大隐静脉腔内激光消融联合泡沫硬化治疗静脉曲张性溃疡

目的观察腔内激光消融(EVLA)大隐静脉联合泡沫硬化治疗下肢静脉曲张性溃疡(VULE)的临床疗效。方法回顾性分析接受EVLA联合泡沫硬化治疗的19例VULE患者(20条患肢)的资料,并观察治疗效果。结果EVLA联合泡沫硬化治疗19例20条患肢均获成功,溃疡长径术前[(2.30±1.61)cm],术后2周明显缩小到(0.90±0.32)cm(t=10.53,P0.01),溃疡愈合时间为7天~3个月,无复发病例。结论大隐静脉EVLA联合泡沫硬化治疗VULE临床疗效好。     

腔内激光闭合术纠正局部血流动力学紊乱治疗继发性静脉性溃疡

目的探讨腔内激光闭合(EVLA)膝下及溃疡床周围浅静脉反流治疗继发性静脉性溃疡(SVU)的疗效。方法回顾性分析2005年1月～2008年12月在我科就诊的51例(54条患肢,72个溃疡面)SVU患者的临床资料,EVLA闭合膝下段及溃疡床周围浅静脉反流,保留膝上段大隐静脉,术后穿循序弹力袜(20～30 mmHg)。术后记录溃疡愈合率、临床症状改善情况及生活质量评分。结果术后随访6～47(平均25)个月,术后半年、1年及2年溃疡愈合率分别为81.9%(57/72)、71.4%(45/63)和69.1%(37/55)。患肢肿胀和疼痛缓解率分别为76.9%(40/52)和90%(27/30),患者生活质量较术前明显改善,且无严重并发症的发生。结论 SVU多由膝下段浅静脉反流所致,EVLA膝下段及溃疡床周围浅静脉反流纠正溃疡周围血流动力学紊乱治疗SVU安全有效。     

腔镜深筋膜下穿通静脉离断术治疗大隐静脉抽剥术后静脉性溃疡

目的 评估腔镜深筋膜下穿通静脉离断术治疗下肢大隐静脉抽剥术后静脉性溃疡的可行性及疗效.方法 对扬州市第一人民医院血管外科在2008年7月-2013年7月收治的152条大隐静脉抽剥术后下肢静脉性溃疡肢体的临床数据进行回顾性分析,分为保守治疗组(72例)和腔镜深筋膜下穿通静脉离断术组(80例),分别比较下肢症状和体征改善率、溃疡愈合时间、溃疡愈合率及溃疡复发率情况;针对已愈合溃疡随访2年,分别比较6、12、24个月时间点溃疡的未复发率情况.结果 腔镜深筋膜下穿通静脉离断术组患者未出现肺栓塞、死亡等严重并发症,其中2条肢体术后血肿,5例患者诉有术区皮肤的麻木;保守治疗和腔镜深筋膜下穿通静脉离断术组下肢症状和体征改善率分别为81.9％ (59/72)和86.3％ (69/80),两者差异无统计学意义(P=0.528);溃疡愈合率分别为65.3％ (47/72)和78.8％ (63/80),愈合时间分别为(73±15.7)d和(41±12.6)d.随访2年显示,复发率分别为34.0％(16/47)和14.3％ (9/63),差异均有统计学意义(P＜0.05);愈合溃疡6个月未复发率分别为89.4％ (42/47)、96.8％ (61/63),P=0.135;12个月未复发率分别为72.3％(34/47)和92.1％(58/63),P=0.006;24个月未复发率分别为66.0％ (31/47)和85.7％(54/63),P=0.014.结论 腔镜深筋膜下穿通静脉离断术结扎穿通静脉确实可靠,创伤小,安全性好;同时对于治疗大隐静脉抽剥术后静脉性溃疡具有良好的近中期疗效,值得在临床进一步推广应用.     

静脉剥脱联合硬化疗法治疗下肢静脉性溃疡

目的探讨大隐静脉高位结扎剥脱联合泡沫硬化剂注射对下肢静脉性溃疡的治疗效果。方法回顾性分析2013年7月~2015年8月收治的28例下肢静脉性溃疡患者临床资料,均行大隐静脉高位结扎剥脱联合泡沫硬化剂注射治疗。结果 28例患者成功接受大隐静脉高位结扎剥脱联合泡沫硬化剂注射术,平均手术时间为72(45~98)min,平均手术出血量为40(20~86)ml,平均每条肢体注射16(8~26)ml泡沫硬化剂,所有患者手术切口均一期愈合。术后活动性溃疡愈合27例(96.4%),平均愈合时间为15.8(10~28)d。1例溃疡面积较大者术后溃疡面积缩小后行植皮手术后愈合。3例患者术后小腿部曲张静脉附近呈现明显的炎症反应,予33%硫酸镁溶液湿敷后症状缓解,未出现下肢深静脉血栓形成等严重并发症。术后随访26例,平均11.6(3~26)个月,随访期间均未出现溃疡复发。结论大隐静脉高位结扎剥脱联合泡沫硬化剂注射治疗下肢静脉性溃疡安全、微创,临床效果满意。     

腔镜深筋膜下交通支结扎+溃疡周围环缝术治疗慢性下肢静脉性溃疡23例

目的 探讨腔镜深筋膜下交通支结扎（SEPS）＋溃疡周围环缝术联合治疗慢性下肢静脉性溃疡的临床疗效。方法 2004年3月至2006年9月对23例慢性下肢静脉性溃疡患者实施SEPS＋溃疡周围环缝术（联合治疗组）。另有SEPS组（19例）和溃疡周围环缝组（30例）作对照。所有病例均行常规大隐静脉高位结扎＋剥脱术。结果 联合治疗组溃疡于术后12～60d愈合,平均25．7d;SEPS组于术后18～90d愈合,平均35．1d;溃疡周围环缝组于术后21～90d愈合,平均47．3d,各组间差异均有统计学意义（P〈0．05）。3组间复发率比较,差异无统计学意义（P〉0．05）。结论 SEPS＋溃疡周围环缝术能够有效地治疗慢性下肢静脉性溃疡,2个术式联合应用其溃疡愈合时间较单独应用缩短。     

保留上段主干的激光闭合术在大隐静脉曲张治疗中的应用

目的:讨论保留上段主干的腔内激光闭合术(endo-venous laserablation,EVLA)在大隐静脉曲张治疗中的应用。方法:自2009年1月至2009年12月收治我科的大隐静脉曲张病例,经术前光电容积描记和多普勒超声检查确定隐股静脉瓣膜无返流且大隐静脉根部直径≤8 mm共63例(71条肢体),分成保留组35例(38条肢体)和非保留组28例(33条肢体),分别实施与否保留大隐静脉上段主干的EVLA。取两组的Aberdeen评分改善值,手术时间,住院天数,1年复发率和手术并发症率进行比较。结果:保留组的手术时间短于非保留组(17.5±4.3 min比22.7±5.6min,P     

透光直视旋切术与腔镜深筋膜下结扎交通支静脉在静脉性溃疡治疗中的疗效比较研究

目的比较透光直视旋切术(TriVex)与腔镜深筋膜下结扎交通支静脉(SEPS)治疗静脉溃疡的效果。方法将我院在2009年1月至2011年6月间收治的静脉溃疡患者根据住院单双号分为TriVex组和SEPS组。TriVex组行大隐静脉高位结扎、抽剥和TriVex静脉旋切系统旋切术,对溃疡周围浅静脉予完全刨除;SEPS组行大隐静脉高位结扎、抽剥和腔镜深筋膜下结扎交通支静脉,对小腿曲张静脉及溃疡周围静脉行点状抽剥术。比较两组患者在溃疡愈合率、愈合时间及术后溃疡复发率的差异。结果两组患者的溃疡愈合率、愈合时间及溃疡复发率比较,差异无统计学意义(P>0.05),且均未发生深静脉血栓形成等严重并发症,但SEPS组术后皮下淤血或局部皮肤麻木感等轻微并发症高于TriVex组,而患者满意率低于TriVex组,两组差异有统计学意义(P<0.05)。结论 TriVex和SEPS均可有效治疗静脉溃疡,但SEPS可能会出现更多的皮下淤血或局部皮肤麻木感等轻微并发症,患者对TriVex的满意度更高。     

腔镜深筋膜下交通支离断术治疗下肢静脉性溃疡30例临床分析

目的 探讨腔镜深筋膜下交通支离断术(subfascial endoscopic perforating vein surgery,SEPS)治疗下肢静脉性溃疡的效果及优势.方法 对苏州大学附属第一医院2006年12月至2008年5月期间收治的30例下肢静脉性溃疡患者(32条患肢)实施SEPS.术后观察溃疡的愈合情况及其他症状的改善情况.结果 全组随访3～15个月(平均8.5个月),静脉性溃疡于术后27～103 d(平均65 d)内愈合,湿疹消失,色素沉着逐渐变浅; 随访期间无切口感染等并发症,未见溃疡复发及新生溃疡.结论 SEPS安全有效,损伤小,并发症少,是治疗下肢静脉性溃疡较为有效的方法.     

保留主干的激光闭合术治疗下肢静脉功能不全

目的 探讨保留上段主干的腔内激光闭合术(EVLA)在慢性静脉功能不全(CVI)治疗中的应用.方法 将术前经Doppler超声和光电容积描记法证实隐股瓣膜无反流且大隐静脉根部直径小于或等于8 mm的63例(71条肢体)CVI患者分成两组:保留组(35例,38条肢体)和非保留组(28例,33条肢体),分别实施保留和不保留大隐静脉上段主干的EVLA术,对两组的临床疗效、复发率和并发症发生率进行比较.结果 保留组的手术耗时少于非保留组[(17.5±4.3)min vs(22.7±5.6)min,P＜0.01)];保留组隐神经损伤比例低于非保留组(2/38 vs 4/33,P＜0.05);两组的Aberdeen评分改善值和住院天数基本相当,且组织灼伤、皮下硬结、瘀斑等并发症发生率在两组间比较,差异无统计学意义(P＞0.05),两组均未出现肺栓塞等严重并发症.结论 保留大隐静脉上段主干的EVLA是治疗下肢静脉功能不全安全有效的微创手术方法.     

慢性下肢静脉性溃疡的临床治疗分析

目的:探讨慢性下肢静脉性溃疡的临床治疗与疗效。方法:回顾性分析2014年3月—2015年9月收治的48例慢性下肢静脉性溃疡患者的临床资料,治疗上包括对基础病因的治疗、药物治疗、物理治疗、大隐静脉高位结扎加点式抽剥术、溃疡周围环扎术,对溃疡面积较大的(≥48.0 cm~2)患者联合行游离皮瓣植皮术;溃疡愈合后长期穿医用弹力袜以促进静脉回流。结果:经治疗溃疡面一期痊愈12例(25.0%),其中5例溃疡面积较大的植皮患者皮瓣全部存活;溃疡愈合面积达70%以上27例(56.3%),另外9例(18.7%)溃疡愈合面积亦达50%以上。平均住院时间17.8 d,残余溃疡面门诊定期清洁换药。随访3~12个月,溃疡全部愈合,平均愈合时间1.5个月。结论:在治疗原发基础病因的基础上,选择多种治疗手段相结合的复合式手术治疗慢性下肢静脉性溃疡效果满意,溃疡愈合快,复发率低。     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.     

移植物局部Th1和Th2型细胞因子在猪胰肾联合移植门脉和体静脉回流术式的表达及其意义

Objective To investigate the expression and significance of local Th1 and Th2 cytokines in the grafts of pig simultaneous pancreas-kidney with portal versus systemic venous drainage. Methods Fifty-eight non-related and first hybrid landraces were divided into Sham (n = 10), PE (portal-enteric drainage) (n =24) and SE ( systemic-enteric drainage) (n =24) groups. Type 1 diabetic mellitus was induced by whole pancreatectomy ,and right-side nephrectomy was also performed in the recipients. The pigs in sham group were only subjected to ]aparotomy. The portal vein was anastomosed to superior mesenteric vein of the recipient in PE group or to the inferior hepatic cava of the recipients in SE group. The tissues of the graft pancreas and kidney were obtained by surgery for detecting the expression of mRNA and protein of IFN-γand IL4 by RT-PCR and ELISA on the day 3,and 7 after transplantation. Results Compared with sham group,the local expression of mRNA and protein of IFN in the graft pancreas and kidney of both SE and PE groups was significantly up-regulated ( P < 0. 05 ) ( On the day 7, protein expression in sham, SE, and PE groups :in the graft pancreas, [ (3.36±0.25 ), (7.72±0.67 ), and ( 6.52±0.34 ) pg/mg protein ];in the graft kidney, [ ( 3.66±0.28 ), ( 10.83±1.48 ), and (7.79±0.60) pg/mg protein ]. The local expression of mRNA and protein of IL-4 was significantly up-regulated in PE group (P < 0.05 ), but down-regulated or no expression was detected in group SE (on the day 7, protein expression in sham, SE, and PE groups:in the graft pancreas, [ (7.18±0.16), (6.10±0.16) ,and (20.66±1.47) pg/mg protein];in the graft kidney, [ (5.74±0.48) ,(10.38±0.92) ,and ( 19.66±1.57) pg/mg protein]. Conclusion That the blood flow of graft pancreas passes by liver in SPK with PVD can induce a Th1 to Th2 inmaune shift. This may be one of mechanisms of immunologic benefits of PVD.