自制KYL液和UW液保存大鼠肝脏效果的比较

目的比较自制的KYL液和UW液对大鼠肝脏的保存效果。方法采用大鼠肝脏非循环离体灌注模型(noncirculatedisolatedperfusionofratliver),随机以KYL液和UW液对大鼠肝脏保存0、4、8、16、24和48h,记录胆汁流出量,测定灌注流出液天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、乳酸脱氢酶(LDH)和氧自由基代谢产物丙二醛(MDA)及超氧化物歧化酶(SOD)含量,检测肝细胞内钙离子浓度,观察肝脏组织形态学变化。同时设生理盐水保存阴性对照组,了解器官保存液对大鼠肝脏有无保护作用。结果KYL液保存的大鼠肝脏在保存16h以内各时相胆汁流出量均较UW液保存者高(P<0.01),灌注流出液AST、ALT和LDH含量与UW液保存者相近,肝细胞内钙离子浓度较UW液保存者低(P<0.01);KYL组保存24及48h时,MDA含量低于UW组,SOD含量高于UW组(P<0.01);光、电镜观察两者形态学变化基本一致。两组所有指标均较生理盐水保存组好,提示KYL保存与UW液一样对大鼠肝脏具有保护作用。结论自制的KYL液对大鼠肝脏的保存效果总体上与UW液相当,在再灌注后肝细胞胆汁分泌方面和钙拮抗方面略优于UW液,而在防止细胞水肿方面较UW液稍差。     

Adaptation to fresh water in the sea snake Hydrophis cyanocinctus: Tissue electrolytes and peripheral corticosteroids

Groups of mature sea snakes, Hydrophis cyanocinctus, were transferred from seawater to tanks of running fresh water and sampled at 10, 16, 21, 27, 31, 35, and 51 days after transfer. The following were measured as parameters of adaptation to fresh water and compared with control (seawater maintained) animals: rate of weight loss; muscle water and ion content; blood hematocrit; plasma osmolarity; plasma Na⁺, K⁺, Cl^?, and urea concentrations. Peripheral levels of corticosterone and aldosterone were measured using competitive protein binding assay and radioimmunoassay, respectively. Adrenal in vitro 18-oxygenase activity was determined radiometrically using [³H]corticosterone. The rate of weight loss was lower in snakes in fresh water, but hematocrit and tissue water composition were unaltered. Plasma ion concentrations and total osmolarity fell significantly within 10 days and stabilized after approximately 16 days. Only after 51 days did muscle ionic composition or plasma $\text{Na}{}^{\mathrm{+}}\text{K}{}^{\mathrm{+}}$ alter. Urea was below detectable levels in all animals. Peripheral aldosterone concentrations remained at 1 to 4 μg/100 ml plasma whereas mean corticosterone titers fell significantly from 8 to 3 μg/100 ml. Adrenal in vitro 18-oxygenase activity was, however, significantly increased after 51 days of freshwater treatment. It was concluded that H. cyanocinctus is an osmoconforming euryhaline reptile, and possible roles for the adrenal in hydromineral balance are discussed.     

改良HCA肾保存液对肾脏低温保存效果的动物实验研究

目的:探讨改良高渗枸橼酸盐嘌呤肾保存液(HCA)对离体肾脏的低温保存效果。方法:将36只雄性草犬随机分为6组，分别用改良HCA(mHCA)液、Uw液(uNIVERSITY wISCOSIN器官保存液)、HCA液对其离体肾脏进行保存，并于24、48小时后观察肾脏皮质线粒体呼吸控制率(RCR)、细胞内ATP含量、pH值以及丙二醛(MDA)含量；比较肾脏移植前后血肌酐变化。结果肾脏保存24小时后，各项检测指标与移植前比较无明显差异，48小时后，mHCA液组与UW液组血肌酐差异无显著性，但均明显低于HCA液组；肾脏细胞RCR、ATP含量，mHCA液组与UW液组差异无显著性，但均高于HCA液组，mHCA液组与UW液组MDA明显降低，mHCA液组pH最高。结论:mHCA液能明显提高肾脏的低温保存效果，延长肾脏保存时间。     

器官保存的研究进展

器官保存伴随损伤有缺血和低温导致的损伤，以及再灌注时产生的再灌注损伤。该作者对器官保存的基本方法、发展史、现状及器官保存研究中存在的问题进行综述。     

Loss of endothelium-dependent relaxation in abdominal aorta preserved in a co-storage system

The potentially detrimental influence of parenchymal cells on endothelial function during preservation in UW solution was examined by co-storage of rat abdominal aortic rings with isolated liver cells. Cold storage of rings in UW solution alone for up to 96 h had no effect on the response to acetylcholine, though constriction was progressively lost. Co-storage of rings with liver cells resulted in no loss of sodium nitroprusside response, but the relaxation response to acetylcholine was reduced. The loss of acetylcholine response could not be attributed to Kupffer cells, the lowering of pH, oxygen depletion, or the loss of constriction. A similar loss of endothelial function was observed in rings stored in pieces of liver, kidney or heart. We conclude that parenchymal cells exude factors during preservation by cold storage which reversibly inhibit vascular NO production. These factors could significantly impair whole organ function on reperfusion.     

低温灌洗UW液和Euro-Collins液保存离体鼠肺效果的组织形态学比较研究

目的　比较UW液和Euro Collins液的肺保存效果。方法　选用 2 1只Wistar大鼠 ,应用 10℃的UW液和Euro Collins液同时分别进行左、右肺动脉内灌洗 ,灌洗前主肺动脉内快速推注PGE1。灌洗结束后于肺充气状态下切取左、右肺 ,并迅速分别置于 10℃的UW液及Euro Collins液中保存。分别于 0 ,2 ,4,6h取材 ,在光镜及电镜下观察肺组织形态学变化 ,并互相比较 ,以判定组织活力 ,确定肺保存效果。结果　低温灌洗 10℃的UW液肺保存效果优于低温灌洗Euro Collins液。 6h后 ,组织损伤表现为不可逆性。结论　在肺保存不超过 6h时 ,UW液比Euro Collins液更有效     

Comparison of intermittent injection of nondepolarizing solution with a single flush of UW solution for donor heart preservation

Isolated canine hearts were preserved for 6 h at 5°C followed by normothermic reperfusion for 2 h. The dogs were divided into two groups of nine hearts each; group 1 received a nondepolarizing preservation solution in multidose, and group 2 received a single flush of University of Wisconsin (UW) solution. Serum MB-CK and mitochondrial aspartate aminotransferase (m-AAT) concentrations and calcium overload during reperfusion were lower in group 1 than in group 2. At the end of reperfusion, myocardial ATP and total adenine nucleotide concentrations were higher and mitochondrial morphology appeared more intact in group 1 than in group 2. Left ventricular diatolic function was preserved better in group 1 than in group 2. These results suggest that in 6-h heart preservation, a nondepolarizing solution applied in multidose fashion protects the myocardium from the deleterious effects of hypothermia and cardioplegia better than a single flush of UW solution.     

尼可地尔改善心脏停搏液对心脏的保护作用

目的　观察在HTK液和UW液中加入尼可地尔 (Nicorandil)对心肌保存液保存效果的影响。方法　实验分为 4组 :UW液 (U)组 ;HTK液 (H)组 ;UW液组 +Nicorandil(U +N)组 ;HTK液 +Nicorandil(H +N)组 ;每组 8只大白鼠。麻醉和抗凝后 ,快速取下鼠心并悬挂在Langendorff灌注模型上灌注 ,测定血流动力学基础值。分别用四组保存液灌停离体鼠心并低温 (4℃ )浸泡保存 6h。复温、复灌后再次测定血流动力学值 ,留取标本分别测定心肌水含量、心肌酶漏出量、心肌细胞ATP和CP含量和心肌细胞超微结构变化。结果　心肌血流动力学恢复率 :H +N组>U +N组 >H组 >U组。心肌水含量 :4组间差异无显著意义。灌脉流出液中心肌酶漏出量 :H +N组 U +N组 >H组 >U组。心肌细胞超微结构变化 :H +N组心肌损害最轻 ,H组轻于U +N组 ,U组心肌损害最严重。结论　HTK液和UW液都是比较合适的心肌保存液 ,HTK液对心肌的保护作用优于UW液 ,钾离子通道开放剂Nicorandil能够善器官保存液HTK液和UW液对心肌的保存效果。     

Comparison of histidine-tryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution for organ preservation in human liver transplantation

Over a 30-month period, 60 patients (30 in each group) suffering from end-stage liver disease or primary hepatic malignancy and scheduled for liver transplantation were enrolled in a prospective, randomized study to compare two methods of liver preservation: histidinetryptophan-ketoglutarate (HTK) solution versus University of Wisconsin (UW) solution. Entry criteria for both groups were: age (18–65 years), elective surgery (transplantable or urgent category of the recipients), first transplantations and harvesting procedure performed by the same team. The parameters under investigation were the clinical and laboratory data preand post-transplantation, as well as follow-up data such as complications and survival. There were no significant differences in the two groups as far as the evaluation criteria were concerned, even when cold ischemia time was more than 15h (n=7). A slight, yet not significant, increase in late complications of the biliary anastomoses could be seen in the UW group. Hepatocellular injury (SGOT, SGPT, GLDH, lactate) appeared to be more marked in the HTK group. These results suggest that both HTK and UW solutions are appropriate for clinical use in liver transplantation, even if cold ischemia time is more than 15h.     

自制移植肝低温保存液对氧自由基的影响

背景：在肝脏移植过程中,低温保存和缺血可导致肝脏产生氧自由基而损伤肝组织。 目的：研究自制器官保存液对低温保存大鼠肝脏氧自由基的影响,并与器官保存液的“金标准”UW液进行对比。 方法：16只9周龄SD大鼠随机分为实验组和对照组,每组8只。建立SD大鼠肝脏灌注模型,分别用自制器官保存液组和UW液组灌洗肝脏,取出肝脏置于4 ℃保存液中,于保存24,48,72 h后分别检测肝脏超氧化物歧化酶、一氧化氮合酶、总抗氧化能力和活性丙二醛水平。 结果与结论：自制器官保存液对大鼠肝脏低温保存各时点超氧化物歧化酶、一氧化氮合酶、总抗氧化能力活性及丙二醛含量与UW液组比较差异均无显著性意义(P > 0.05),表明自制器官保存液能够减轻缺血再灌注后氧自由基对大鼠肝脏的损伤。自制器官保存液对低温保存大鼠肝脏在减轻氧自由基损伤方面有较好的效果,与UW液相当。