Toil-like receptors (TLRs) present in the cell membrane and are transmembrane receptors.TLR4 is a key member of the TLRs family involved in inflammatory response and recognizing microbes. Gut barrier mainly include mechanical, immunological, chemical and biological barrier four major sections. Liver transplantation leads to intestinal ischemia-reperfusion (I/R) injury, then intestinal bacteria and endotoxin translocate into the blood circulation and at the same time, I/R injury stimulates the release of a large number of endogenous molecules. TLR4 is combined with both endotoxin and endogenous ligand and promotes the release of multi-kinds of cytokines and inflammatory mediators, causing a series of inflammatory reactions,and even leading to liver failure.

The most common site of hematogenous metastasis of gastric is liver,its prognosis is bad.It is a common cause of death in patients with gastric cancer.In the past few years,along with the development of molecular biology,the mechanism of tumor metastasis has been known gradually.Tumor metastasis is multistep process,the most important condition is cell invading and angiogenesis.Here the author summarize the mechanism of cell invasion and angiogenesis.

Colorectal cancer (CRC),a common gastrointestinal malignancy,has been a threat to the health and life of human being.CRC is concealed with no obvious clinical symptoms or signs.Therefore,most of the patients have been in the middle and advanced stage when CRC has been diagnosed.Thus it seriously affects the prognosis and life.Accordingly,early diagnosis is crucial in earlier treating,prognosis improving and survivability increasing.In recent years,the morbidity and mortality of CRC are still on the rise.Hence,how to improve the early diagnosis rate has been a research focus in clinical study.Based on this point,the author makes a literature review on the early diagnosis of CRC.

In clinical practice,regional portal hypertension is infrequent,but it is the only type which could be cured of portal hypertension.Pancreatic diseases are the chief pathogeny of regional portal hypertension,and the obstruction of spleen vein is the basic reason.The common clinical manifestation is isolatism varicose veins of pylorus.The golden standard of its iconography diagnosis is DSA,and the treatment should follow the individual principle.The splenectomy is the basic measure for them who have UGIB or hypersplenism.This is a review about recent advance in regional portal hypertension of etiology and classification,pathology and physiology,clinical manifestation,diagnosis,radiographic examination,cure,and so on.

Abdominal incisional hernia is a common complication of abdominal surgery,of which the two major direct causes are surgery wound healing and intra-abdominal pressure.Therefore,the factors causing poor wound healing and intra-abdominal pressure are incisional hernia incentives.Surgery is the only radical method to cure it,including open surgery and laparoscopic surgery.This review contains two contents,the summary of the current research and the prospects.

Intrahepatic cholangiocarcinomas is a type of biliary epithelial cell carcinoma.Hepatolithiasis,viral hepatitis,primary sclerosing cholangitis,Caroli disease,parasitic infections are its risk factors.In recent years,the incidence of intrahepatic cholangiocarcinomas is gradually increased.Ultrasound,CT,MRI can be used to diagnose.The main way to treat intrahepatic cholangiocarcinomas is comprehensive treatment based on liver resection.There is still some controversy in liver transplantation.Adjuvant therapy will play a more and more important role in patients who unable to accept surgery.

Objective To explore the effect of Radix Isatidis( indigowoad root,RI) polysaccharide on NO and ET-1 in orthopotic liver autotransplantation of rats.Methods The rats used in the experiment were randomly divided into three groups:normal control group (NC), autotransplantation group (AT) and RI polysaccharide group (RIPS).At 1, 6, 12 and 24 hours after autotransplantation, the content of NO,ET-1, alanine aminotransferase ( ALT), and aspartate amin-otransferase ( AST) in serum was assayed.Morphological observation of hepatic tissues was also performed.Results The serum level of ET-1 in RIPS group was significantly lower than that of AT group (P<0.05), and NO content in serum of RIPS group was increased significantly compared with AT group ( P<0.05) at 1, 6, 12 and 24 hours after autotransplanta-tion.The serum level of ALT and AST in RIPS group was lower than that of AT group (P<0.05) at each measurement point.The morphology of hepatocytes changed abnormally under light microscopy.The blood stasis and swelling of hepatic tissues, denaturalization and necrosis of hepatocytes in RIPS group were milder than that in AT group.Conclusion RIPS has a protective effect on hepatic ischemia reperfusion injury after orthotopic liver autotransplantation, which may be related to increased NO levels and lower levels of ET-1.

The incidence of primary nonfunction in the early period of liver transplantation,is reported to be 2%-23%,which is the main cause of death of liver transplant patients.It can be induced by many complicated factors and is particularly associated with the pathological changes caused by acute immunological rejection.Current studies of liver transplantation are focused on how to reduce the injury and improve the function of the liver graft and raise the success rate of liver transplantation.

Children's portal hypertension is a hemodynamic abnormalities syndrome,it refers to children with portal vein pressure exceeds 5 mmHg,or portal vein,hepatic venous pressure gradient exceeds 10 mmHg.Etiology of portal hypertension of children:portal vein obstruction,congenital hepatic fibrosis,biliary atresia.Current treatment methods are:drug treatment,varicose vein ligation or sclerosis,surgical treatment.Although the incidence of children's portal hypertension is relatively low,it can cause various serious complications,such as ascites,gastric variceal bleeding,hepatic encephalopathy and so on.To increase awareness,improve the cure rate and reduce complications,the artical will review the children's portal hypertension etiology,pathogenesis,diagnosis,and treatment progress.

Gallstone ileus is a rare complication of cholelithiasis,and is common in older gallstones patients.It lacks the typical clinical presentation,so preoperative diagnosis is very difficult.The best diagnostic modality now is abdominal CT scan.Surgery is the most important and useful treatment.According to patient' s own situation,choose individualized surgical approach.Endoscopic,laparoscopic and other minimally invasive treatment are promising.With the development of related technologies,it maybe increased of the gollstone ileus treatment.