Background: Intermittent Pringle manoeuvre resul- ted in less blood loss and better preservation of liver function when it was applied for fewer than 120 mi- nutes. The mechanism of better preservation of liver functi...Background: Intermittent Pringle manoeuvre resul- ted in less blood loss and better preservation of liver function when it was applied for fewer than 120 mi- nutes. The mechanism of better preservation of liver function under intermittent Pringle manoeuvre at molecular level remains unclear. Furthermore, the ultrastructural features in the liver with chronic di- seases under intermittent Pringle manoeuvre have not been studied. The aim of the study is to investigate the expression of stress genes and ultrastructural change of the liver under intermittent Pringle ma- noeuvre. Methods: From July 1995 to February 1998, 131 pa- tients underwent hepatectomy for liver tumours (61 patients without Pringle manoeuvre and 70 patients with intermittent Pringle manoeuvre). Twenty-five patients (15 with Pringle manoeuvre and 10 without Pringle manoeuvre) were included in the study of he- patic stress gene expression during hepatectomy. Twenty-two patients (18 patients with intermittent Pringle manoeuvre and four patients without Pringle manoeuvre) were randomly assigned for electron mi- croscopic examination. Results: For the expression of stress genes, both the heat shock genes (HSP 70A and HSC 70) and acute phase genes (TNF-α and interleukin-6) were detec- ted simultaneously in the patients with or without in- termittent Pringle manoeuvre. The patients under in- termittent Pringle manoeuvre had relatively higher mRNA levels of heat shock gene 70 family, which is related to intracellular repair and protection. Induc- tion of TNF-α and interleukin-6 genes, which con- tributed to ischaemia-reperfusion injury and posto- perative complication, was not found in the patients under intermittent Pringle manoeuvre. Under the e- lectron microscopy, the hepatic ultrastructure was well maintained under intermittent Pringle manoeu- vre whatever the liver status, even when the accumu- lated ischaemic duration was extended to 120 min. Conclusion: Intermittent Pringle manoeuvre induced relatively higher expression of heat shock genes, which are related to intracellular homeostasis, and is consistent with the well maintenance of liver ultra- structure.展开更多
文摘Background: Intermittent Pringle manoeuvre resul- ted in less blood loss and better preservation of liver function when it was applied for fewer than 120 mi- nutes. The mechanism of better preservation of liver function under intermittent Pringle manoeuvre at molecular level remains unclear. Furthermore, the ultrastructural features in the liver with chronic di- seases under intermittent Pringle manoeuvre have not been studied. The aim of the study is to investigate the expression of stress genes and ultrastructural change of the liver under intermittent Pringle ma- noeuvre. Methods: From July 1995 to February 1998, 131 pa- tients underwent hepatectomy for liver tumours (61 patients without Pringle manoeuvre and 70 patients with intermittent Pringle manoeuvre). Twenty-five patients (15 with Pringle manoeuvre and 10 without Pringle manoeuvre) were included in the study of he- patic stress gene expression during hepatectomy. Twenty-two patients (18 patients with intermittent Pringle manoeuvre and four patients without Pringle manoeuvre) were randomly assigned for electron mi- croscopic examination. Results: For the expression of stress genes, both the heat shock genes (HSP 70A and HSC 70) and acute phase genes (TNF-α and interleukin-6) were detec- ted simultaneously in the patients with or without in- termittent Pringle manoeuvre. The patients under in- termittent Pringle manoeuvre had relatively higher mRNA levels of heat shock gene 70 family, which is related to intracellular repair and protection. Induc- tion of TNF-α and interleukin-6 genes, which con- tributed to ischaemia-reperfusion injury and posto- perative complication, was not found in the patients under intermittent Pringle manoeuvre. Under the e- lectron microscopy, the hepatic ultrastructure was well maintained under intermittent Pringle manoeu- vre whatever the liver status, even when the accumu- lated ischaemic duration was extended to 120 min. Conclusion: Intermittent Pringle manoeuvre induced relatively higher expression of heat shock genes, which are related to intracellular homeostasis, and is consistent with the well maintenance of liver ultra- structure.
