Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.

Objective This study is to explore the expression of CIP2A mRNA in hepatocellular carcinoma (HCC), and its correlations with clinicopathologic features and prognosis of HCC patients.Methods CIP2A mRNA expression was analyzed in four liver cancer cell lines (Hep-G2, MHCC97,SMMC-7721 and BEI-7402), one immortalized liver cell line L-O2, neoplastic tissues and adjacent matched non-neoplastic liver tissues in 120 HCC patients and normal liver tissues of 20 cases using semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). The correlations between CIP2A mRNA and clinicopathologic features and prognosis of HCC were analyzed. Results CIP2A mRNA was detected in Hep-G2, MHCC-97H, SMMC-7721 and BEL-7402, but not in L-O2.The positive rate of CIP2A mRNA expression was significantly increased in HCC tissues (78.3%)than in adjacent matched non-neoplastic liver tissues (28.3%) and normal liver tissues (5.0%,P＜0. 01). CIP2A mRNA expression was correlated with tumor size, differentiation and TNM stage (P＜0.05). Patients with positive expression of CIP2A mRNA had lower overall survival and diseasefree survival rates. Conclusions CIP2A mRNA, which is highly expressed in liver cancer cell lines and HCC tissues, may be involved in hepatocarcinogenesis. CIP2A mRNA may be a valuable biomarker for assessing the prognosis of HCC.

Objective To study the effect of Du meridian electroacupuncture on growth associated protein-43 (GAP-43) expression in rats after spinal cord injury (SCI). Methods The SCI models were established with MASCIS Impactor at T11 segment in Sprague-Dawley rats. They were equally divided into control group (group A, n=18) and Du meridian electroacupuncture group (group B, n=18). Group B received electroacupuncture once a day since 1 week after SCI. They were evaluated with the Basso-Beattie-Bresnahan (BBB) score 1, 2, 4, 8 weeks after SCI. The mRNA and protein of GAP-43 was detected with RT-PCR and immunohistochemistry 2, 4, 8 weeks after SCI. Results Compared with group A, the BBB score, the expression of GAP-43 mRNA and protein increased in group B after SCI (P<0.01). Conclusion Du meridian electroacupuncture can promote the expression of GAP-43 after spinal cord injury.

Surgical resection is the best method for patients with colorectal cancer liver metastases. However, tumor recurrence rate is still high after surgery. Preoperative chemotherapy can help shrink the tumor, test biological behavior, and reduce recurrence rate; but it may also cause liver injury and delay surgery. There is still controversy whether neoadjuvant chemotherapy should be performed and how to select patients from chemotherapy before surgery. Thus, in this article, combined the research progress and the clinical experience of author's center, we discuss this issue in 4 aspects: the development of neoadjuvant chemotherapy; the indications and guideline recommendation for neoadjuvant chemotherapy; the selection of neoadjuvant chemotherapy regimens; common problems in neoadjuvant chemotherapy.

Objective To investigate the influence of portal hypertension (PHT) on the postoperative complications after hepatectomy for patients with hepatocellular carcinoma (HCC). Methods Clinical data of 152 HCC patients undergoing hepatectomy in Sun Yat-sen University Cancer Center from March 2003 to October 2005 were retrospectively analyzed. The patients were divided into the PHT and non-PHT groups. There were 76 patients in the PHT group including 62 males and 14 females, with a mean age of (49±11) years. There were 76 patients in the non-PHT group including 66 males and 10 females, with a mean age of (49±12) years. The informed consents of all patients were obtained and the local ethical committee approval had been received. After hospitalization, all patients received routine examination. The incidence of postoperative complications in two groups was observed and the independent risk factors for postoperative complications were evaluated. Normally distributed data were compared using t test. Non-normally distributed data were compared using Z test. The comparison of rate was conducted using Chi-square test. Independent risk factors for the incidence of postoperative complications were analyzed by Logistic multivariate regression test. Results The incidence of postoperative complications was 42%(32/76) and the liver function-related complications was 36% (27/76) in the PHT group, and were 20% (15/76), 16% (12/76) respectively in the non-PHT group, significant difference was observed between two groups (χ2=8.901, 7.760;P<0.05). No signiifcant difference was observed in the percentage of patients with grade I-II complications between PHT group [75%(24/32)] and non-PHT group [73%(11/15)] (χ2=0.015, P>0.05). No significant difference was observed in the 90-day mortality between PHT group [7%(5/76)] and non-PHT group [3%(2/76)] (χ2=0.599, P>0.05). Logistic regression analysis revealed that PHT complication (OR=3.376, 95%CI:1.564-7.287, P<0.05) and number of tumors>2 (OR=1.984, 95%CI:1.248-3.154, P<0.05) were the independent risk factors for postoperative complications. PHT complication (OR=3.231, 95%CI:1.431-7.298, P<0.05), number of tumors>2 (OR=1.832, 95%CI:1.137-2.952, P<0.05) and intraoperative transfusion > 400 ml (OR=2.776, 95%CI: 1.123-6.864, P<0.05) were the independent risk factors for liver function-related complications. Conclusions PHT can increase the incidences of postoperative complications and liver function-related complications after hepatectomy in HCC patients and is the independent risk factor for both complications. However, PHT will not increase the severity of postoperative complications or postoperative mortality.

Objective To investigate the value of preoperative platelet count (Plt) in predicting prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy. Methods Clinical data of 399 patients who underwent hepatic resection for HCC in Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center from January 1987 to December 1994 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. Of the 399 patients, 356 cases were male, and 43 cases were female with age ranging from 21 to 78 years old and a median age of 48 years old. The relations between preoperative Plt and patients' gender, age, gamma-glutamyl transpeptidase (GGT), hepatitis B surface antigen (HBsAg), alpha fetal protein (AFP), cirrhosis, tumor encapsulation, tumor diameter, tumor number, vascular invasion and histological differentiation were observed. Patients were divided into 3 groups according to the level of preoperative Plt:group 1 (<100×109/L, n=41), group 2 (100×109/L-300×109/L, n=321), group 3 (>300×109/L, n=37). Survival analysis of patients in 3 groups was conducted. The relations between preoperative Plt and clinicopathological parameters were compared using t test. Survival analysis was conducted using Kaplan-Meier method and Log-rank test. Survival prognosis was analyzed using Cox's proportional hazard model. Results Preoperative Plt was associated with HBsAg, AFP, and tumor diameter (t=2.069, 2.222,-3.911;P<0.05). The 5-, 10-, 15-year cumulative survival rates were 41.2%, 25.2%, 11.8%in group 1, 33.7%, 23.0%, 18.1%in group 2, and 11.4%, 8.6%, 5.7%in group 3 respectively. The survival rate in group 3 was signiifcantly lower than those in group 1 and group 2 (χ2=5.706, 11.361;P<0.05). Increasing preoperative Plt was an independent risk factor for postoperative prognosis. The prognosis in group 3 was poorer than those in group 1 and group 2 (HR=1.761, 1.845;P<0.05). Conclusions Increasing preoperative Plt is an independent risk factor for postoperative prognosis of patients with HCC after hepatectomy. Patients with increasing preoperative Plt have poor prognosis.