Hepatic stellate cells(HSCs) are the mesenchymal cells in the liver. In the process of tumori-genesis and metastasis, the interactions between HSCs and tumor ceils play an important role in promoting tumor invasion through extracellular matrix remodelling. Here we review the latest investigative advances a-bout the tumor-stromal interactions.

Gastrointestinal stromal tumors are rare tumors of alimentary tract and originated from the interstitial Cajal cells,with acquired mutation of KIT(CD117).Surgery is the main therapy for resectable tumors,while imatinib,a small-molecule inhibitor of receptor of tyrosine kinase,plays an important role in treating metastatic and recurrent tumors.

Objective To explore the structure and type of sugar chain in 33 500 pro-nucleating protein, and its role in gallstone formation. Methods The 33 500 vesicular protein was examined by dot-immunobinding assay of lectin coupled to a peroxidase (HRP-DSA,HRP-ConA,HRP-WGA). The morphology of biliary vesicles was observed under transmission electron microscopy in process of massive vesicular aggregation, culmination and crystal formation. The protein and its enzymatic deglycosylation fractions nucleation promoting activity were detected by cholesterol crystal growth assay. Results 33 500 vesicular protein with multiantennary and complicated glycan displayed apparent potency of nucleation promotion, which clearly reflected by HRP-DSA immunobinding, and derived crystal growth curve indices. It, Ig, Ic were presented as 0.57, 1.52, 1.63 respectively, but after treated by N-glycanase enzyme, no promoting activity was found. Conclusions Our data suggest the sugar chain play an important role in pro-nucleating process, and may be involved in the gallstone formation.

Apoptosis is great advancement in sphere of biology,it is characteristic death form at physiological state.Rencent researchs discover that apoptosis take important role in transplantation immunity.That graft is rejected is the major obstruction in transplantation.Allogeneic transplantation rejection is because of immune response that is mediated by T lymphocyte and aimed directly at allogenic antigen.Apoptosis of activated T lymphocyte through some pathways can induce immune tolerance.Some immune suppressant produce effect just by cell apoptosis.This review mainly presents recent advance in transplantation tolerance induced by apoptosis of T lymphocyte.

Colorectal cancer is one of the malignant tumors that endangers human health. Nowadays the surgery is the primary therapy for colorectal cancer. Laparescopic surgery has developped for more than ten years. It consolidates its position in the field of colorectal surgery gradually. We now make a comparison of laparoscopic surgery and open surgery about the safety, the pathophysiological influence and the effective-ness, etc, in order to discuss the value of the laparoscopic surgery in the therapy of colorectal cancer.

The PIK3CA gene codes p100α,the catalytic subunit of phosphatidylinositol 3-kinase (PI3K) and is involved in the initiating the PI3K/AKT pathway.PIK3CA plays its biological roles through.downstream PI3K pathway. PIK3CA gene mutants can be detected in many kinds of tumors. The mutant PIK3CA gene can abnormally activate PI3K pathway,leading to the abnormal cell cycle,decreased cell adhesion,down regulated apoptosis and neovascularization,and then promotes tumor genesis and development.Recent researches have found that mutant PIK3CA gene is closely correlated with the genesis,development,differentiation,metastasis and drug resistance of colorectal cancer.Research of PIK3CA in colorectal cancer may provide significant evidence for the early diagnosis,gene screen,therapeutic regimen making,recurrence and follow up.

Objective Brain metastasis(BM) is unusual in colorectal carcinoma(CRC) patients.This study was to evaluate the characteristics and prognosis of brain metastasis of colorectal carcinoma patients.Methods Twenty-eight consecutive CRC patients underwent surgical resection for BM between January 2001 and December 2008.The clinical data were analyzed by univariate (logrank) and Cox regression test.Results The median age at BM diagnosis from CRC was 57 years(41-75 years).Median survival after neurosurgical intervention was 9.4 months.The 1-year and 5-year survival rates were 28.9%and 7.1%,respectively.Seventeen patients(61%)had concurrent systemic metastasis.All patients were symptomatic with neurologic deficits and symptoms.On multivariate analysis,gender,infratentorial location of lesions and characteristics of primary CRC had no significant impact on survival.Two factors were signitlcandy associated with better survival:single brain metastases and absence of extracranial metastases.Perioperative mortality was zero.There were no difference of survival among patients undergoing resection alone and resection combined with whole brain radiotherapy (WBRT) or stereotactic radiosurgery(SRS). Conclusions Brain metastases from colorectal cancer is an evil omen of poor prognosis of CRC patients.Sursical resection of symptomatic brain metastases from colorectal cancer is relatively safe and provides the opportunity for prolonged survival.

Objective To investigate the prognostic factors of gastrointestinal stromal tumors.Methods From Nov.1999 to Dec.2006,a total of 85 patients were diagnosed by postoperative pathology as gastrointestinal stromal tumors.The relationship between the prognosis of GIST and demographic factors、tumor location、operation style、preoperative metastasis、lymphadenectomy、grading of Fletcher were analyzed retrospectively.Results The 1 year、3 year and 5 year survival rate of these 85 patients were 94%,60%,57%respectively,Univariate analysis indicated that tumor location、operation style、grading of Fletcher and preoperative metastasis were significant predictors of survival(P<0.05),while demographics and lymphadenectomy were not statistically related with prognosis.Multivariate analysis showed that preoperative metastasis was the independent factor predicting the prognosis(P=0.020,β=4.226).Conclusion Radical surgical excision is still the therapy of choice for primary gastrointestinal stromal tumors.Preoperative metastasis is the independent factor predicting poor prognosis,therefore early diagnosis and treatment are very important for GIST.Fletcher grading is also a simple recalls to predict the prognosis of GIST.

Objective To investigate the clinical efficacy of liver resection combined intraoperative choledochoscope for intra‐hepatic biliary calculi .Methods A retrospective analysis of clinical data in seventeen patients with intrahepatic biliary calculi ,who have been received liver resection combined intraoperative choledochoscope in the department of hepatobiliary surgery during 2005 to 2014 was conducted .According to the distribution of intrahepatic bile duct stones ,six cases located in left liver lobe ,five cases lo‐cated in left half liver ,three cases located in liver section Ⅵ ,one case located in liver section Ⅶ ,one case located in liver section Ⅷ , one case located in left liver lobe associated with right posterior lobe lower segment .Seventeen cases were treated with hepatolobec‐tomy or segmental liver resection (single clamp method combined first hilar occlusion) ,among which six cases received hepatic left lateral lobectomy ,five cases received left hemihepatectomy ,three cases received partial hepatic resection in paragraph Ⅶ ,one case received partial hepatic resection in paragraph Ⅶ and one in Ⅷ ,one case received the left lateral lobe combined right posterior lower segmental resection ,ten cases at the same time received choledocholithotomy and T tube drainage .Results All patients were cured without serious complications ,no long term stone recurrence .Conclusion Liver resection combined intraoperative choledochoscope is positive and effective treatment for intrahepatic biliary calculi patients .

OBJECTIVE: To establish a rapid and precise detective method of 33.5 kd vesicular protein and to screen an effective treatment of cholelithiasis. METHODS: Specific antibody of the biliary vesicular protein was obtained by immunizing rabbits and enzyme-linked immunosorbent assay (ELISA) kit was developed. The concentrations of 33.5 kd vesicular protein in serum and bile of gallstone patients and control were examined respectively. The effects of Cholagogue Dry Syrup and Eulektrol Capsule on decreasing 33.5 kd vesicular protein were also studied by ELISA kit. RESULTS: One-step ELISA equation was Y=0.035 X (r=0.99). The vesicular protein concentrations in serum and bile of cholesterol gallstone group [(179.8+/-97.9) mg/L and (213.4+/-70.1) mg/L respectively] were significantly (P<0.05) higher than in the pigment stone group and control. Data showed that, with 2-week administration, Cholagogue Dry Syrup significantly decreased both biliary and serum 33.5 kd vesicular protein of cholesterol gallstone patients, while Eulekrol Capsule and control groups didn't have the same results. CONCLUSION: The concentrations of 33.5 kd protein are different in cholesterol gallstone patients and healthy groups which might be related to cholesterol nucleation process. Cholagogue Dry Syrup is of cholagogic and litholytic effect by decreasing biliary lithogenesis.