To systematically summarize the current status of surgical techniques in biliary reconstruction and biliary complications following living donor liver transplantation and analyze the biliary reconstruction techniques and difficulties in the prevention of biliary complications.The refinements of surgical techniques and successful prevention and therapeutic strategies for reducing biliary complications after living donor liver transplantation are discussed.

Under active exploration and practice of several generations of organ transpant workers,organ transplantation in China has developed rapidly since 2000 and achieved remarkble results.Techniques of transplantation become mature,and liver transplantation and renal transplantation have reached international advanced level,which benefit massive patients.With high attention and promotion of national government and health administrative departments,structural changes have occurred to source of national organ transplantation to form a China Model.The donation after citizen's death has become the new normal in the organ transplantation in China.Human organ donation work promots the rapid development of transplantation in China,but it also faces challenges of the donor organ shortage and quality improvement.Under the new situation,health,family planning and medical reform work of the national13th Five Year Plan puts forward new requirements on human organ donation and transplantation.Combined with practical work,this article gives a few opinions on how to scientifically further improve the quality and quantity of organ donation and transplantation and directions of future works.

AIM:To determine the effects of posthepatic manipulative bleeding on the lung injury induced by hepatic ischemia-reperfusion (HIR)in rat model. METHODS:Rat 35 min total hepatic ischemia model was used in this study. We treated the experimental rats by posthepatic manipulative bleeding or IH-CV manipulative bleeding at 10 min after reperfusion. RESULTS:Two percent of body weight posthepatic manipulative bleeding with blood transfusion at 10 min after reperfusion significantly decreased circulating malondialdehyde(MDA). Tissue edema,myeloperoxidase(MPO) and MDA concentrations in lung were significantly decreased 6 h after treatments. The 7 d survival rate was remarkably improved in experimental group. CONCLUSION:Two percent of body weight posthepatic manipulative bleeding with blood transfusion at 10 min after reperfusion significantly protects the rats from lung injury induced by HIR.

Histone acetylation and deacetylation is an important regulatory way of gene expression in eukaryotic cells. As a key regulatory enzyme, histone deacetylase is overexpressed in many malignant tumors, including hepa- tocellular carcinoma. In addition, it has been suggested to be a potential therapeutic target for solid tumors. In this study, we review the classification, mechanisms, as well as the expression and regulation of histone deactylases in hepatocelhlar carcinoma.

Translational medicine is an emerging medical research pattern,its connotation includes a two-way process with effective translation of the latest basic research results into the available clinical medical technologies and products,and give the feedback of the clinical medical problems to the laboratory.It's a kind of bidirectional research,namely Bench to Bedside and Bedside to Bench.Translational medicine is one of the medical science frontiers.In recent years,scientists around the world pay high attention to the clinical translational applications of research results of hepatobiliary surgery,and relevant research and regulations formulation have started under the leadership of government.Actually,translational medicine plays an important role in the success of hepatobiliary surgery in liver transplantation era till now.China is expected to be at the forefront in hepatobiliary surgery and translational medicine in the world in the near future.Chinese surgical circles should have the whole world in view,set in the worldwide development in translational medicine,accelerate the dissemination of ideas in-depth to improve the technology and curative effect.

AIM: To investigate the transfection efficiency of mouse liver with non-viral vector containing manganese superoxide dismutase (Mn-SOD) gene. METHODS: The eukaryotic expression vector, gWiz/Mn-SOD, encoding human manganese superoxide dismutase was constructed. The plasmids of gWiz/Mn-SOD were mixed with cationic lipids, followed by injection into mice via branch of superior mesenteric vein, to induce Mn-SOD over-expression in murine liver detected by RT-PCR, Western blotting, SOD activity and immunohistochemical staining. RESULTS: gWiz/Mn-SOD transfection resulted in the obvious expression of exogenous Mn-SOD mRNA and protein in hepatic tissues at 8 hours after injection, and elevated mitochondria SOD activity 8.4 times in transfected hepatocytes than that in non-transfected cells at 72 hours after injection. It was showed that nearly 70% of mouse hepatocytes was obviously Mn-SOD positive after transfection. CONCLUSION: High expression efficiency of Mn-SOD gene in mouse liver is achieved safely by injection of gWiz/Mn-SOD and cationic lipid mixture into branch of superior mesenteric vein. [

Hepatocellular carcinoma(HCC) is one of the most common devastating neoplasms worldwide with very poor prognosis.Recent studies have identified a CpG is land methylator phenotype(CIMP),which was characterized by simultaneous methylation of multiple TSGs.CIMP has been observed in multiple human malignant tumors including HCC.CIMP also plays a critical role in HCC carcinogenesis,progression,metastasis and recurrence. Therefore,detection of the methylation status of tumor-related genes can provide key information for early diagnosis,molecular classification and predicting prognosis of HCC.

Tumor-stroma ratio is the ratio of tumor cells and stromal tissue. It can be evaluated through HE-stained sections. Usually a 50% cut-off value is taken. TSR is stratified as stroma rich(TSR < 50% )and stroma poor(TSR≥50% ). The different prognosis between the two groups can be assessed. Several previous studies show that TSR is an independent prognostic factor for colon carcinoma,breast cancer,esophageal squa-mous cell carcinoma,cervical carcinoma and non-small cell lung cancer;patients with stroma-rich tumor suffer worse prognosis. The cause might be that tumor cells could activate stroma cells while activated stroma cells could promote the growth,infiltration and metastasis of tumors. And tumor stroma should be recognized as an indispensible participant in progression and invasion of carcinoma.

Objective Misdiagnosis of benign hepatic mass as malignancy is not infrequent. This study was to improve the clinical diagnosis by reviewing our clinical data for space occupying hepatic lesions. Methods In this study 545 patients undergoing hepatic resection for suspected malignant hepatic lesions were retrospectively studied from Jan 1998 to Jun 2004. All patients were pre-operatively assessed with plasma tumor makers, ultrasonography, computed tomography or magnetic resornance imaging. Percutaneous liver biopsy was employed in selected patients. Final pathological data was reviewed to evaluate preoperative diagnosis. Results Twenty-four out of 545 patients were pathologically diagnosed as with benign lesion. Preoperative misdiagnosis involved atypical radiological characteristics, incomprehensive clinical data and inexperienced recognition for liver lesions. Two of 24 cases suffered from minor post-operative complications, and there was no mortality. No recurrence was found by a mean follow-up of 3 years and 1 month. Conclusions Some benign hepatic lesions are easily misdiagnosed as malignant tumor. Appropriate use of multimodality examination in combination with correct algorithm of diagnostic protocol could improve diagnostic accuracy in cases of benign solid space occupying lesions of the liver.

Objective To evaluate liver transplantation for patients with hepatocellular carcinoma (HCC).Methods From Feb,1999 to Mar,2002 a total of 95 cases underwent liver transplantation(LTX) in our centre, among them there were 23 cases of HCC.SPSS 10 0 software was used to evaluate the risk factors on the tumor recurrence after LTX.Results The tumor recurrence rate was 65% during the period of follow up. The patients' tumor free survival rate at 6 and 12 months was 75 0% and 58 3%, respectively. Multi variants analysis revealed that there was a statistical relationship between pretransplant tumor size and tumor recurrence( P =0 024).Statistical relations between preoperative demograplaic, clinical features and post LTX recurrence were not found.Conclusion Large hepatocellular carcinoma is a relative contraindication for LTX.