一、大鼠小肠移植耐受中调节性T细胞作用及TLSF_(JM)免疫抑制作用的机理研究
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摘要
目的 建立适合小肠移植动物实验研究的高成功率的大鼠小肠移
植模型。方法 用小儿用5F心导管用鞘管作为供体门静脉-受体左肾静脉吻合
袖套，部分腹主动脉作为供体肠系膜上动脉-受体腹主动脉端侧吻合袖套的双
cuff技术重建移植物血液供应。选用供体回肠为主移植肠15cm于受体大鼠左
下腹行双造口。结果 移植物平均缺血时间为12.5±1.2分钟，较未行双cuff
组16.1±1.5分钟显著缩短；技术失败率在为5％（1/20），较未行双cuff技术
组30％（6/20）显著降低；应用免疫抑制剂FK506后，无论在行双cuff或未
第叫军医人学博十学位论义 中义摘要
行Cliff组均不影［114手术的成功率，但应用FK506后大鼠体重下降显著小于未
川厂＊506组。结论采用SF小儿心导管用鞘管制作的D’16／［脉－人肾静脉Ct；付，
材料易得，管壁潜、内径大、硬度适当弹性好不变形。管壁外用手术用尖刀
片反复刻划后，结扎线不易发生脱落；采用双CUff技术，极大地缩短了下术
时间，显著提高了手术成功率；异位移植及移植肠双口腹壁造口，不破坏受
体原有肠道连续和完整性，减少污染，缩短手术时问。有利于通过腹壁移植
肠造口观察排斥反应，进行病理组织学检查和对移植肠功能进行研究；免疫
抑制剂FK506有效抑制大鼠同种小肠移植的排斥反应，但不影响手术的成功
率，且较发生排斥反应大鼠减少体重的丢失。
THE FIRST PART
The Inhibitory Mechanisms of the TLSFJM and the Role
of Regulatory T Cells on Allograft Rejection in rat
Heterotopic Small Bowel Transplantation
Study one.
The rat model of heterotopic small bowel transplantation with
double cuff and double stoma
Abstract Aims To set up a heterotopic small bowel transplantation rat model with
double cuff and double stoma which with high success rates and lower mortality, it could be
widely employed in small bowel transplantation studies. Methods Revascularization of the
graft using SF plyethylene tube which for children (inside diameter:1.7mm) as the donor’s
portal vein cuff; cuffed donor portal vein anastomosis with the recipients?left renal vein; The
donors?aortic cuff of the superior mesenteric arteiy anastomosis with recitients?aorta. A 15cm
segment of the ileac be selected for graft, both ends of graft were exteriorized as stoma.
Results Mean ischemic time was 12.5±1.2 minutes in with double cuff group and 16.1 ±1.5
minutes without cuff group, there are significant difference between two groups. Technical
failures in with double cuff group were only 5%, while they were 30% in without cuff group,
there are significant difference between two groups. The immunosuppressive FK506 not
affects operation success rates, but the rats?body weight loss in with FK506 group was
significant less than in without FK506 group. Conclusion The donor portal vein cuff made of
SF plyethylene tube which material had thin tube wall, large inside diameter, appropriate
hardness, good elasticity, and easy to got. After to carve on outside of cuff with operation knife
which make ligature silk did not to get out of tube. Using double cuff technique to shorten
operation time, significant increase operation success rates. Heterotopic small bowel
transplantation with double stoma maintain the recipients' bowel continuous and integrated,
reduce pollution and shorten operation time. And with stoma, it advantageous to observe
rejection, get graft histological check and graft function studies. The immunosuppressive agent
FK506 suppress allograft rejection and reduce recipient body weight loss but not affect on the
operation success rates.
植模型。方法 用小儿用5F心导管用鞘管作为供体门静脉-受体左肾静脉吻合
袖套，部分腹主动脉作为供体肠系膜上动脉-受体腹主动脉端侧吻合袖套的双
cuff技术重建移植物血液供应。选用供体回肠为主移植肠15cm于受体大鼠左
下腹行双造口。结果 移植物平均缺血时间为12.5±1.2分钟，较未行双cuff
组16.1±1.5分钟显著缩短；技术失败率在为5％（1/20），较未行双cuff技术
组30％（6/20）显著降低；应用免疫抑制剂FK506后，无论在行双cuff或未
第叫军医人学博十学位论义 中义摘要
行Cliff组均不影［114手术的成功率，但应用FK506后大鼠体重下降显著小于未
川厂＊506组。结论采用SF小儿心导管用鞘管制作的D’16／［脉－人肾静脉Ct；付，
材料易得，管壁潜、内径大、硬度适当弹性好不变形。管壁外用手术用尖刀
片反复刻划后，结扎线不易发生脱落；采用双CUff技术，极大地缩短了下术
时间，显著提高了手术成功率；异位移植及移植肠双口腹壁造口，不破坏受
体原有肠道连续和完整性，减少污染，缩短手术时问。有利于通过腹壁移植
肠造口观察排斥反应，进行病理组织学检查和对移植肠功能进行研究；免疫
抑制剂FK506有效抑制大鼠同种小肠移植的排斥反应，但不影响手术的成功
率，且较发生排斥反应大鼠减少体重的丢失。
THE FIRST PART
The Inhibitory Mechanisms of the TLSFJM and the Role
of Regulatory T Cells on Allograft Rejection in rat
Heterotopic Small Bowel Transplantation
Study one.
The rat model of heterotopic small bowel transplantation with
double cuff and double stoma
Abstract Aims To set up a heterotopic small bowel transplantation rat model with
double cuff and double stoma which with high success rates and lower mortality, it could be
widely employed in small bowel transplantation studies. Methods Revascularization of the
graft using SF plyethylene tube which for children (inside diameter:1.7mm) as the donor’s
portal vein cuff; cuffed donor portal vein anastomosis with the recipients?left renal vein; The
donors?aortic cuff of the superior mesenteric arteiy anastomosis with recitients?aorta. A 15cm
segment of the ileac be selected for graft, both ends of graft were exteriorized as stoma.
Results Mean ischemic time was 12.5±1.2 minutes in with double cuff group and 16.1 ±1.5
minutes without cuff group, there are significant difference between two groups. Technical
failures in with double cuff group were only 5%, while they were 30% in without cuff group,
there are significant difference between two groups. The immunosuppressive FK506 not
affects operation success rates, but the rats?body weight loss in with FK506 group was
significant less than in without FK506 group. Conclusion The donor portal vein cuff made of
SF plyethylene tube which material had thin tube wall, large inside diameter, appropriate
hardness, good elasticity, and easy to got. After to carve on outside of cuff with operation knife
which make ligature silk did not to get out of tube. Using double cuff technique to shorten
operation time, significant increase operation success rates. Heterotopic small bowel
transplantation with double stoma maintain the recipients' bowel continuous and integrated,
reduce pollution and shorten operation time. And with stoma, it advantageous to observe
rejection, get graft histological check and graft function studies. The immunosuppressive agent
FK506 suppress allograft rejection and reduce recipient body weight loss but not affect on the
operation success rates.
引文
1． Willetts IE, Tam PK, Morris PJ, et al. Treatment with an HLA-peptide and cyclosporine A prolongs rat small bowel allograft survival. J-Pediatr-Surg. 1997;32(3) :469-472．
2． Kirkman RL. Small bowel transplantation. Transplantation. 1984;37(5) :429-433．
3． 夏五一.小肠移植.国外医学外科学分册.1985;12：271-274．
4． Lillehei RC, Goott B, Miller FA. The physiological response of the small bowel of the dog to ischemia including prolonged in vitro preservation of the bowel with successful replacement and survival. Ann Surg, 1959;160:543-560．
5． Sonnino RE, Besser AS, Polley TZ, et al. A modified technique for small-bowel transplantation in the rat. J-Pediatr-Surg. 1986;21(12) :1073-1077．
6． Kawabe T, Nakai T, Okuno K, et al. Small bowel transplantation in rats using a venous cuff technique. Microsurgery. 1998;18(5) :344-347．
7． Monchik GJ, Russell PS. Transplantation of small bowel in the rat: Technical and immunological considerations. Surgery 1971;70(5) :693-702．
8． Sinnino RE, Harmel RP. Technical aspects of intestinal transplantation in the rat. J Invest Surg. 1988;1(1) :55-64．
9． Wallander J, Holtz A, Larsson E, et al. Small-bowel transplantation in the rat with a nonsuture cuff technique. Transplant Int. 1988;1(3) :135-139．
10． Kort WJ, Westbroeck DL, MacDicken I, et al. Orthotopic total small-bowel transplantation in the rat. Eur Surg Res. 1973 ;5(2) :81-89．
11． Fecteau AH, Tchervenkov JI, Guttman FM, et al. Small bowel transplantation. The effect of intraportal donor-specific transfusion 24 hours pretransplant and low-dose cyclosporine. Transplantation. 1994;58(4) :399-402．
12． Fryer JP, Kim S, Wells CL, et al. Bacterial translocation in a large-animal model of small-bowel transplantation. Portal vs systemic venous drainage and effect of thcrolimus immunosuppression. Arch-Surg. 1996;131(l):77-84．
13． Hashimoto N, Ishii H, Kitada T, et al. Significance of venous drainage for small-bowel allografts. Hepatogastroenterology. 1992;39(6) :511-514．
14． Sarnacki S, Calise D, Brousse N, et al. A study of tolerance induced by liver tansplantation on intestinal graft in the rat. Chirurgie. 1991;117(9) :710-716．
15． Kobayashi E, Kamada N, Enosawa S, et al. Comparison of potentiality to induce graft-versus-host reaction with small vowel, Pancreas/spleen, and liver transplantation in the rat. Clin Exp Immunol. 1993;92(3) :527-531．
16． Li XC, Zhong R, He G, et al. Host immune suppression after small bowel/liver transplantation in rats. Transpl-Int. 1994;7(2) :131-135．
17． Zhong R. Organ transplantation in mice: Current status and future prospects. Microsurgery. 1999;19(2) :52-55．
18． Squirers E, Kelley S, West J. Small bowel transplantation in the mouse: development of a model. Microsurgery. 1992;13(6) :345-347．
19． Zhong R, Zhang Z, Quan D, et al. Intestinal tansplantation in the mouse. Transplantation. 1993;56(4) :1034-1037．
20． Zhong R, Zhang Z, Quan D, et al. Development of a mouse intestinal transplantation model. Microsurgery. 1993;14(2) :141-145．
21． He G, Hart J, Thistlethwaite JRJr, et al. Modified surgical model of paratopic small bowel tansplantation in mice. J Surg Res. 1998;80(2) :188-193．
22． Ricour C, Revillon Y, Arnaud-Battandier F, et al. Successful small bowel allografts in piglets using cyclosporine. Transplant Proc. 1983;15(6) :3019-3024．
23． Li YS, Li JS, Jing JW, et al. Glycyl-glutaine-enriched long-term total parenteral nutrition attenuates bacterial translocation following small bowel transplantation in the pig. J Surg Res. 1999;82(1) :106-111．
24． Nishida S, Komodata T, Ogata S, et al. Small bowel rejection in isolated small bowel transplantation and in multivisceral transplantation: a comparative study in a large animal model. In Vivo. 1998;12(2) :259-266．
25． Calleja Kempin J, Martin-Cavanna J, Vazquez-Estevez J, et al. Combined small bowel and reduced liver transplantation in pigs. Rev-Esp-Enferm-Dig. 1997;89(5) :375-384．
26． Gruessner RW, Fryer JP, Fasola C, et al. A prospective study of FK506 versus CsA and pig ATGin a porcine model of small bowel transplantation. Transplantation. 1995;59(2) :164-171．
27． 李宁,黎介寿,李幼生,等。同种异体小肠移植的实验研究和临床应用中华外科杂志 1995：33(1) ：11-14。
28． Kaneko H, Fischman MA, Buckley TM, et al. A comparison of portal versus systemic venous drainage in the pig small-bowel allograft recipient. Surgery. 1991;109(5) :663-670．
29． Gatti S, Rossi G, Piazzini A, et al. Orthotopic liver-small bowel allotransplantation-Surgical technique in the pig. Transplant Proc. 1994;26(3) :1627-1628．
30． Carretier M, Richer JP, Rouffineau J, et al. Perfecting a model of orthotopic liver/small bowel transplantation in pigs: determination of the best harvesting and transplantation technique. Transplant Proc. 1995;27(2) :1717-1719．
31． Spada M, Alessiani M, Bonfichi M, et al. Development of a model of combined bone marrow and small bowel transplantation in swine. Transplant Proc. 1998;30(6) :2609-2610．
32． Starzl TE, Kaupp HA, Brock DR, et al. Homotransplantation of multiple visceral organs. Am J Surg 1962;103(1) :219．
33． Lillehei RC, Manax WG, Lyons GW, et al . Transplantation of gastrointestinal organs, including small intestine and stomach. Gastroenterology 1966;51(5) :936．
34． Holmes JT. Small bowel transplantation: an experimental study. Ann R Coll Surg Engl 1973;52(3) :165-181．
35． Craddock GN, Nordgren SR, Reznick RK, et al. Small bowel transplantation in the dog using cyclosporine. Transplantation. 1983;35(4) :284-288．
36． Diliz-Perez HS, McClure J, Bedetti, et al. Successful small bowel allotransplantation in
dogs with cyclosporine and prednisone. Transplantation 1984;37(2) :126-129．
37． 刘敦贵，范昱，夏穗生。模拟临床的动物小肠移植实验研究。中华器官移植杂志。1993：14(1) :6-8。
38． Filez L, Penninckx F, Stalmans W, et al, Prevention of mucosal reperfusion damage after orthotopic small bowel autotransplantation in cats. Transplant-Proc 1994;26(3) :1485-1488．
39． Schier F, Oner A, Waldschmidt J, Microlymphography of spontaneous lymph vessel anstomosis in small bowel transplantation in the rat. J Pediatr Surg, 1991;26: 1239-1242,
40． Schmidt T, Koeroezsi G, Oberhuber G, et al. Lymphatic regeneration after small bowel transplantation. Transplant Proc, 1990;22:2060-2061．
41． Battistini C, de Franco S. Experimental mesenteric microlymphaticovenous anastomoses. In: Olszewski W, editor. Handbook of microsurgery. Boca Raton: CRC Press; 1984． p 157-167．
42． Szymula von Richter TP, Baumeister RG, Hammer C. Microsurgical reconstruction of the lymphatic and nerve system in small bowel transplantation: the rat model, first results. Transplant Int, 1996;9(suppl 1) :S286-S289．
43． Kellersmann R, Grant D, Zhong R. Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats. Microsurgery, 1999;19:108-112．
44． Baumeister RG, Seifert J, Liebich H, et al. The rat model as precursor of clinical lymph vessel transplantation. In: thiede A, Deltz E, Hamelmann H, editors. Microsurgical models in rats for transplantation research. Berlin: Springer-Verlag; 1985． p 133-116．
45． Szymula TP, Richter von, Baumeister RGH. Allograft survival prolongation after microsurgical lymphatic reconstruction in a short-term immunosuppressed rat small bowel transplantation model. Transplantation Proceedings, 1997;29(3) : 1804-1806．
46． Kitagawa H, Ford EG, Sinatra F, et al. Fecal fat, cyclosporine, and β1-antitrypsin for assessment of small bowel function following transplantation. J Pediatr Surg 1991;26:1091-1096．
47． Sigalet DL, Kneteman NM, Fedorak RN, et al. Intestinal function following allogeneic small intestinal transplantaion in the rat. Transplantaion 1992;53:264-271．
48． Grant D, Hurlbut D, Zhong R, et al. Intestinal permeability and bacterial translocation following small bowel transplantation in the rat. Transplantation 1991;52:221-224．
49． Sileri P, pastellini C, Dicuonzo G, et al. Transplantion of the intestinal and bacterial translocation. G Chir 2000;21 (4) : 196-204．
50． Demetris AJ, Murase N, Ye Q, et al. Analysis of chronic rejection and obliterative arteriopthy. possible contributions of donor antigen-presenting cells and lymphatic disruption. Am J Patholol 1997; 150:563-578．
51 . Kellersman R, Zhong R, Kiyochi H, et al. Reconstruction of the intestinal lymphatic drainage after small bowel transplantation. Transplantation, 2000;69(1) ;10-16．
52． Kellersmann R, Zhong R, Gao ZH, et al. Beneficial effects of microsurgical lymphatic
reconstruction after intestinal transplantation in rats. Transplantation Proceedings, 1998;30(6) :2642．
53． Gonzales AP, Sepulveda S, Massberg S, et al. Ivivo fluorescence microscopy for the assessment of microvascular reperfusion injury in small bowel transplants in rats. Transplantation 1994;58:403-408．
54． Unthank JL, Bohlen HG. Lymphatic pathways and role of valves in lymph propulsion from small intestine. Am J Physiol 1988;254:G389-398．
55． Wood RFM, Grant DR: In Grant DR, Wood RFM (eds): Small bowel transplantation. London: Edward Amold. 1994, p 133．
56． Haval Shirwan, Luqman Barwari, and Nasreen Sattar Khan. Predominant expression of T helper 2 cytokines and altered expression of T helper 1 cytokines in long-term allograft survival induced by interathymic immune modulation with donor class Ⅰ major histocompatibility complex pepetides, Transplantation 1998;66(12) :1802-09．
57． Yuan Z, Jerzy W, Kupiec W. What is the role of regulatory T cells in transplantation tolerance? Current Opinion in Immunology 1999;11:497-503．
58． Grant D. Curent results of intestinal transplantation: the International Intestinal Transplant Registry. Lancet 1996;347(9017) :1801．
59． 1996 annual report of the U.S. Scientific Registry for Transplant Recipients and the Organ Procurement and Transplantation Network. Transplant data: 1988-1995． Richmond,VA: United Network of Organ Sharing, and Rockville, MD: Division of Transplantation, Bureau of Health Resources Development, Health Resources and Services Administration, US Department of Health and Human Services, 1996．
60． Zhong Z, Zhu L, Quan D, et al. Pattern of liver, kidney, heart, and intestine allograft rejection in different mouse strain combinations. Transplantation 1996;62:1267．
61． Lehmann M, Graser E, Risch K, et al. Anti-CD4 monoclonal antibody-induced allograft tolerance in rats despite persistence of donor-reactive T cells. Transplantation 1997;64:1181-1187．
62． Onodera K, Handcock WW, Graser E, et al. Type 2 helper T cell-type cytokines and the development of 'infectious' tolerance in rat cardiac allograft recipients. J Immunol 1997;158:1572-1581．
63． Punch JD, Tono T, Qin LH, et al. tolerance induction by anti-CD2 plus anti-CD3 monoclonal antibodies: evidence for an IL-4 requirement. J Immunol 1998;161:1156-1162．
64． Bushell A, Niimi M, Mom's PJ, et al. Evidence for immune reulation in the induction of transplantation tolerance: a conditional but limited role for IL-4． J Immunol 1999;162::1359-1366．
65． Josien R, Douillard P, Guillot C. et al. A critical role for transforming growth factor-beta in donor transfusion-induced allograft tolerance. J Clin Invest 1998; 102:1920-1926．
66． Scully R, Cobbold SP, Mellor AL, et al. A role for Th2 cytokines in the suppression of CD8+T cell-mediated graft rejection. Eur J Immunol 1997;27:1663-1677．
67． Powell D, Mason D. Evidence that the T cell repertoire of normal rats contains cells with the potential to cause diabetes. Characterization of the CD4+ T cell subset that inhibits this autoimmune potential. J Exp Med 1993;177:627-6636．
68． Stumbles P, Mason D. Activation of CD4+ T cdlls in the presence of a nondepleting monoclonal antibody to CD4 induces a Th2-type response in vitro. J Exp Med 1995182:5-13．
69． Zelenika D, Adams E Mellor A, et al. Rejection of H-Y disparate skin grafts by monospecific CD4+ Thl and Th2 cells: no requirement for CD8+ T cells or B cells. J Immunol 1998;161:1868-1874．
70． Li XC, Zand MS, Li Y, et al. On histocompatibility barriers, Thl to Th2 immune deviation, and the nature of the allograft responses. J Immunol 1998; 161:2241-2247．
71． Bishop DK, Chan S Li W, et al. CD4-positive helper T lymphocytes mediate mouse cardiac allograft rejection independent of donor alloantigen specific cytotoxic T lymphocytes. Transplantation 1993;56:892．
72． Morton AL, Bell EB, Bolton EM, et al. CD4+ T cell-mediated rejection of major histocompatibility complex class f11-disparate grafts: a role for alloantibody. Eur J Immunol 1993;23:2078．
73． Yokoi Y, Sumimoto R, Yamaguchi A, et al. Role of T-cell subsets in rat liver allograft rejection. Transplant Proc 1993:25:1994．
74． Yin DP, Sankary HN, Williams J, et al. Induction of tolerance to small bowel allografts in high-responder rats by combining anti-CD4 with CTLA4IG. Transplantation 1996;62:1537．
75． Bowles MJ, Webster GA, Wood RF, et al. Effect of anti-CD4 monoclonal antibody therapy on rat small bowel allograft survival. Transplant Proc 1994;26:1605．
76． Newell KA, He G, Hart J, et al. Treatment with either anti-CD4or anti-CD8 monoclonal antibodies blocks alphabeta T cell-mediated rejection of intestinal allografts in mice. Transplantation 1997;64:959．
77． He G, Hart J, Kim OS, et al. the role of CD8 and CD4 T cells in intestinal allograft rejection-A comparison of monoclonal antibody-treated and knockout mice. Transplantation, 1999;67(1) :131-137．
78． He G, Hart J, Thistlethwaite JR, et al. Role of CD8+ and CD4+ T cells in the rejection of murine intestinal allogafts. Transplantation proceedings 1998;30:2592-2593．
79． Miyauchi T, Ishikawa M, Tashiro S, et al. Effect of donor-specific splenocytes via portal vein and FK506 in rat small bowel transplantation. Transplantation 1998;65(l):27-32．
80． Jiang H, Kobayashi M. Differences between cyclosporin A and tacrolimus in organ transplantation. Transplant Proc 1999;33:1978-1980．
81． Annacker 0, Burlen-Defranoux O, Pimenta-Araujo R, et al. Regulatory CD4 T cells control the size of the peripheral activated/memory CD4 T cell compartment, J Immunol 2000 Apr 1;164(7) :3573-80．
82． Krieger NR, Yin DP, Fathman CG. CD4+ but not CD8+ cells are essential for
alJorejection. J Exp Med 1996; 184:2013．
83． Reimann J, Rudolphi A. Co-expression of CD8α in CD4+ Tcell receptor αβ+ T cell migrating into the murine small intestine epithelial layer. Eur. J. Immunol. 1995;25(6) :1580-1588．
84． Umesaki Y, Setoyama H, Matsumoto S, et al. Immunology 1993;79:32．
85． Bosma MJ,Carroll AM. Annu Rev Immunol 1991;9:323．
86． Zhang ZX, Yang L, Young KJ, et al. Identification of a previously unknown antigen-specific regulatory T cell and its mechanism of suppression. Nat Med 2000;6(7) :782-9
87． Mulligan MS, Warner RL, McDuffie JE, et al. Regulatory role of Th-2 cytokines, IL-10 and IL-4, in cardiac allograft rejection. Exp Mol Pathol 2000;69(l):1-9
88． Karpus WJ, Peterson JD, Miller SD. Anergy in vivo: down-regulation of antigen-specific CD4+ Th1 but not Th2 cytokine responses. Int Immunol 1994;6:721-730．
89． Ke B, Ritter T, Kato H, Zhai Y, Li J, et al. Regulatory cells potentiate the efficacy of IL-4 gene transfer by up-regulating Th2-dependent expression of protective molecules in the infectious tolerance pathway in transplant recipients. J Immunol 20001; 164(11) :5739-45．
90． Ritter, Seifert M, Risch K, et al. Depletion of IL-4 does not prevent tolerance induction in an allogeneic rat kedney transplantation model. Transplant Proc 1999;31:887-888．
91． Hall BM, Fava L, Chen J, et al. Anti-CD4 monoclonal antibody-induced tolerance to MHC-incompatible cardiac allografts maintained by CD4+ suppressor T cells that are not dependent upon IL-4． J Immunol 1998; 161:5147-5156．
92． Sonoda KH, Faunce DE, Taniguchi M,et al. NK T cell-derived IL-10 is essential for the differentiation of antigen-specific T regulatory cells in systemic tolerance. J Immunol 2001;166(1) :42-50．
93． Yagihashi A, Zou XM, Hirata K, Asanuma K, Tsurruma T, Matuno T, Yamaguchi H, Yamashiro K, Koide S, Terimoto K. Evaluation of serum IL-8 concentrations after orthotopic liver transplantation in rats[J]. Transplantation proceedings, 1995;27(2) :1632-1633．
94． Mosmann TR, Coffiman RL. Two types of mouse helper T-cell clone: Implications for immune regulation. Immunol Today 1987;8:223．
95． Bradley JA, Mowat AM, Bolton EM. Processed MHC class Ⅰ alloantigen as the stimulus for CD4+ T cell-dependent antibody-mediated graft rejection. Immunol Today 1992;13:434．
96． 李元新，李宁，吴波，等。小肠移植急性排斥反应期移植肠白细胞介素2受体和细胞间黏附分子1的表达。中华实验外科杂志 1999：16(5) ：423-424．
97． Newell KA, He G, Guo Z, et al. Cutting Edge: Blockade of the CD28/B7 costimulatory pathway inhibits intestinal allograft rejection mediated by CD4+ but not CD8+ T cell. The Journal of Immunology, 1999;163(5) :2358-2362．
98． Holan V, Sedlanckova K, Ruzickova M. Production of high levels of Thl and Th2 cytokines in mice with acquired transplantation tolerance. Cell Immunol 1996; 174:7-11．
99. Willetts IE, Tam PK, Morris PJ, et al. treatment with an HLA-peptide and cyclosporine A prolongs rat small bowel allografi survival. J Pediatr Surg 1997; 32: 469-472.
100．董光龙，王为忠，吴国生，等。Th1/Th2 相关细胞因子在活体小肠移植术后检测中的意义。细胞与分子免疫学杂志 2000；16(4)：326-328．
101. Yagihashi A, Zou XM, Hirata K, et al. Evaluation of serum IL-8 concentrations after orthotopic liver transplantaion in rats. Transplant Proc 1995; 27(2): 1632-1633.
102. Davenport RD, Strieter RM, Standiford TJ, et al. Interleukin-8 production in red blood cell incompatibility. Blood 1990; 76(12): 2439-2442.
103．董光龙，王为忠，吴国生，等。人活体小肠移植受体血清IL-8与排斥反应相关。第四军医大学学报 2001；22(2)：131-134。
104. Grace LS, Klaus-J(?)rgen W, Peter HH, et al. Increased expression of interferon-γ in a rat moden of chronic intestinal allograft rejection. Transplantation 1996; 63(2): 242-248.
105．金伯泉，等．一株人急性淋巴细胞白血病细胞所分泌抑制因子的免疫调节作用．中华血液学杂志 1990；11：247．
106．夏海滨，等．免疫抑制因子的研究进展．国外医学免疫学分册．1991；14：311．
107．申立中，等．TLSF_(JM)对DNFB诱导的小鼠接触性皮炎和同种异体皮片移植排斥反应的抑制作用．细胞与分子免疫学杂志 1996；12：27．
108．夏海滨，等，TLSF_(JM)对活化T细胞内IP3、Ca2~+水平和Fos蛋白表达的调节作用．中国免疫学杂志 1993；9：199．
109．韩卫宁，等．TLSF_(JM)对同种异体抗原诱导的小鼠杀伤性T细胞分化及效应功能的影响．细胞与分子免疫学杂志 1999；15(suppl)：85-88．
110．夏海滨，等．TLSF_(JM)对T细胞IL-2R表达和蛋白酪氨酸磷酸化的调节作用．中国免疫学杂志 1991；7(6)：342．
111. Nakao A, Mitsuoka N, Shen SD, et al. Rat small intestinal transplantation: a comparison of the cuff and hand-suture methods. Acta Med Okayama 2000; 54(6): 259-64。
112. Zhong R, grant D, Sutherland f, et al. Refined technique for intestinal transplantation in the rat. Microsurgery 1991; 12: 268-274.
113. Schmidt T, Koeroezsi G, Oberhuber G, et al. Lymphatic regeneration after small bowel transplantation. Transplant Proc, 1990; 22(4): 2060-2061.
114. Kellersmann R, Grant D, Zhong R. Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats. Microsurgery, 1999; 19: 108-112.
115. Szymula von Richter TP, Baumeister RG, Hammer C. Microsurgical reconstruction of the lymphatic and nerve system in small bowel transplantation: the rat model, first results. Transplant Int, 1996; 9(suppl 1): S286-S289.
116. Battistini C, de Franco S. Experimental mesenteric microlymphaticovenous anastomoses. In: Olszewski W, editor. Handbook of microsurgery. Boca Raton: CRC Press; 1984. p 157-167.
117．董光龙，王为忠，吴国生，等．活体部分小肠移植患者围手术期营养支持策略．世界华人消化杂志 2000；8(5)：539-541．
118. Szymula TP, Richter von, Baumeister RGH. Allograft survival prolongation after microsurgical lymphatic reconstruction in a short-term immunosuppressed rat small bowel transplantation model. Transplantation Proceedings, 1997; 29(3): 1804-1806.
119. Kellersman R, Zhong R, Kiyochi H, et al. Reconstruction of the intestinal lymphatic drainage after small bowel transplantation. Transplantation, 2000; 69(1); 10-16.
120. Askanazi J, Katz DP, Suchner U. New horizons in nutritional biochemistry and metabolism: part Ⅰ. Biochemical and cellular basis for potential therapeutic value of n3 fatty acid derived from fish oil. Nutr Inter. JABNS, 1993; 9: 113.
121. Belluzzi A, Pironi L, Gionchetti P, et al. Possible role of structural lipids in artificial nutrition: Comparison of a linoleic acid-based with an oleic acid-based enteral formula in humans. Clinical Nutrition 1993; 12(suppl 1): S91.
122．李可洲，李幼生，鲍扬，等。短链脂肪酸对TPN大鼠小肠黏膜结构就细胞增殖作用的研究。肠外与肠内营养 1999；6(3)：144-147．
123. Sewing KFr. Pharmacokinetics, dosing principles and blood level monitoring of FK506. Transplant Proc 1994; 26(6): 3267-3269.
124. Sigalet DL, Thorne PC, Williams DC, et al. Effect of combined immunosuppressive drug therapy on small intestinal nutrient transport in the rat. Clin Biochem 1999 Feb; 32(1): 51-7.
125．宋维亮，王为忠，吴国生，等。活体小肠移植术后抗排斥反应。第四军医大学学报 2001；6：16-18．
126. Miyauchi T, Ishikawa M, Tashiro S, et al. Effect of donor-specific splenocytes via portal vein and FK506 in rat small bowel transplantation. Transplantation 1998; 65(1): 27-32.
127. Tzakis AG, Nery JR, Thompson J, et al. New immunosuppressive regimens in clinical intestinal transplantation. Transplant Proc 1997; 29(1): 283-285.
128. Fung JJ, Starzl TE. FK506 in solid organ transplantation. Transplant Proc 1994; 26(5): 3017-3020.
129.Mekki O, Lee C, Carrier S, et al. The effect of food on oral bioavailability ot tacrolimus (FK506) in liver transplant patients. Clin Pharmacol Ther 1993; 53(2): 229-230.
130. Gasser M, Otto C, Timmermann W, et al. Putative regulatory function of alloreactive Th2 cells in tolerant recipients after small bowel transplantation. Transplant Proc 2001; 33 (1-2): 161-162.
2． Kirkman RL. Small bowel transplantation. Transplantation. 1984;37(5) :429-433．
3． 夏五一.小肠移植.国外医学外科学分册.1985;12：271-274．
4． Lillehei RC, Goott B, Miller FA. The physiological response of the small bowel of the dog to ischemia including prolonged in vitro preservation of the bowel with successful replacement and survival. Ann Surg, 1959;160:543-560．
5． Sonnino RE, Besser AS, Polley TZ, et al. A modified technique for small-bowel transplantation in the rat. J-Pediatr-Surg. 1986;21(12) :1073-1077．
6． Kawabe T, Nakai T, Okuno K, et al. Small bowel transplantation in rats using a venous cuff technique. Microsurgery. 1998;18(5) :344-347．
7． Monchik GJ, Russell PS. Transplantation of small bowel in the rat: Technical and immunological considerations. Surgery 1971;70(5) :693-702．
8． Sinnino RE, Harmel RP. Technical aspects of intestinal transplantation in the rat. J Invest Surg. 1988;1(1) :55-64．
9． Wallander J, Holtz A, Larsson E, et al. Small-bowel transplantation in the rat with a nonsuture cuff technique. Transplant Int. 1988;1(3) :135-139．
10． Kort WJ, Westbroeck DL, MacDicken I, et al. Orthotopic total small-bowel transplantation in the rat. Eur Surg Res. 1973 ;5(2) :81-89．
11． Fecteau AH, Tchervenkov JI, Guttman FM, et al. Small bowel transplantation. The effect of intraportal donor-specific transfusion 24 hours pretransplant and low-dose cyclosporine. Transplantation. 1994;58(4) :399-402．
12． Fryer JP, Kim S, Wells CL, et al. Bacterial translocation in a large-animal model of small-bowel transplantation. Portal vs systemic venous drainage and effect of thcrolimus immunosuppression. Arch-Surg. 1996;131(l):77-84．
13． Hashimoto N, Ishii H, Kitada T, et al. Significance of venous drainage for small-bowel allografts. Hepatogastroenterology. 1992;39(6) :511-514．
14． Sarnacki S, Calise D, Brousse N, et al. A study of tolerance induced by liver tansplantation on intestinal graft in the rat. Chirurgie. 1991;117(9) :710-716．
15． Kobayashi E, Kamada N, Enosawa S, et al. Comparison of potentiality to induce graft-versus-host reaction with small vowel, Pancreas/spleen, and liver transplantation in the rat. Clin Exp Immunol. 1993;92(3) :527-531．
16． Li XC, Zhong R, He G, et al. Host immune suppression after small bowel/liver transplantation in rats. Transpl-Int. 1994;7(2) :131-135．
17． Zhong R. Organ transplantation in mice: Current status and future prospects. Microsurgery. 1999;19(2) :52-55．
18． Squirers E, Kelley S, West J. Small bowel transplantation in the mouse: development of a model. Microsurgery. 1992;13(6) :345-347．
19． Zhong R, Zhang Z, Quan D, et al. Intestinal tansplantation in the mouse. Transplantation. 1993;56(4) :1034-1037．
20． Zhong R, Zhang Z, Quan D, et al. Development of a mouse intestinal transplantation model. Microsurgery. 1993;14(2) :141-145．
21． He G, Hart J, Thistlethwaite JRJr, et al. Modified surgical model of paratopic small bowel tansplantation in mice. J Surg Res. 1998;80(2) :188-193．
22． Ricour C, Revillon Y, Arnaud-Battandier F, et al. Successful small bowel allografts in piglets using cyclosporine. Transplant Proc. 1983;15(6) :3019-3024．
23． Li YS, Li JS, Jing JW, et al. Glycyl-glutaine-enriched long-term total parenteral nutrition attenuates bacterial translocation following small bowel transplantation in the pig. J Surg Res. 1999;82(1) :106-111．
24． Nishida S, Komodata T, Ogata S, et al. Small bowel rejection in isolated small bowel transplantation and in multivisceral transplantation: a comparative study in a large animal model. In Vivo. 1998;12(2) :259-266．
25． Calleja Kempin J, Martin-Cavanna J, Vazquez-Estevez J, et al. Combined small bowel and reduced liver transplantation in pigs. Rev-Esp-Enferm-Dig. 1997;89(5) :375-384．
26． Gruessner RW, Fryer JP, Fasola C, et al. A prospective study of FK506 versus CsA and pig ATGin a porcine model of small bowel transplantation. Transplantation. 1995;59(2) :164-171．
27． 李宁,黎介寿,李幼生,等。同种异体小肠移植的实验研究和临床应用中华外科杂志 1995：33(1) ：11-14。
28． Kaneko H, Fischman MA, Buckley TM, et al. A comparison of portal versus systemic venous drainage in the pig small-bowel allograft recipient. Surgery. 1991;109(5) :663-670．
29． Gatti S, Rossi G, Piazzini A, et al. Orthotopic liver-small bowel allotransplantation-Surgical technique in the pig. Transplant Proc. 1994;26(3) :1627-1628．
30． Carretier M, Richer JP, Rouffineau J, et al. Perfecting a model of orthotopic liver/small bowel transplantation in pigs: determination of the best harvesting and transplantation technique. Transplant Proc. 1995;27(2) :1717-1719．
31． Spada M, Alessiani M, Bonfichi M, et al. Development of a model of combined bone marrow and small bowel transplantation in swine. Transplant Proc. 1998;30(6) :2609-2610．
32． Starzl TE, Kaupp HA, Brock DR, et al. Homotransplantation of multiple visceral organs. Am J Surg 1962;103(1) :219．
33． Lillehei RC, Manax WG, Lyons GW, et al . Transplantation of gastrointestinal organs, including small intestine and stomach. Gastroenterology 1966;51(5) :936．
34． Holmes JT. Small bowel transplantation: an experimental study. Ann R Coll Surg Engl 1973;52(3) :165-181．
35． Craddock GN, Nordgren SR, Reznick RK, et al. Small bowel transplantation in the dog using cyclosporine. Transplantation. 1983;35(4) :284-288．
36． Diliz-Perez HS, McClure J, Bedetti, et al. Successful small bowel allotransplantation in
dogs with cyclosporine and prednisone. Transplantation 1984;37(2) :126-129．
37． 刘敦贵，范昱，夏穗生。模拟临床的动物小肠移植实验研究。中华器官移植杂志。1993：14(1) :6-8。
38． Filez L, Penninckx F, Stalmans W, et al, Prevention of mucosal reperfusion damage after orthotopic small bowel autotransplantation in cats. Transplant-Proc 1994;26(3) :1485-1488．
39． Schier F, Oner A, Waldschmidt J, Microlymphography of spontaneous lymph vessel anstomosis in small bowel transplantation in the rat. J Pediatr Surg, 1991;26: 1239-1242,
40． Schmidt T, Koeroezsi G, Oberhuber G, et al. Lymphatic regeneration after small bowel transplantation. Transplant Proc, 1990;22:2060-2061．
41． Battistini C, de Franco S. Experimental mesenteric microlymphaticovenous anastomoses. In: Olszewski W, editor. Handbook of microsurgery. Boca Raton: CRC Press; 1984． p 157-167．
42． Szymula von Richter TP, Baumeister RG, Hammer C. Microsurgical reconstruction of the lymphatic and nerve system in small bowel transplantation: the rat model, first results. Transplant Int, 1996;9(suppl 1) :S286-S289．
43． Kellersmann R, Grant D, Zhong R. Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats. Microsurgery, 1999;19:108-112．
44． Baumeister RG, Seifert J, Liebich H, et al. The rat model as precursor of clinical lymph vessel transplantation. In: thiede A, Deltz E, Hamelmann H, editors. Microsurgical models in rats for transplantation research. Berlin: Springer-Verlag; 1985． p 133-116．
45． Szymula TP, Richter von, Baumeister RGH. Allograft survival prolongation after microsurgical lymphatic reconstruction in a short-term immunosuppressed rat small bowel transplantation model. Transplantation Proceedings, 1997;29(3) : 1804-1806．
46． Kitagawa H, Ford EG, Sinatra F, et al. Fecal fat, cyclosporine, and β1-antitrypsin for assessment of small bowel function following transplantation. J Pediatr Surg 1991;26:1091-1096．
47． Sigalet DL, Kneteman NM, Fedorak RN, et al. Intestinal function following allogeneic small intestinal transplantaion in the rat. Transplantaion 1992;53:264-271．
48． Grant D, Hurlbut D, Zhong R, et al. Intestinal permeability and bacterial translocation following small bowel transplantation in the rat. Transplantation 1991;52:221-224．
49． Sileri P, pastellini C, Dicuonzo G, et al. Transplantion of the intestinal and bacterial translocation. G Chir 2000;21 (4) : 196-204．
50． Demetris AJ, Murase N, Ye Q, et al. Analysis of chronic rejection and obliterative arteriopthy. possible contributions of donor antigen-presenting cells and lymphatic disruption. Am J Patholol 1997; 150:563-578．
51 . Kellersman R, Zhong R, Kiyochi H, et al. Reconstruction of the intestinal lymphatic drainage after small bowel transplantation. Transplantation, 2000;69(1) ;10-16．
52． Kellersmann R, Zhong R, Gao ZH, et al. Beneficial effects of microsurgical lymphatic
reconstruction after intestinal transplantation in rats. Transplantation Proceedings, 1998;30(6) :2642．
53． Gonzales AP, Sepulveda S, Massberg S, et al. Ivivo fluorescence microscopy for the assessment of microvascular reperfusion injury in small bowel transplants in rats. Transplantation 1994;58:403-408．
54． Unthank JL, Bohlen HG. Lymphatic pathways and role of valves in lymph propulsion from small intestine. Am J Physiol 1988;254:G389-398．
55． Wood RFM, Grant DR: In Grant DR, Wood RFM (eds): Small bowel transplantation. London: Edward Amold. 1994, p 133．
56． Haval Shirwan, Luqman Barwari, and Nasreen Sattar Khan. Predominant expression of T helper 2 cytokines and altered expression of T helper 1 cytokines in long-term allograft survival induced by interathymic immune modulation with donor class Ⅰ major histocompatibility complex pepetides, Transplantation 1998;66(12) :1802-09．
57． Yuan Z, Jerzy W, Kupiec W. What is the role of regulatory T cells in transplantation tolerance? Current Opinion in Immunology 1999;11:497-503．
58． Grant D. Curent results of intestinal transplantation: the International Intestinal Transplant Registry. Lancet 1996;347(9017) :1801．
59． 1996 annual report of the U.S. Scientific Registry for Transplant Recipients and the Organ Procurement and Transplantation Network. Transplant data: 1988-1995． Richmond,VA: United Network of Organ Sharing, and Rockville, MD: Division of Transplantation, Bureau of Health Resources Development, Health Resources and Services Administration, US Department of Health and Human Services, 1996．
60． Zhong Z, Zhu L, Quan D, et al. Pattern of liver, kidney, heart, and intestine allograft rejection in different mouse strain combinations. Transplantation 1996;62:1267．
61． Lehmann M, Graser E, Risch K, et al. Anti-CD4 monoclonal antibody-induced allograft tolerance in rats despite persistence of donor-reactive T cells. Transplantation 1997;64:1181-1187．
62． Onodera K, Handcock WW, Graser E, et al. Type 2 helper T cell-type cytokines and the development of 'infectious' tolerance in rat cardiac allograft recipients. J Immunol 1997;158:1572-1581．
63． Punch JD, Tono T, Qin LH, et al. tolerance induction by anti-CD2 plus anti-CD3 monoclonal antibodies: evidence for an IL-4 requirement. J Immunol 1998;161:1156-1162．
64． Bushell A, Niimi M, Mom's PJ, et al. Evidence for immune reulation in the induction of transplantation tolerance: a conditional but limited role for IL-4． J Immunol 1999;162::1359-1366．
65． Josien R, Douillard P, Guillot C. et al. A critical role for transforming growth factor-beta in donor transfusion-induced allograft tolerance. J Clin Invest 1998; 102:1920-1926．
66． Scully R, Cobbold SP, Mellor AL, et al. A role for Th2 cytokines in the suppression of CD8+T cell-mediated graft rejection. Eur J Immunol 1997;27:1663-1677．
67． Powell D, Mason D. Evidence that the T cell repertoire of normal rats contains cells with the potential to cause diabetes. Characterization of the CD4+ T cell subset that inhibits this autoimmune potential. J Exp Med 1993;177:627-6636．
68． Stumbles P, Mason D. Activation of CD4+ T cdlls in the presence of a nondepleting monoclonal antibody to CD4 induces a Th2-type response in vitro. J Exp Med 1995182:5-13．
69． Zelenika D, Adams E Mellor A, et al. Rejection of H-Y disparate skin grafts by monospecific CD4+ Thl and Th2 cells: no requirement for CD8+ T cells or B cells. J Immunol 1998;161:1868-1874．
70． Li XC, Zand MS, Li Y, et al. On histocompatibility barriers, Thl to Th2 immune deviation, and the nature of the allograft responses. J Immunol 1998; 161:2241-2247．
71． Bishop DK, Chan S Li W, et al. CD4-positive helper T lymphocytes mediate mouse cardiac allograft rejection independent of donor alloantigen specific cytotoxic T lymphocytes. Transplantation 1993;56:892．
72． Morton AL, Bell EB, Bolton EM, et al. CD4+ T cell-mediated rejection of major histocompatibility complex class f11-disparate grafts: a role for alloantibody. Eur J Immunol 1993;23:2078．
73． Yokoi Y, Sumimoto R, Yamaguchi A, et al. Role of T-cell subsets in rat liver allograft rejection. Transplant Proc 1993:25:1994．
74． Yin DP, Sankary HN, Williams J, et al. Induction of tolerance to small bowel allografts in high-responder rats by combining anti-CD4 with CTLA4IG. Transplantation 1996;62:1537．
75． Bowles MJ, Webster GA, Wood RF, et al. Effect of anti-CD4 monoclonal antibody therapy on rat small bowel allograft survival. Transplant Proc 1994;26:1605．
76． Newell KA, He G, Hart J, et al. Treatment with either anti-CD4or anti-CD8 monoclonal antibodies blocks alphabeta T cell-mediated rejection of intestinal allografts in mice. Transplantation 1997;64:959．
77． He G, Hart J, Kim OS, et al. the role of CD8 and CD4 T cells in intestinal allograft rejection-A comparison of monoclonal antibody-treated and knockout mice. Transplantation, 1999;67(1) :131-137．
78． He G, Hart J, Thistlethwaite JR, et al. Role of CD8+ and CD4+ T cells in the rejection of murine intestinal allogafts. Transplantation proceedings 1998;30:2592-2593．
79． Miyauchi T, Ishikawa M, Tashiro S, et al. Effect of donor-specific splenocytes via portal vein and FK506 in rat small bowel transplantation. Transplantation 1998;65(l):27-32．
80． Jiang H, Kobayashi M. Differences between cyclosporin A and tacrolimus in organ transplantation. Transplant Proc 1999;33:1978-1980．
81． Annacker 0, Burlen-Defranoux O, Pimenta-Araujo R, et al. Regulatory CD4 T cells control the size of the peripheral activated/memory CD4 T cell compartment, J Immunol 2000 Apr 1;164(7) :3573-80．
82． Krieger NR, Yin DP, Fathman CG. CD4+ but not CD8+ cells are essential for
alJorejection. J Exp Med 1996; 184:2013．
83． Reimann J, Rudolphi A. Co-expression of CD8α in CD4+ Tcell receptor αβ+ T cell migrating into the murine small intestine epithelial layer. Eur. J. Immunol. 1995;25(6) :1580-1588．
84． Umesaki Y, Setoyama H, Matsumoto S, et al. Immunology 1993;79:32．
85． Bosma MJ,Carroll AM. Annu Rev Immunol 1991;9:323．
86． Zhang ZX, Yang L, Young KJ, et al. Identification of a previously unknown antigen-specific regulatory T cell and its mechanism of suppression. Nat Med 2000;6(7) :782-9
87． Mulligan MS, Warner RL, McDuffie JE, et al. Regulatory role of Th-2 cytokines, IL-10 and IL-4, in cardiac allograft rejection. Exp Mol Pathol 2000;69(l):1-9
88． Karpus WJ, Peterson JD, Miller SD. Anergy in vivo: down-regulation of antigen-specific CD4+ Th1 but not Th2 cytokine responses. Int Immunol 1994;6:721-730．
89． Ke B, Ritter T, Kato H, Zhai Y, Li J, et al. Regulatory cells potentiate the efficacy of IL-4 gene transfer by up-regulating Th2-dependent expression of protective molecules in the infectious tolerance pathway in transplant recipients. J Immunol 20001; 164(11) :5739-45．
90． Ritter, Seifert M, Risch K, et al. Depletion of IL-4 does not prevent tolerance induction in an allogeneic rat kedney transplantation model. Transplant Proc 1999;31:887-888．
91． Hall BM, Fava L, Chen J, et al. Anti-CD4 monoclonal antibody-induced tolerance to MHC-incompatible cardiac allografts maintained by CD4+ suppressor T cells that are not dependent upon IL-4． J Immunol 1998; 161:5147-5156．
92． Sonoda KH, Faunce DE, Taniguchi M,et al. NK T cell-derived IL-10 is essential for the differentiation of antigen-specific T regulatory cells in systemic tolerance. J Immunol 2001;166(1) :42-50．
93． Yagihashi A, Zou XM, Hirata K, Asanuma K, Tsurruma T, Matuno T, Yamaguchi H, Yamashiro K, Koide S, Terimoto K. Evaluation of serum IL-8 concentrations after orthotopic liver transplantation in rats[J]. Transplantation proceedings, 1995;27(2) :1632-1633．
94． Mosmann TR, Coffiman RL. Two types of mouse helper T-cell clone: Implications for immune regulation. Immunol Today 1987;8:223．
95． Bradley JA, Mowat AM, Bolton EM. Processed MHC class Ⅰ alloantigen as the stimulus for CD4+ T cell-dependent antibody-mediated graft rejection. Immunol Today 1992;13:434．
96． 李元新，李宁，吴波，等。小肠移植急性排斥反应期移植肠白细胞介素2受体和细胞间黏附分子1的表达。中华实验外科杂志 1999：16(5) ：423-424．
97． Newell KA, He G, Guo Z, et al. Cutting Edge: Blockade of the CD28/B7 costimulatory pathway inhibits intestinal allograft rejection mediated by CD4+ but not CD8+ T cell. The Journal of Immunology, 1999;163(5) :2358-2362．
98． Holan V, Sedlanckova K, Ruzickova M. Production of high levels of Thl and Th2 cytokines in mice with acquired transplantation tolerance. Cell Immunol 1996; 174:7-11．
99. Willetts IE, Tam PK, Morris PJ, et al. treatment with an HLA-peptide and cyclosporine A prolongs rat small bowel allografi survival. J Pediatr Surg 1997; 32: 469-472.
100．董光龙，王为忠，吴国生，等。Th1/Th2 相关细胞因子在活体小肠移植术后检测中的意义。细胞与分子免疫学杂志 2000；16(4)：326-328．
101. Yagihashi A, Zou XM, Hirata K, et al. Evaluation of serum IL-8 concentrations after orthotopic liver transplantaion in rats. Transplant Proc 1995; 27(2): 1632-1633.
102. Davenport RD, Strieter RM, Standiford TJ, et al. Interleukin-8 production in red blood cell incompatibility. Blood 1990; 76(12): 2439-2442.
103．董光龙，王为忠，吴国生，等。人活体小肠移植受体血清IL-8与排斥反应相关。第四军医大学学报 2001；22(2)：131-134。
104. Grace LS, Klaus-J(?)rgen W, Peter HH, et al. Increased expression of interferon-γ in a rat moden of chronic intestinal allograft rejection. Transplantation 1996; 63(2): 242-248.
105．金伯泉，等．一株人急性淋巴细胞白血病细胞所分泌抑制因子的免疫调节作用．中华血液学杂志 1990；11：247．
106．夏海滨，等．免疫抑制因子的研究进展．国外医学免疫学分册．1991；14：311．
107．申立中，等．TLSF_(JM)对DNFB诱导的小鼠接触性皮炎和同种异体皮片移植排斥反应的抑制作用．细胞与分子免疫学杂志 1996；12：27．
108．夏海滨，等，TLSF_(JM)对活化T细胞内IP3、Ca2~+水平和Fos蛋白表达的调节作用．中国免疫学杂志 1993；9：199．
109．韩卫宁，等．TLSF_(JM)对同种异体抗原诱导的小鼠杀伤性T细胞分化及效应功能的影响．细胞与分子免疫学杂志 1999；15(suppl)：85-88．
110．夏海滨，等．TLSF_(JM)对T细胞IL-2R表达和蛋白酪氨酸磷酸化的调节作用．中国免疫学杂志 1991；7(6)：342．
111. Nakao A, Mitsuoka N, Shen SD, et al. Rat small intestinal transplantation: a comparison of the cuff and hand-suture methods. Acta Med Okayama 2000; 54(6): 259-64。
112. Zhong R, grant D, Sutherland f, et al. Refined technique for intestinal transplantation in the rat. Microsurgery 1991; 12: 268-274.
113. Schmidt T, Koeroezsi G, Oberhuber G, et al. Lymphatic regeneration after small bowel transplantation. Transplant Proc, 1990; 22(4): 2060-2061.
114. Kellersmann R, Grant D, Zhong R. Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats. Microsurgery, 1999; 19: 108-112.
115. Szymula von Richter TP, Baumeister RG, Hammer C. Microsurgical reconstruction of the lymphatic and nerve system in small bowel transplantation: the rat model, first results. Transplant Int, 1996; 9(suppl 1): S286-S289.
116. Battistini C, de Franco S. Experimental mesenteric microlymphaticovenous anastomoses. In: Olszewski W, editor. Handbook of microsurgery. Boca Raton: CRC Press; 1984. p 157-167.
117．董光龙，王为忠，吴国生，等．活体部分小肠移植患者围手术期营养支持策略．世界华人消化杂志 2000；8(5)：539-541．
118. Szymula TP, Richter von, Baumeister RGH. Allograft survival prolongation after microsurgical lymphatic reconstruction in a short-term immunosuppressed rat small bowel transplantation model. Transplantation Proceedings, 1997; 29(3): 1804-1806.
119. Kellersman R, Zhong R, Kiyochi H, et al. Reconstruction of the intestinal lymphatic drainage after small bowel transplantation. Transplantation, 2000; 69(1); 10-16.
120. Askanazi J, Katz DP, Suchner U. New horizons in nutritional biochemistry and metabolism: part Ⅰ. Biochemical and cellular basis for potential therapeutic value of n3 fatty acid derived from fish oil. Nutr Inter. JABNS, 1993; 9: 113.
121. Belluzzi A, Pironi L, Gionchetti P, et al. Possible role of structural lipids in artificial nutrition: Comparison of a linoleic acid-based with an oleic acid-based enteral formula in humans. Clinical Nutrition 1993; 12(suppl 1): S91.
122．李可洲，李幼生，鲍扬，等。短链脂肪酸对TPN大鼠小肠黏膜结构就细胞增殖作用的研究。肠外与肠内营养 1999；6(3)：144-147．
123. Sewing KFr. Pharmacokinetics, dosing principles and blood level monitoring of FK506. Transplant Proc 1994; 26(6): 3267-3269.
124. Sigalet DL, Thorne PC, Williams DC, et al. Effect of combined immunosuppressive drug therapy on small intestinal nutrient transport in the rat. Clin Biochem 1999 Feb; 32(1): 51-7.
125．宋维亮，王为忠，吴国生，等。活体小肠移植术后抗排斥反应。第四军医大学学报 2001；6：16-18．
126. Miyauchi T, Ishikawa M, Tashiro S, et al. Effect of donor-specific splenocytes via portal vein and FK506 in rat small bowel transplantation. Transplantation 1998; 65(1): 27-32.
127. Tzakis AG, Nery JR, Thompson J, et al. New immunosuppressive regimens in clinical intestinal transplantation. Transplant Proc 1997; 29(1): 283-285.
128. Fung JJ, Starzl TE. FK506 in solid organ transplantation. Transplant Proc 1994; 26(5): 3017-3020.
129.Mekki O, Lee C, Carrier S, et al. The effect of food on oral bioavailability ot tacrolimus (FK506) in liver transplant patients. Clin Pharmacol Ther 1993; 53(2): 229-230.
130. Gasser M, Otto C, Timmermann W, et al. Putative regulatory function of alloreactive Th2 cells in tolerant recipients after small bowel transplantation. Transplant Proc 2001; 33 (1-2): 161-162.