The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure is a new surgical strategy.ALPPS is mainly used in the patients with insufficient future liver remnant (FLR) and advanced liver tumor.ALPPS provides fast and effective growth of FLR,so as to meet the normal liver function after surgery.The preliminary studies of liver regeneration of ALPPS rat model also have obtained certain achievements,a synergistic activation of the liver regeneration-associated signaling pathways,such as cytokines and transcription factors,contribute to the significant liver regeneration after ALPPS.In this paper,the advantages of ALPPS and preliminary research progress are summarized.

Portal vein thrombosis (PVT) is a severe complication in patients with cirrhosis and portal hypertension after splenectomy.PVT can aggravate liver damage,ischaemic intestinal necrosis and gastrointestinal bleeding.In recent years,numerous studies have been published on the risk factors,diagnosis,prevention and treatment of PVT.Imaging examination in patients could be done for early diagnosis of PVT and improve the prognosis of patients.

OBJECTIVE:To study the efficacy of the compound preparation of Yangshen and Chuanxiong in the treatment of cardiovascular diseases. METHODS: The effect of the compound preparation of Yangshen and Chuanxiong on blood pressure of spontaneous hypertensive rats was observed. The myocardial ischemia model was established in rats by ligating coronary artery for the observation of the effect of the compound preparation on serum creatine phosphoric acid activating enzyme (CK), lactic dehydrogenase (LDH), malonaldehyde (MDA), and hyperoxide mutase (SOD). The ischemic cerebral edema model was established in rats by carotid ligation for the observation of the effect of the compound preparation on brain water content. The experimental thrombus model was established in rats by extracorporeal circulation for the observation of the effect of the compound on thrombus weight. The model of blood stasis was established in rats by injecting them with adrenalin hydrochloride for the investigation of the effect of the compound on whole blood viscosity. RESULTS: The compound preparation of Yangshen and Chuanxiong brought down the blood pressure in model rats significantly, increased serum levels of SOD and MDA as well as brain water content, inhibited the empirical thrombogenesis, and reduced the whole blood viscosities in rats with acute myocardial ischemia. CONCLUSION: The compound preparation of Yangshen and Chuanxiong has remarkable efficacy in anti-thrombosis, improving the cerebral circulation disturbance and cerebral oxygen supply, eliminating cerebral edema and promoting blood circulation to remove blood stasis.

Mechanical stapling devices have been widely applied in the gastrointestinal surgery since the 1950s because of its advantages of easy manipulation,less time consumption and low incidence of postoperative complications.With modification of these devices and technical proficiency,mechanical staplers have been introduced into several surgical procedures in hepatopancreatobiliary surgery including pancreatoduodenectomy,hepatectomy,cholecystojejunostomy,gastroenterostomy,cystogastrostomy and enteroenterostomy.Currently,there are no guidelines or consensus in China concerning the use of mechanical stapling devices. Current advances in mechanical stapling devices and complications in the clinical practice are discussed in this article.

After the concept of damage control resuscitation is introduced, in the most severely injured casualties, when the lethal triad of hypothennia, acidosis, and coagulopathy are present, resuscitation prac-tice for damage control usually focuses on rapid reversal of acidosis and prevention of hypothermia, while di-rect treatment of eoagulopathy has been relatively neglected. Recent studies have brought back to light the importance of treating the coagulopathy of trauma at an earlier stage. This review focused on the importance and the right time of treating this disorder, analyzed the methods of addressing the early coagalopathy in damage control resuscitation and gave some advices.

The diagnosis of nonparasitic hepatic cysts has been significantly improved with the development of imaging techniques,however,the successful differential diagnosis depends on more careful consideration.The differential diagnosis of multiple hepatic cysts and polycystic liver disease depends on the family heredity,number of cysts,combination of polycystic kidney,division and the results of B ultrasound.The differential diagnosis of hepatic cyst and hepatic cystic adenocarcinoma depends on the imaging features and results of histopathological examination.Recently,laparoscopic surgery has been widespread-ly used in the management of hepatic cystic disease,while it still cannot replace open surgery.The individualized and various treatment should be selected according to the condition of the patients.

Precise hepatectomy is the application of minimally invasive concept in hepatic surgery. There are big challenges for surgeons to choose the proper approaches to achieve the aim of precise hepatectomy. How to choose therapeutic strategy, chemotherapy, radiotherapy, liver transplantation or radiofrequency ablation? How to choose the operation type, laparoscopic surgery, transabdominal surgery or Da Vinci robot-assisted surgery? How to choose the surgical instruments during hepatectomy? Although answers for these questions are various, the principle is unchangeable, which is providing minimal injury, less blood loss, fast recovery, little expense and good prognosis. The concept of precise hepatectomy includes precise judgment of liver function and careful preparation before operation, and also the elaborate nursing and multi-disciplinary cooperation during operation, as well as the fast track surgery after operation. Precise hepatectomy requires surgeons take the safety and effectiveness of the operations into account, and the conditions of hospitals, the skills and experiences of the surgeons should also be evaluated before operation. Finally, the economic condition of the patients should be considered and proper application of advanced equipments should be emphasized.

To improve standardization and consensus regarding interpreting,and reporting CT and MRI scans of the liver in patients with high-risk HCC,Liver Imaging Reporting and Data System (LI-RADS) was launched in 2011 and subsequently modified in 2013 and 2014,respectively.Major diagnostic imaging features for HCC are hyper-enhancement in the arterial phase,rapid dissection in the portal vein phase and balance phase,capsule presence and appearance,interval threshold tumor growth and tumor diameter.LI-RADS categorizes nodules recognized at CT or MRI as LR-1 (definitively benign),LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.LR-2 (probably benign),LR-3 (intermediate probability of being HCC),LR-4 (probably HCC) and LR-5 (definitively HCC).According to diagnostic classification,different options for treatment recommendations are adopted by surgeons including continue standard surveillance,regular follow-up,alternative imaging method,multidisciplinary discussion,liver resection or transplantation.LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.

Objective To review the epidemiology, etiology,pathology,clinical presentation,diagnosis and treatment,recurrance and prognosis of Mondor disease.Methods Literatures on Mondor disease were reviewed,and our study of Mondor disease was also included.Results Mondor disease is difficult to diagnose,but is with good prognosis in most patients.It's unclear whether Mondor disease is associated with the etiology of breast cancer.Conclusion The diagnosis and therapy of Mondor disease are important,especially when it is accompanied with breast cancer.

Liver hanging maneuver(LHM)was first performed to assist right hepateetomy by Jacques Belghiti in 2001.During the procedure of hepatectomy,the liver is lifted by a tape which passes between the anterior Surface of the inferior vena cava and the liver.LHM provides effective vascular control and makes the anterior approach safer and easier.As one of the most important innovations in the field of liver resection,LHM has some definite advantages over the classical approach,including less hemorrhage,less tumoral manipulation and rupture,better hemodynamic stability,reduced ischemic damage of the liver remnant and better survival for patients with hepatocellular carcinoma.Moreover,LHM can serve as a guide to the correct analomical transection plane,and help to improve the exposure of the deep parenchymal plane.LHM developed rapidly in the past few years and it has been widely adopted not only in the treatment of liver cancer,but also in living donor liver transplanration,orthotopic liver transplantation and the treatment of benign liver diseases.Furthermore,many surgeons utilize LHM to facilitate various anatomical liver resections.Although the concept of LHM is widely accepted,its limits and contraindications still need to be investigated in the future.