The use of laparoscopic liver resections for benign and malignant diseases has spread worldwide.As in open liver surgery,anatomical orientation and the ability to control intraoperative challenges as bleeding have to be combined with expertise in advanced laparoscopic techniques.We provide an overview regarding the literature on laparoscopic liver resection for benign and malignant liver tumors with the aim to discuss the current standards and define remaining challenges.Laparoscopic liver resection is feasible and safe in selected patients and experienced hands.The minimal invasive approach offers benefits in perioperative shortterm outcome without compromising oncological outcomes compared to open liver resections.Further randomized trials are needed to formally prove these statements and to define the optimal indication and techniques for the individual patient.

Objectives To observe the effect of Jianpi-Huayu decoction for preventing the patients from the recurrence of colonic adenoma after endoscopic mucosal resection. Methods A total of 60 patients with colonic adenoma who received endoscopic mucosal resection were divided randomly into the experimental group (taking Jianpi-Huayu decoction) and the controlled group (taking nothing as treatment), 30 patients in each group. Both groups were treated for 1 year. After 1 year, colonscopy was taken, and the number and size of colonic adenoma were recorded. The expression of COX-2, Ki67 in the colonic mucosa were detected the immunohistochemistry, and the negative rate of COX-2, Ki67 were also detected. Results After the treatment, the number (0.20 ± 0.48 vs. 1.67 ± 1.54, t=4.980) and size (0.23 ± 0.57 vs. 2.73 ± 2.80, t=4.788) of colonic adenoma in the experimental group were statistically lower than those in the ontrolled group (P<0.01);the expression of COX-2 (1.96 ± 1.27 vs. 3.64 ± 1.95, t=3.673) and Ki67 (2.04 ± 1.46 vs. 4.50 ± 1.73, t=5.558) in the the experimental group were statistically lower than those in the ontrolled group (P<0.01). The number of the paitents whose COX-2, Ki67 negative rates in the experimental group were 21 and 22, and the control group were 12(P=0.004) and 14 (P<0.001), which showed the significant difference between two groups. Conclusions The Jianpi-Huayu decoction could reduce recurrence of colonic adenoma after endoscopic mucosal resection, the mechanism was decreasing the expression of COX-2, Ki67 in colonic mucosa.

Activator protein-1(AP-1) is a collective term referring to dimeric transcription factors composed of Jun protein family and Fos protein family that bind to the AP-1 sites of many genes,also known as TPA-responsive elements.AP-1 involves in the gene transcriptional regulation of a large number of growth factors and cytokines and leads to a series of physiological and pathophysiological changes of the body.Increasing attention has been paid to the relationship between AP-1 and the allergic diseases in recent years.This article reviewed the structure?activation of AP-1,and the relationship between AP-1 and the allergic diseases.

Cathepsin S is one of the cathepsins that distributes generally at lysosomes of histiocyte in humans body.It has variety of actions when it is unbalancing,including promote inflammation,atherosclerosis,diabetes and obesity,etc.Studies in recent years have demonstrated that there are certain correlations of adiponectin with vascular risk factor and cerebrovascular disease.

Objective To study the preoperative self-efficacy of patients with lumbar disc herniation(LDH) and its influential factors. Methods Seventy-six patients with LDH underwent operation from June 2008 to March 2009 were enrolled in the current study. The patients were investigated with GSES,SAS,SDS and self-made general characteristics before operation. The data were analyzed with SPSS 11.5. Results The score of preoperative self-efficacy was 25. 84 ±6. 76. The course of disease, education level, patients' hobbits could affect self-efficacy (F = 15. 371,P<0.01;F = 18.078,P<0.01;t =2. 368,P<0. 05). Preoperative self-efficacy correlated negatively with the course of disease (r = - 0.541, P < 0. 01). And preoperative self-efficacy correlated with education level and hobbits(r = 0. 589, P < 0. 01; r = 0. 226, P < 0.05) . The score of preoperative dysphoria and depression was significantly higher than norm (P < 0. 01) . Preoperative self-efficacy correlated negatively with dysphoria and depression (r = -0. 494, P < 0.01; r = - 0. 443, P < 0. 01). Conclusions The score of preoperative self-efficacy with LDH is low; the score of preoperative dysphoria and depression is high. Preoperative self-efficacy correlated negatively with the course of disease. And preoperative self-efficacy correlated with education level and hobbits; Preoperative self-efficacy correlated negatively with preoperative dysphoria and depression.

Objective To determine the effects of tacrolimus (FK506) pretreatment on the liver ischemia reperfusion (IR) injury.Methods 32 mature SD rats were randomly assigned into four groups,which were sham-operated group (S),ischemia reperfusion group (IR),low-dose FK506-treated group (L) and high-dose FK506-treated group (H).After the treatment of liver ischemia for 60 minutes and reperfusion for 6 hours,the levels of serum ALT and AST in rats were tested.The TNF-α and IL-1β levels were evaluated by enzyme linked immunosorbent assay.Liver damage was assessed by paraffin sections stained with H&E.The quantitative real-time PCR,the immunohistochemistry and Western blot were used to detect the expression of HMGB1 mRNA and protein with or without FK506 pretreatment.Results The levels of serum ALT [(424.0 ± 137.4)U/L,(291.0 ±42.0)U/L],AST [(554.2 ± 127.7)U/L,(410.2 ±7.0)U/L],TNF-α [(115.1±49.0)ng/L,120.4±28.5) ng/L] and IL-1β [(424.5 ±105.2) ng/L,(612.1 ± 49.6) rig/L] decreased markedly in the group L and group H compared with the group IR (P ＜ 0.05).The liver in the IR group showed hepatic sinusoids congestion,neutrophil infiltration and necrosis.In contrast,tissue damage of the L group and the H group was significantly decreased.The expressions of HMGB1 mRNA and protein reduced significantly when pretreatment with FK506 after reperfusion (P ＜ 0.01).However,there was no significant difference between the group L and group H (P ＞ 0.05).Conclusion FK506 pretreatment can protect the liver by reducing the expression of HMGB1,inhibiting the release of inflammatory cytokines and alleviating cell necrosis after the liver ischemia reperfusion injury in rats.

Gallbladder cancer is a highly malignant tumor of the digestive tract with a poor prognosis. Currently, only radical surgical resection can achieve good results. As an important part of tumor adjuvant treatment and palliative treatment, radiotherapy has been widely used in the treatment of various malignant tumors and achieved certain effect. This article mainly reviews advances of radiotherapy in gallbladder cancer from four aspects: postoperative radiotherapy, preoperative neoadjuvant radiotherapy, intraoperative radiotherapy and palliative radiotherapy for gallbladder cancer.

OBJECTIVE: To classify congenital laryngeal cysts in 62 newborn or infants, and to discuss the characteristics of different operation mode. METHOD: The clinical data of 62 infants with laryngeal cysts treated were reviewed retrospectively. After the examination of neck palpation, laryngoscope and imaging (CT or MRI), all patients were under general anesthesia of laryngeal cyst excision. we select operation mode according to the classification. Classification include: 61 cases of cysts were confined to the larynx, 1 case was beyond the larynx. Surgical managements include: an excision through external carotid approach in 1 case beyond the larynx, 61 cases had endoscopic excision under general anesthesia (12 cases with traditional bite exception, 12 cases with powered system and 37 cases with low-temperature radiofrequency ablation). RESULT: The operations was successful. No recurrence was found after 0.5 to 7 years follow-up. CONCLUSION To chose surgical management after classification and preoperative assessment, which could avoid unnecessary opening surgical approaches, reducing the recurrence, and preventing repeated endoscopic treatment or tracheotomy. The low-temperature radiofrequency ablation had the advantages of short operation time, less bleeding, little injury, low recurrence rate and light postoperative reaction. It is worthy of clinical promotion.
Child, Preschool ; Cysts ; congenital ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Laryngeal Diseases ; congenital ; surgery ; Male ; Retrospective Studies

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.

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.