Objective To study the effect on liver hemodynamics of portal arterialization and complete shunt (PACS), splenorenal shut (SRS) and peripheral cardia divided vessel (PCDV). Methods The preparation of canine model was made. Group PCDV accepted a splenectomy and peripheral cardia divided vessel, while the group SRS accepted a spleen-renal vein shunt. Group PACS accepted a splenectomy, splenic artery and upper portal vein anastomosis, and complete portal-caval shunt. The blood pressure and flow of the portal system were observed. The hepatic function was also measured before and 2 weeks after the three kinds of operation. Results In the PCDV group, the postoperative PVF decreased in 17% while PVP decreased in 5%. In the SRS group, the postoperative PVF decreased in 51% while PVP decreased in 51%. In the PACS group, the postoperative hepatic inflow PVF increased to 180% of the former while PVP increased to 196%; the caval-inflow PVF increased to 130% of the former while PVP decreased to 46%. The results of PACS group had a magnificent statistic difference comparing with those two traditional operations (P<0.05,P<0.01). ALT obviously increased after SRS (P<0.05), whereas slightly changed after the other two. Conclusion PACS can significantly increase the hepatic inflow and decreased the blood pressure of the portal system with a pleasant dog survival, and without obvious influence to the hepatic function. It may be a worthy attempt in the treatment of portal hypertension and need more research work going on.
Objective To investigate the effects of hypertonic saline (HTS) treatment on the function and susceptibility to sepsis of reticuloendothelial system (RES) in mice with hemorrhagic shock. Methods Forty percent of total blood volume of male Balb/c mice was withdrawn by cardiac puncture. Two hours later, the mice were treated with blood infusion and normal saline (10 ml/kg) or 7.5% NaCl (10 ml/kg).The survival rate of the mice was observed after cecal ligation and puncture (CLP). The phagocytosis function of the RES was measured by carbon clearance rate(α) and carbon amount ingested by the macrophages of liver and spleen. In vitro, the peritoneal phagocyte function in solutions of different osmotic pressor was measured by assaying neutral red amount taken in. Results The survival rate after CLP in HTS treated group was 70%, whereas all the mice in the normal saline group died. At the third hour after hemorrhagic shock, the RES carbon clearance rate(α) and carbon amount ingested by the macrophages of liver in the HTS treated mice were 5.61±0.42 and 0.59±0.19 respectively, significantly higher than those in the normal saline treated mice (4.15±0.62, 0.42±0.16). In vitro, hyperosmolarity below 40 mmol/L had no significant effects on the phagocytosis activity of peritoneal macrophages in mice. Conclusion Treating hemorrhagic shock with HTS can decrease the susceptibility to sepsis and improve the RES phagocytosis function indirectly.