Hepatocellular carcinoma (HCC) with a diameter > 5 cm is defined as large HCC. Hepatic resection is the first choice for solitary large HCC with intact capsule and without satellite nodules. The key to successful large HCC resection is to judge the resectability and estimate the remnant liver function preoperatively. Moreover, the liver must be exposed and dissociated adequately, and familiarity with the anatomy of the liver is crucial. Choosing the right technique of hepatic blood flow occlusion and avoiding excessive resection of the liver are important elements. Special attention should be paid to the efficacy of liver transplantation for patients with large HCC exceeding Milan criteria, h is advisable to resect large HCC actively.The hepatic resection is safe and feasible in selected patients with large HCC.

OBJECTIVE:To establish the quality standard for Xianrengu oral liquid. METHODS:Thin layer chromatography (TLC) was used for qualitative identification of Epimedii Folium,Astragali Radix,lycium barbarum,Atractylodes macrocephala and Panax ginseng in Xianrengu oral liquid;RP-HPLC was preformed on the column of Dikma Diamonsil C18 with the mobile phase of acetonitrile-0.1% phosphoric acid (30∶70,V/V)at the flow rate of 1.0 ml/min,the detection wavelength was 270 nm,the temperature was 30℃and the volume was 10μl. RESULTS:TLC identification had good separation,clear spots and high specifica-tion. The linear range of icariin was 7.97-510.00 μg/ml(r=0.999 3);RSDs of precision,stability and reproducibility tests were no more than 0.83%;and the average recovery was 97.69%(RSD=1.30%,n=6). CONCLUSIONS:This method is simple,accu-rate and simple,which can be used for the quality control of Xianrengu oral liquid.

Objective To investigate the preventive effects of aspirin on liver metastases of colorectal cancer in mice and study the mechanisms.Methods Twenty BALB/c mice were divided into the control group and the experimental group according to the random number table with 10 mice in each group.Mice in the control group were fed with saline each day at a concentration of 0.2 mL/d for 60 days,while mice in the aspirin group were fed with aspirin each day at a concentration of 30 μg/(g · d) for 60 days.Then C26 colon cancer cells were injected into the spleen and then the spleen was cut to establish mice model of colon cancer liver metastasis.The C26 colon cancer cells were divided into 2 groups.C26 colon cancer cells in the control group remained untreated,and C26 colon cancer cells in the experimental group were treated with aspirin at a concentration of 10 mmol/L for 24 hours.The scratches and transwell assays were conducted to observe the effects of aspirin on the invasion and metastasis of C26 colon cancer cells.The expressions of epithelial-mesenchymal transition (EMT)-related genes were detected using RT-PCR and Western blot.All data were analyzed using the Student t test.The survival curve was drawn by Kaplan-Meier method,and the survival analysis was done by Log-rank test.Results The numbers and weights of hepatic metastatic tumors were 4.8 ± 1.9 and (504 ± 107) mg in the control group and 2.6 ± 1.6 and (362 ± 67) mg in the experimental group,with significant difference between the 2 groups (t =2.840,3.584,P ＜ 0.05).The 1-month survival rate was 80％ in the experimental group,which was significantly higher than 40％ of the control group (x2=4.418,P ＜ 0.05).The results of pathological examination showed that tumor cell heteromorphism was reduced by aspirin.The results of scratches experiment showed an obvious migration of C26 colon cancer cells in the control group at 24 hours later,while no C26 colon cancer cells migrated in the experimental group.The numbers of C26 colon cancer cells penetrated the Watrige were 253 ± 21 in the control group and 148 ± 13 in the experimental group,with significant difference between the 2 groups (t =5.101,P ＜0.05).The relative mRNA expression of the E-cadherin and the Vimentin were 0.002 ±0.001 and 1.005 ±0.286 in the control group and 0.005 ± 0.001 and 0.270 ± 0.168 in the experimental group,with significant difference between the 2 groups (t =-4.606,4.942,P ＜ 0.05).The relative protein expressions of the E-cadherin and the Vimentin were 0.473 ±0.179 and 0.787 ± 0.118 in the control group and 1.585 ± 0.410 and 0.280 ± 0.133 in the experimental group,with significant difference between the 2 groups (t =-5.542,6.355,P ＜ 0.05).Conclusion Aspirin inhibits liver metastasis of colon cancer and promote the survival ratio of mice.Aspirin can up-regulate the expression of E-cadherin and down-regulate the expression of Vimentin,which inhibits EMT and reduces the invasion and metastasis of tumor cells.

Objective: To develop a headspace gas chromatography ( HS-GC ) assay for simultaneous determination of dichloroacetic acid ( DCA ) and trichloroacetic acid ( TCA ) in urine. Methods: Urine samples (5 mL) were transferred to a 22 mL headspace bottle, added with 0.5 mL 10% sodium acetate solution , immediately sealed, and shaken evenly. The bottle was placed in the HS-GC system, and equilibrated at 90 ℃ for 60 minutes. The mixture was separated with the HP-INNOWAX chromatographic column, and the DCA and TCA concentrations were detected with the hydrogen flame detector. Results: Under the optimal experimental conditions, the correlation coefficient of DCA and TAC was both > 0.999 0 within the range of 10-500.0 μg/L, and the lowest detection limits of DCA and TAC were 2.0 and 3.5 μg/L, with the spike recovery rate of 87.40% to 101.44%, and relative standard deviations of 1.89% to 3.25%. Of the 35 urine samples sampled from occupational populations, DCA and TCA were not detected. Conclusions The establishment of the HS-GAS assay through addition of sodium acetate and optimization of the headspace conditions, has high recovery and precision, which is effective to meet the requirements for daily determination of DCA and TCA in urine samples.

Objective To observe the effect of meridian balancing on speech disorder in children with cerebral palsy. Methods 130 childrenaged 1.5~7 years old were divided into the control group (n=62) and treatment group (n=68). The control group received routine rehabilitationwhile the treatment group received meridian balancing in addition. Results The rate of improvement was 89.7% in treatmentgroup and 79% in control group (P<0.05). The rate was more for those with language retardation than with anarthria in the treatment group(P<0.01). Conclusion The meridian balancing is effective on speech disorder in children with cerebral palsy, especially for those with languageretardation.

Objective To explore the clinical value of total hemihepatic vascular exclusion (THHVE) in right hepatectomy for hepatocellular carcinoma (HCC). Methods One hundred and twenty-three consecutive patients who underwent right hepatectomy for HCC between February 2006 and December 2008 were studied retrospectively. THHVE was used in 58 patients (group A) and Pringle maneuver in 65 patients (group B). The patient's demographics,surgical procedure and outcome were collected and compared between the two groups.ResultsThe tumor size was significantly bigger in group A than group B (7.69±3.70 cm vs.6.08±4.07 cm,P＜0.05).The vascular occlusion time in group A was significantly longer than groupB (28.55±8.67 min vs.19.85±6.71 min,P＜0.05). However, intraoperative blood loss in group A was significantly less than group B (304.31±270.36 ml vs.542.62±876.84 ml,P＜0.05),and the elevation of serum alanine aminotransferase (ALT) on day- 1,-3 and- 7 after operation in group A were significantly lower than group B (P＜0.05).The postoperative complication rate in group A was lower than group B (18.97％ vs.38.46％,P＜0.05).ConclusionTHHVE was a safe and efficacious technique in right hepatectomy for HCC.It significantly decreased blood loss,alleviated liver injury and reduced postoperative morbidity and mortality.

Objective To investigate the risk factors of extrahepatie recurrences after curative resection of primary hepatocellular carcinoma (HCC). Methods Clinicopathologic data of 238 curative resected cases of primary HCC were retrospectively reviewed for parameters affecting postoperative extrahepatic recurrences. Results During a median follow-up of 34 months (7 - 78 months), extrahepatic recurrences were observed in 32 out of 238 patients (13.4%). According to univariate analysis, the risk factors for extrahepatic recurrences were preoperative serum a-fetoprotein (AFP) level of > 1000 ng/ml,aspartate aminotransferase level of > 50 IU/L, presence of hepatic vein invasion, neighboring organ invasion, tumor satellites, and lack of tumor capsule formation. Preoperative serum AFP levels of > 1000 ng/ml, hepatic vein invasion, neighboring organ invasion proved to be independent risk factors by multivariate analysis. Conclusions Extrahepatic recurrences after curative resection of HCC was found to be related to preoperative serum AFP level of > 1000 ng/ml, hepatic vein invasion, and neighboring organ invasion.

Objective To evaluate the inhibitory effects of sustained-release 5-fluorouracil(5-FU)micmparticles on the growth of HepG2 eels.Methods The inhibitory effects of sustained-releage 5-FU micropartides,5-FU microparticles and poly L-lactic acid on HepG2 cells were detected by MTT assay.The HepG2 cell apoptosis was demonstrated by flow cytomerry after Hoehest staining.Results The survival rate of HepG2 cells in sustained-release 5-FU microparticles group decreased as time passed by.The survival rate of HepG2 cells in 5-FU microparticles group wag the lowest on the first day,and then it increased gradually.The survival rates of HepG2 ceHs in 5-FU microparticles group on day 21 and 28 were hJigher than those in sustained-release 5-FU microparticles group.The survival rate of HepG2 cells in poly L-lactic acid group WSB higher than that in the other two groups.The difference upon survival rate among the 3 groups had statistical significance(F=3163.52,128.47.P＜0.01).Conclusions The sustained-release 5-FU micropartieles could keep on inhibiting tlle growth and inducing apoptosis of HepG2 cells in time-dependant manner.The inhibitory effect of sustained-release 5-FU is better than that of 5-FU microparticles.

Objective To assess hepatitis B virus(HBV)and hepatitis C virus(HCV)infections in different anatomic location of cholangiocarcinoma(CC)and relationship with abnormal p53 expression.Methods A total of 411 CC samples including intrahepatic cholangiocarcinoma(ICC 312 cases);perihilar cholangiocarcinoma(PHC,73 cases)and distal cholangiocarcinoma(DC,26 cases)underwent serologic test for HBsAg and anti-HCV using microparticle enzyme immunoassay.Abnormal p53 expression was detected in formalin-fixed.paraffin-embedded CC tissues by immunohistochemistry.Results Seropositivity for HBsAg and anti-HCV were found in 48.4%(151/312)and 2.9%(9/312)of ICC cases,and in 10.9%(8/73)and zero of PHC,and in 7.7%(2/26)and zero of DC,respectively.Abnormal p53 expression was detected in 30.1%(94/312)of ICC cases.23.3%(17/73)of PHC cases and 19.2%(5/26)of DC cases.There was no correlation between seropositivity of HBsAg and anti-HCV and p53 overexpression among three groups of CC. Conclusions HBV but not HCV infection may be associated with the development of ICC.p53 abnormality may not play a significant role in HBV-associated carcinogenesis of ICC.

Objective To evaluate embedding 5-FU microparticles during operation after hepatectomy for small hepatocellular carcinoma to prevent recurrence. Methods A retrospective analysis on 184 patients was done.All patients received liver resection for HCC from 2007 Mar.to 2008 Mar.In 90 cases,5-FU releasing microparticles were embeded on liver cutting surface after the tumor was resected (group A).94 cases in which no micropaticles were given served as controls (group B).All patients had a single tumor( ≤5 cm) without visible vessel invasion. Results The postoperative disease-free survival ( DFS),and median period of DFS of group A vs.group B was 43 months vs 35 months.Postoperative DFS rates of 1-,2-and 3-year were 86％,76％ ％ and 64％ respectively in A group,while they were 77％,61％and 49％ respectively in B group ( x2 =4.77,P ＜ 0.05 ).In two groups the liver and kidney main function index( TB,ALB,ALT,BUN,Scr)on day 7 and postoperative complications were not statistically different (P ＞ 0.05 ). Conclusions Embeding 5-FU microparticle after hepatectomy for HCC could increase the postoperative DFS rates,and patients do not suffer from significant liver and kidney malfunctions.