Tumor lysis syndrome (TLS) is the rapid dissolution of tumor cells and cell contents, and its metabolite is rapidly released into the blood, causing a series of complications such as high uric acid, high potassium, high phosphorus, hypocalcemia and acute renal insufficiency. TLS is commonly seen in patients with rapidly growing malignant tumors that are sensitive to chemotherapy, and which is rare in solid tumors. We found one case of primary liver cancer with acute TLS, who was given hemodialysis to protect the liver and symptomatic treatment, and the patient is on the mend.

Partial hepatectomy (PH) is widely used and the preferred method for the surgical treatment of hepatocellular carcinoma,and liver regeneration is directly related to the prognosis of the patients after the operation.Therefore,the specific mechanism and cytokines related to liver regeneration have become a hot topic in recent years.Currently,there is a wide variation of reported gene expressions and signal transduction pathways in the literature,but the mechanism and interactions are still unclear,especially for postoperative liver regeneration with hepatitis or cirrhosis.This review summarizes current research on the liver regeneration process,the mechanism of liver regeneration after partial hepatectomy,and the different mechanisms of hepatocirrhosis.

BACKGROUND:Studies have shown that the reason of the slower liver regeneration in individuals of cirrhotic liver after partial hepatectomy compared with healthy liver may be related to the delayed synthesis and secretion of hepatocyte growth factor during liver regeneration, but the cause of this phenomenon is not clear. The hepatocyte growth factor activator inhibitor found in recent years can indirectly inhibit the activation of hepatocyte growth factor, but there is little research to explore the expression of hepatocyte growth factor activator inhibitor in the regeneration process after partial hepatectomy in cirrhotic liver and its relationship with the liver regeneration. OBJECTIVE:To investigate the expression of hepatocyte growth factor activator inhibitors (HAI-1, HAI-2) during cirrhotic and normal liver regeneration after partial hepatectomy through establishing the cirrhotic rat model, and to explore the biological effects of HAI-1, HAI-2 in cirrhotic liver during the liver regeneration after partial hepatectomy. METHODS:We used 40%CCl4 subcutaneous injection to establish the cirrhotic rat model, then we performed 70%liver resection for the experimental group. The rats in the control group only received ordinary water feeding and 70%liver resection. Rats in each group were randomly sacrificed before surgery and at 3 hours, 6 hours, 12 hours, 24 hours and 48 hours after surgery, and samples were col ected. We used RT-PCR technology to detect the expression of HAI-1 mRNA, HAI-2 mRNA in splenic tissue. RESULTS AND CONCLUSION:The expression levels of HAI-1 mRNA of two groups after partial hepatectomy were increased firstly and then decreased. The expression of HAI-1 mRNA in cirrhotic rats was sustained higher than that of the control group (P<0.05), there was no significant difference between the two groups of the expression of HAI-2 mRNA (P>0.05). The expression of HAI-1 mRNA in liver cirrhosis rats after resection was consistently higher than that in healthy rats, which may lead to the insufficient synthesis and secretion of hepatocyte growth factor activator in cirrhotic rats, then hepatocyte growth factor precursor may not be activated enough, eventual y leading to slow liver regeneration. HAI-2 may not be involved in the wound repair process of liver.

Objective To investigate the differential expression of hepatocyte growth factor activator (HGFA) and its inhibitors (HAI-1,HAI-2) during cirrhotic and normal liver regeneration after partial hepatectomy,and to explore the causes of the delayed liver regeneration after partial hepatectomy in cirrhotic rat model.Methods We used 40％ CCl4 subcutaneous injection to establish the cirrhotic rat model,and then performed 70％ liver resection for the experimental group together with no operation for the healthy rats as control group.Rats in each group after 3 hours,6 hours,12 hours,24 hours and 48 hours were randomly sacrificed and specimens were collected.The serum HGFA was detected by enzyme-linked immunosorbent assay (ELISA),and we used RT-PCR to detect the mRNA expressions of HAI-1 and HAI-2 in splenic tissue.Results The serum HGFA level in cirrhotic rats at each time point was all significantly lower than that in the control group (P ＜0.05).The expression of HAI-1 mRNA in cirrhotic rats was sustained at a higher level than that in the control group (P ＜ 0.05),but there was no significant difference on the HAI-2 mRNA expression between the two groups (P ＞ 0.05).Conclusions The synthesis of HGFA during the liver regeneration after partial hepatectomy in cirrhosis rats is lower compared with healthy rats,which may lead to the insufficient activation of HGF precursor,eventually causing the slow liver regeneration.HAI-2 may not be involved in the healing process of liver.

Objective To study the promoting effects and mechanisms of interleukin-22 on liver regeneration in GCl4-induced liver fibrosis mice after partial hepatectomy.Methods One hundred and fortyfour C57/BL6 mice were randomly divided into four groups:PHX group,CCl4 group,CCl4 + PHX group,and CCl4 + IL22 + PHX group.The blood samples were taken to measure serum ALT and AST levels.ALT /AST was calculated to observe the liver injury at 3 h,6 h,12 h,24 h,48 h and 72 h after hepatectomy.The liver tissue specimens were collected at each time point after hepatectomy.We measured the hepatic lobe to calculate the liver weight ratio and conducted pathological examinations to observe the degree of fibrosis and pathological changes at each time point.The positive expression of proliferating cell nuclear antigen (PCNA) in liver tissue was tested by immunohistochemistry.The level of CyclinD1 and STAT3 (Signal transducer and activator of transcription 3) signaling pathway was detected by Western blot.Results (1) Compared with CCl4 + PHX group,the ALT/AST ratio of CCl4 + IL22 + PHX group was significantly higher at 24 h,48 h and 72 h,and the level of ALB of CCl4 + IL22 + PHX group was obviously increased at 48 h and 72 h (P ＜ 0.05).(2) The liver regeneration was significantly increased in CCl4 + IL22 + PHX group.Compared with CCl4 + PHX group (2.08 ± 0.16,2.77 ± 0.07,2.97 ± 0.14),the liver weight ratio of CCl4 + IL22 + PHX group(2.34 ± 0.07,3.23 ± 0.09,3.55 ± 0.09) dramatically increased at 24 h,48 h and 72 h.Moreover,the pathological sections displayed that the disease was alleviated (P ＜ 0.05).(3) Immunohistochemical assay and western blot revealed that compared with other three groups,the level of PCNA,STAT3 and Cyclin D1 was significantly lower in the CCl4 + PHX group.However,the level of PCNA,STAT3 and Cyclin D1 apparently increased in CCl4 + IL22 + PHX group at 24 h,48 h and 72 h (P ＜ 0.05).Conclusion Interleukin-22 may significantly promote liver regeneration and reduce liver pathological injury in liver fibrosis mice induced by administration of CCl4 after hepatectomy,which plays a positive role in the recovery of liver function.

Objective To explore a reliable method of 70% hepatectomy model in liver fibrosis mice. Methods Sixty-six C57BL6 mice were randomly devided into control group (n=6), the traditional group (n=30, ligation and removal liver lobe) and improved group (n=30, removal of liver lobe after blocking blood flow). Those 60 mice were induced liver fibrosis firstly, then randomly divided into six mice in each group, and were sacrificed at preoperative, 12, 24, 48 and 72 hours after liver resection. Liver tissues and blood samples were collected. The survival rate and incidence of complications were recorded and compared between two groups. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured to observe the liver injury after 70%hepatectomy. The ratio of liver weight to body weight and the expression of proliferating cell nuclear antigen (PCNA) were also measured to observe the difference of liver regeneration between the two groups. Results (1) Compared to the pathological control group, liver fibrosis model was established successfully in both traditional group and improved group, which can be used in 70%hepatectomy. So the follow-up experiment can be undertook timely. (2) Compared to traditional group, the survival rate was improved significantly in improved group (96.67%vs. 73.33%), and the incidence of complications was significantly lower (P<0.05). (3) The ALT and AST levels were higher 12 h and 24 h after operation in traditional group than those of improved group (P<0.05), while ALT and AST levels were increased first 12 h after operation and then decreased in both groups (P<0.05). (4) The liver/body weight ratio showed a decreasing trend 12 h after hepatectomy in two groups. The expression of PCNA increased at the beginning of postoperative, and reached its peak at 48 h (P<0.05). However, there was no significant difference at each time point between the two groups. Conclusion By blocking blood flow to establish 70% hepatectomy model in liver fibrosis mice, we can significantly improve the success rate of the model, and reduce the incidence of complications.

Objective To search for the most appropriate subzero nonfreezing temperature,and explore the effect of subzero nonfreezing preservation of rat kidney by comparing with the kidney preservation with conventional temperature (4 ℃,0 ℃) and freezing temperature (-4 ℃).Method The thermocouple probeand the temperature data logging device were used to detect the temperature decreasing curves in different parts of the rat kidney and determine the freezing point of the kidney.The perfused kidneys in rats were removed and put into the sterile tubes containing 2.5 mL hypertonic citrate adenine.Following 6 group were set up:-0.8 ℃ group (subzero nonfreezing),-0.5 ℃group (subzero nonfreezing),0 ℃ group (zero nonfreezing),-4 ℃ group (control group),-1 ℃group(subzero freezing)、-4 ℃ group (subzero freezing).After the cryopreservation for 24 and 48 h,the preservative fluid was harvested for measurement of the contents of LDH and AST,and the paraffin sections from the upper pole of the kidney were made for observation of the pathological changes and apoptosis.Result The freezing temperature of kidney was-1℃ and the most appropriate subzero nonfreezing temperature for preserving the rat kidney was-0.8 ℃.Subzero nonfreezing significantly inhibited the basal metabolic rate of the histiocytes,reduced the contents of LDH and AST released due to the membrane damage,and decreased the apoptosis rate [48 h:-0.8 ℃ (40.1 ± 7.0) ％ vs.4 ℃ (47.1 ± 7.6) ％].Under the light microscope after preservation for 48 h,the pathological changes in-0.8 ℃ group were less than in 4 ℃ group.Conclusion Compared with the organ preservation in conventional temperature (0 ℃-4 ℃),the subzero nonfreezing (-0.8 ℃) can further inhibit the basal metabolic rate of histocytes obviously,reduce its energy consumption,and lower the apoptosis caused by low temperature damage.

Objective To study the therapeutic effect of temporary hepatic venous occlusion(TACE-THVO) in transplanted hepatoma rat model and to compare the effect between the adriamycin or the athanol iodized oil emulsion. Methods The seventy five SD rats with transplanted hepatoma were classified into five groups. In the control group, TACE-THVO was performed separately by injecting the adriamycin or the ethanol iodized oil emulsion. Within one week, ten rats in each group were all sacrificed. Then the results were analyzed by light microscopy and scanning electron microscopy.Results (1) Gross study results: within one week, the hepatoma volume in each group was reduced after therapy. The experimental groups showed a lower tumour growth rate than that in the control groups; (2) Light microscopy results: within one week, the area of the tumor necrosis and the capacity of the adriamycin or the ethanol iodized oil emulsion in the portal venous were increased in the experimental groups rather than that in the control groups. The area of the tumor necrosis with the adriamycin iodized oil emulsion was less than that of the ethsnol iodized oil emulsion; (3) Scanning electron microscopy results: within one week, the rough-surfaced reticulum showed a hydropic degeneration. There might be lipodol drop in the tumor nuceus, which appeared karyorrhesis. Conclusion The area of the tumor necrosis with the ethanol iodized oil emulsion is larger than that of the adriamycin iodized oil emulsion. TACE-THVO may be a effective therapy for the hepatoma.

Objective To investigate the relationship between diabetes and bone metabolism and the potential epigenetic mechanisms. Methods BMSCs were cultured for 7 and 15 days in cell culture medium with different concentrations of glucose. The mRNA and protein expression of HDACs and osteogenesis-related genes were detected by RT-PCR and Western blot assay ,respectively. Moreover ,the combination of HDAC to the promoter region of Runx2 was tested by the chromatin immunoprecipitation (ChIP) assay. Results ThemRNA expression of osteogenesis-related genes ,incuding OCN(P < 0.05)and Col1(P < 0.05),in the bone marrow of diabetic mice was significantly reduced compared with the control mice. The mRNA and protein expression of ALP ,OCN ,Runx2 and OSX was gradually reduced with the increasing concentration of glucose ,while HDAC2 mRNA and protein expression was increased. The binding activity of HDAC2 to the upstream and downstream of Runx2 promoter region in 25mM glucose-treated BMSCs was higher than the control group(P < 0.05). Conclusoins Diabetes might repress osteogenesis of BMSCs via inhibiting the activity of Runx2 through upregu-lating the expression of HDAC2.