and standard hepatic veins was also studied. Results We found 2.2 accessory hepatic veins in one liver on average in our study. The vein was always within the area of segments 6 and 7, and did not surpass the boundary. We found at most five accessory hepatic veins in a liver in two cases. The accessory hepatic vein to the segments 6 and 7 always had its stem on the dorsal side to the portal vein. Different from the stem, the periphery of the accessory hepatic vein freely distributed with the peripheral branches of the portal vein. The area distributed by the accessory vein was also always dorsal part within the segments 6 and 7. The vein was small usually, but was big in few cases. When the vein was big, the area became solely drained by the accessory vein, because the standard hepatic veins (right and intermediate hepatic veins) did not reach the area, and we did not find any communication between the accessory vein and the standard veins. As the remaining region in the segments 6 and 7 became smaller, the draining right standard hepatic vein became shorter and smaller. Discussion The region drained by the accessory hepatic vein excluded the standard hepatic veins. Therefore, there are two different draining venous networks in the area of segments 6 and 7 classified by Couinaud. Conclusion The accessory hepatic vein draining segments 6 and 7 distributed somewhere dorsal side in the segments 6 and 7. The area where the accessory vein distributed was the region where standard hepatic veins did not reach. This would suggest that the region drained by the accessory hepatic vein makes an isolated segment in the liver in the segments 6 and 7 by the Couinaud’s Classification. The area might have a unique blood circulation system.     

The hepatic arterial blood flow response to portal vein occlusion in the dog

The acute effect of portal vein occlusion on hepatic arterial blood flow was studied in a group of nine anaesthetised dogs. The influence of hepatic artery denervation and total liver denervation on the hepatic arterial flow response was determined subsequently. Blood flows in the hepatic artery and portal vein were measured with electromagnetic flowmeters, and hepatic tissue perfusion with⁸⁵Krypton clearance. A side-to-side mesocaval shunt was constructed to provide a drainage channel for the mesenteric venous blood during the periods of portal vein occlusion.Occlusion of the portal vein produced an immediate and significant increase in hepatic arterial flow which was sustained at approximately 80% above control for the 6 min period of observation. Total liver blood flow and hepatic tissue perfusion were both significantly reduced by about 40%. Denervation either of the hepatic artery alone or the entire liver produced no change in the response, and it is concluded that there is no neurogenic component either initiating or modifying the early changes in hepatic arterial flow.     

Afferent discharges from venous pressoreceptors in liver.

Afterent discharges were observed in dissected filaments or single nerve fibers of hepatic nerve in the guinea pig and the rabbit. Increasing the perfusion pressure of the portal vein in isolated liver preparation in the guinea pig caused an increase in afferent discharge rate. Discharge patterns were compatible with those of the slowly adapting type. Increasing the portal venous pressure by means of intravenous injection of Locke's solution into the left jugular vein in the rabbit in vivo caused an increase in afferent discharge rate. Increasing the hepatic arterial pressure was without effect. It is suggested that pressoreceptors are present in or near the venous wall of the portal venous system and that they send information about blood pressure in the portal vein to the central nervous system.     

The relationships between glucose absorption and insulin secretion and the migrating myoelectric complex in the pig

Net glucose and free amino nitrogen absorption and insulin output in the pig hepatic portal vein were calculated from portal-arterial concentration differences and portal blood flow measured by thermodilution. Duodenal and jejunal motility were assessed by electromyography. In the fed pig, the migrating myoelectric complex (MMC) pattern of motility persisted; glucose and amino nitrogen absorption and insulin secretion all varied with the phase of the MMC, rising to maximum values 19.4 +/- 3.1 min before and falling to minimum values 16.7 +/- 4.4 min after phase III. The variations in glucose absorption with the MMC were caused primarily by changes in duodenal and jejunal motility rather than by changes in the rate of gastric emptying as glucose absorption and insulin secretion varied with the phase of the MMC during duodenal glucose infusions, with maximum values occurring 24.4 +/- 3.3 min before and minimum values 14.9 +/- 2.5 min after phase III activity. The mean glucose absorption time calculated by timing the appearance of glucose in the portal vein following an intraduodenal bolus injection was significantly longer when given in phase I showing that absorption was less rapid when the intestine was not contracting. A significant amount of glucose is metabolized by intestine, as during glucose infusion (500 mg min-1) the average portal glucose absorption (376 mg min-1) was less than the glucose infused.