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 investigate the impact of exogenous of triiodothyronine (T3) on the liver hyperplasia of mouse. Methods Forty-ifve healthy speciifc pathogen free (SPF) C57BL/6 mice were divided into group A, B and control group using random number table method with 15 mice in each group. Mice in group A, B were respectively injected with 2 ml exogenous T3 solutions 10, 5μg/kg intraperitoneally. Mice in control group were injected with 2 ml normal saline. Three mice of each group were put to death respectively on day 0, 7, 14, 21, 42 after treatment. The total liver weight of the mice was measured after death. The proliferation of liver cells was detected by immunohistochemistry. The experimental data were compared using t test or analysis of variance. Results Compared with control group, the liver weight of mice in group A increased signiifcantly on day 7, 14, 21, 42 after treatment (t=3.298, 6.760, 7.119, 6.128;P<0.05) , and the liver weight of mice in group B increased signiifcantly on day 14, 21, 42 after treatment (t=4.188, 4.570, 2.978;P<0.05). The increased liver weight in group A was signiifcantly more than that in group B on day 7, 14, 21, 42 after treatment (t=4.935, 4.303, 4.033, 4.480;P<0.05). The liver weight in group A, B rose to the top on day 21 after treatment (F=21.480, 11.244;P<0.05). Compared with control group, the liver cell count in group A increased signiifcantly on day 0, 7, 14, 21, 42 after treatment (t=28.383, 23.842, 40.194, 31.059, 15.841;P<0.05), and the same with group B (t=9.097, 7.680, 20.597, 42.192, 14.415;P<0.05). The increased liver cell count in group A was signiifcantly more than that in group B (t=8.016, 4.872, 10.719, 9.514, 7.831;P<0.05). The liver cell count rose to the top in group A on day 14 after treatment (F=169.190, P<0.05) and rose to the top in group B on day 21 after treatment (F=90.460, P<0.05). Extensive proliferation of liver cells was observed both in group A and B after treatment. Conclusions Exogenous T3 can effectively promotes the liver hyperplasia of mouse, and the hyperplasia becomes more signiifcant as the T3 concentration rises.

Objective To review the diagnosis and treatment of severe complications after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods Clinical data of 15 patients with severe complications after TACE of HCC in Department of General Surgery, Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from June 2011 to May 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. There were 12 males and 3 females with age ranging from 40 to 78 years old and the median age of 55 years old. Results Manifestations of cholangitis such as abdominal pain, fever, rising white blood cell etc. were observed in all the patients. According to the clinical manifestations, history of receiving TACE and imaging examinations, 10 cases were diagnosed with biloma after TACE of HCC, 4 cases with liver abscess and 1 case with ischemic cholangitis. All the patients received basic treatments of anti-infection, cholagogue and liver protection. Ten cases with biloma were cured after receiving ultrasound-guided percutaneous transcatheter drainage of biloma, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD). Four cases with liver abscess were cured after receiving ultrasound-guided percutaneous transcatheter drainage of liver abscess, local douche with antibiotics. One case with ischemic cholangitis received drainage of 3 catheters of PTCD and the serum bilirubin went down from 500μmol/L to 300μmol/L, but gave up treatment ifnally because of complicating severe biliary infection and gastrointestinal hemorrhage. Conclusions The diagnosis of severe complications after TACE of HCC is mainly based on the clinical manifestations, history of receiving TACE and imaging examinations. The therapies include basic treatments of anti-infection, cholagogue and liver protection etc., and symptomatic treatments of ultrasound-guided percutaneous drainage, PTCD, ENBD, etc.

OBJECTIVETo explore the feasibility and clinical significance of precision low inferior mesenteric artery (IMA) ligation with the left colonic artery (LCA) preservation and root lymph node dissection in laparoscopic radical resection for rectal cancer, according to the inferior mesenteric artery (IMA) types.

METHODSOne Hundred and fore cases of rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from October 2015 to June 2016 were selected and divided into study group and control group according to different surgical methods. The study group (52 cases) accepted precision low IMA ligation with the LCA preservation and root lymph node (No.253) dissection, according to the IMA types and length examined by preoperative computed tomography angiography (CTA) reconstruction. The control group (52 cases) accepted the traditional high IMA ligation. The perioperative efficacy indexes and postoperative recovery situation of the two groups were compared.

RESULTSThe IMA types, IMA length and preoperative clinical stages were not significantly different between the two groups (all P>0.05). The surgery was completed smoothly for patients in both groups, with no conversion to open surgery. But two patients in the study group underwent left colonic artery ligation for intra-operative need. There were no significant differences in the operative time, intra-operative blood lose, the rate of protective ileostomy and post-operative pathological stages between the two groups (all P>0.05). More total lymph nodes [(24.9±5.7) vs. (16.9±4.2), P=0.001] and No.253 lymph nodes [(2.4±1.1) vs. (1.5±0.8), P=0.001] were harvested in study group as compared to control group. However, the positive rate of total harvested lymph nodes and No.253 lymph nodes between the two groups were not significantly different (P>0.05). There were no significant differences between the two groups in postoperative first anal exhaust time, postoperative hospital stay, total volume of postoperative intraperitoneal drainage, postoperative abdominal drainage tube retention time, postoperative anal drainage tube retention time and postoperative catheter retention time (All P>0.05). There were 2 cases of postoperative dysuria and 1 case of anastomotic bleeding in study group. There were 3 cases of postoperative dysuria and 2 cases of anastomotic leak in control group. Less postoperative complications (5.8% vs. 9.6%, P<0.05) in study group as compared to control group. There was no rehospitalization or death case in two groups within 30 days after operation.

CONCLUSIONSIn the laparoscopic radical resection of rectal cancer, preserving LCA and cleaning the root lymph nodes according to IMA types, which could increase the number of harvested lymph nodes and reduce the postoperative complications was safe and effective.

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.