Objective To study the treatment of sponteneous rupture of hepatocellular carcinoma(SRHCC).Methods The clinical data of 64 patients with SRHCC treated by non-operation or operation were analysed retrospectively.Results The mean survival time of 14 patients treated by conservative therapy was 7 days(12 hours～12 days), the mean surival time of 31 patients treated by packing and 6 patients treated by ligation of hepatic artery was 11 days(4 hours-3 months)and 2.5 months(8 days-6 months);and the 1-month survival rate was 3.2% and 66.7% respectively.1 patient underwent transhepatic artery embolism surviving 9 days.The 1-year survival rate of 12 patients treated by hepatectomy was 66.7%;the mean survival time was 36 months(4 days-25 years and 3 months).Of the 12 patients,11 survived for over one and a half months whose liver function was Child-Pugh grade A before operation; 1 died of liver function failure 4 days after operation,whose liver function was Child-Pugh grade B before operation.Conclusions Emergent hepatectomy should be reserved for patients with an easily resectable lesion whose liver function is in Child-Pugh grade A.Early two-stage or delayed hepatectomy would be suitable for those patients who are unsuitable for emergent operation.Conservative therapy and other therapies may be used for patients with terminal stage of SRHCC.

Objective To explore the mechanism of lower molecular weight heparin(LMWH) in the treatment of severe acute pancreatitis(SAP). Methods Wistar rats were randomly divided into 3 groups: Sham group(S group),severe acute pancreatitis group(SAP group) and LMWH treatment group(H group). The serum amylase,IL-6,expressions of p65 mRNA and the activity of NF-?B were tested. Results The value of amylase and IL-6 in SAP group was significantly higher than that in H group (P

Objective To explore the effect and the mechanism of glycynhizin in the prevention of colonic cancer (after) cholecystectomy. Methods Sixty mice were randomly divided into 3 groups: Sham group(S group),group of model of colonic cancer after cholecystectomy(C group) and glycynhizin treatment group(GL group). The incidence of colonic cancer, expressions of p53 mRNA,p21 mRNA and bcl-2mRNA and the activity of NF-?B were tested. Results The incidence of colonic cancer in C group was significantly higher than that in GL group (P

Objective To explore the feaibility of laparoscopic hepatectomy(LH) for hepatolithiasis.Methods Eight patients with hepatolithiasis were treated by laparoscopic cholecystectomy(LC) and common bile duct exploration(LCBDE) and LH.Laparoscopic resection of left lateral lobe of liver was performed in 7 cases,and left hemihepatectomy in 1 case.Results Procedures were all successful with operation time of(285.00?37.42) minutes,and bleeding volume(306.25?29.73)mL.The postoperative hospital stay was(7.88?1.36) days.No complications occurred.No residual stone was found in any patient.Conclusions LH was safe and effective for hepatolithiasis,and gives better results when combined with choledoscopic stone removal.

Objective To explore the mechanism of LMWH therapy for SAP.Methods 48 wistar rats were random divided into 3 groups,sham group(S group),severe acute pancreatitis group(SAP group)and LMWH therapy group(H group).Serum amylase,IL-6,acinar cell apoptosis and the activity of NF-κB were detected and compared.Results The expression of amylase and IL-6 in SAP group was significantly higher than that in H group(P＜0.01).The apoptosis index of acinar cell in SAP group wag significantly lower than that in H group(P＜0.01),while the activity of NF-κB in SAP groupwas stronger than that in H group.Conclusions LMWH therapy may ameliorate SAP by inducing acinar cell apoptosis through suppressing the activity of NF-κB.

Objective To investigate the clinical features and management of bile duct injury caused by laparoscopic cholecysteetomy by using harmonic scalpel (UHS-LC), and its prevention. Methods The clinical data of 1863 UHS-LC cases from April 2003 to February 2008 were retrospectively analyzed. There were 11 patients suffering from UHS-LC related iatrogenic bile duct injury including intraoperatively immediate recognized injuries in 9 cases, and postoperatively found injuries in 2 cases. For those patients in which bile duct injury was found during the UHS-LC procedure, the patient was converted to open surgery, the injury was repaired accordingly by end-to-end bile duet anastomosis or Roux-en-Y procedure. For the injuries found postoperatively (all two cases were of CBD perforation), CBD was sutured by second stage. Results All the 11 patients recovered well and no biliary stricture occurred during the follow up of 1-5 years. Conclusions While UHS-LC is suitable for most cases of choleeystectomy, it causes significant porcentage of bile duct injury (0. 6% ) in hands of unskillful surgeons. It is important to be on alert against iatrugenic bile duct injuries.

Objective To investigate the molecular mechanism of miR-139-5p targeting transforming growth factor-β1 (TGF-β1) in the regulation of epithelial mesenchymal transition (EMT),thus inhibiting invasion and metastasis of hepatoma cells.Methods Bioinformatics methods were used to determine whether miR-139-5p was the best binding miRNA of TGF-β1.Correlation between the TGF-β1 expression as detected by immunohistochemistry and Western blot,and the miR-139-5p level by qRT-PCR in 56 hepatoma tissues and 20 normal tissues,respectively,was analyzed.The relationship between the miR-139-5p level as detected by qRT-PCR,and TGF-β1,E-cadherin and Vimentin by Western blot in the high and low metastatic hepatoma cell lines were investigated.In recombinant cell lines,whether miR-139-5p could bind to the 3'UTR site of TGF-β1 was evaluated,and the effect on invasive ability after modulating miR-139-5p level was also tested by the transwell method.Results A total of 20 miRNAs were found to be able to bind with TGF-β1 by bioinformatics methods and among these mRNAs,miR-139-5p was the best target miRNA with the highest specificity and strongest stability to bind TGF-β1.The positive expression rates of TGF-β1 in hepatoma tissues and adjacent normal liver tissues were 80.4％ (45/56) and 15.0％ (3/20),respectively,(P ＜0.05).There were significant differences on the expressions of TGF-β1,E-cadherin and Vimentin among the different metastatic cell lines (all P ＜ 0.05).After miR-139-5p was transfected into hepatoma cells,miR-139-5p could bind to the 3'UTR site of TGF-β1,resulting in downregulating TGF-β1 expression.When compared to the other three groups,the cell line with a high expression of miR-139-5p had a significantly lower count of invasive cells (53 ± 4/high magnification field) (P ＜ 0.05).Conclusion miRNA139-5p could specifically bind to the 3'UTR site of TGF-β1 and regulate the EMT signaling pathway,thus suppressing invasion and metastasis of hepatoma cells.