From 1978 to 1985, 14 patients with accidental injury of extrahepatic bile ducts at cholecystecto-my were reported. The incidence was 0.12%. The injury caused suffering, severe after effects for the patients.In the analysis of the causes, half of the cases occurred due to over-confidence and negligence of operating surgeons. Other causes were as unsatisfactory anesthesia, improper operative incision, blind clamping for control of hemorrhage in the area of the bile ducts, difficult dissection of the Calot's triangle because of anatomical anomaly, fibrosis, inflammation or adhesion. The methods of the prevention were discussed.According to various types of injury, different therapy should be taken. Early intervention, Roux-Y jejunal reconstruction, judicious use of Y tube and prolonged dilatation of hilar strictures will improve the outlook. No mortality and malfunction occurred.

Objective To investigate the role of Rho/Rho kinase -associated cell migration of hepatic carcinoma cell line and inhibition of tumor cell invasion by Rho kinase inhibitor Y-27632. Methods Western blot was used to estimate the expression of Rho protein in the cells. After treatment of SMMC7721 cell with Y-27632, cell biological behaviors such as colony-forming efficiency, adhesiveness, cell motility, in vitro invasiveness, metastatic potential were observed. Results The ability of Y-27632 treated SMMC7721 cells to invade the reconstituted basement membrane decreased significantly ( P

Objective:In order to study the morphological diversification in heterotopic liver auxiliary transplantation(HLAT). Methods:HLAT model in rats was established, the status of rats survival and graft function was evaluated postoperatively by rheometer, SPECT electrical microscope etc. Results:Rat HLAT model was feasible, the operative success rate was 93.3%, one week postoperative survival rate was 80%,the survival time without complications was more than 3 months. The function of the native liver was not affected, as the time goes by, the graft become atrophic after 45 days postoperatively. Conclusion:In HLAT model, the function of the native liver was not affected, 45-days-after the transplantation, the graft become atrophic.

ObjectiveTo investigate the expression and clinical significance of heat shock transcription factor 1 (HSF1) protein in human hepatocellular carcinoma (HCC) tissues,and deduce the probable molecular mechanism of HSF1 in the development and advancement of HCC.MethodsSixty-seven samples of HCC tissue and 21 samples of normal liver tissue were obtained from March 2006 to March 2007 at the Xijing Hospital.The expressions of HSF1 protein and heat shock protein 70 (HSP70) were detected by using immunohistochemistry.The probable molecular mechanism of HSF1 in the development and advancement of HCC was deduced according to the relationship between the expressions of HSF1 protein and HSP70.Positive rates of HSF1 protein in different tissues and the relationship between HSF1 protein expression in the HCC tissues and clinical pathological factors were analyzed by the chi-square test and by calculating Fisher exact probability,respectively.The correlation between the expressions of HSF1 protein and HSP70 in the HCC tissue was analyzed by the Spearman correlation coefficient.The survival curve was drawn by the Kaplan-Meier method,and the survival rate was analyzed by the Log-rank test.ResultsThe positive rates of HSF1 protein expression was 69％ (46/67) in the HCC tissue,which was significantly higher than 29％ (6/21) in the normal liver tissue ( x2 =10.628,P ＜ 0.05 ),The positive rates of HSP70 expression in the HCC tissue was 57％ (38/67),which was significantly higher than 24％ (5/21) in the normal liver tissue ( x2 =6.929,P ＜ 0.05 ).The expression of HSF1 protein in the HCC tissue was positively correlated with that of HSP70 (r=0.319,P ＜0.05).The high expression of HSF1 protein was correlated with the integrity of capsule of HCC,tumor differentiation and TNM stage (x2 =5.935,9.762,5.159,11.267,P＜0.05 ),while the high expression of HSF1 protein was not correlated with the gender,age,levels of hepatitis B surface antigen and alpha fetoprotein,and portal vein tumor thrombus ( x2 =0.822,0.172,2.059,P ＞0.05 ).The survival time was (21.4 ± 1.9 )months for patients with positive HSF1 protein expression and (29.8 ± 2.7 ) months for patients with negative HSF1 protein expression.There was a significant difference in the survival time between patients with positive and negative HSF1 protein expression ( x2 =4.276,P ＜ 0.05 ).Conclusions HSF1 is correlated with the development,advancement,invasion,metastasis and malignant prognosis of HCC.HSF1 takes effects by regulating the expression of HSP70,and it has a good perspective of clinical application for the diagnosis and treatment of HCC.

Objective To investigate the expression of RhoA gene in human hepatocellular carcinoma (HCC) and to discuss its significance during hepatocellular carcinogenesis. Methods Intratumor RhoA expression level was determined and compared with that in adjacent nontumorous hepatic tissues using quantitative real time reverse transcription polymerase chain reaction and Western blot in 64 HCC patients. Results The mRNA levels of RhoA were significantly higher in tumor tissues than that in the unaffected portions (t =3.445 ,P =0.0006). The expression of RhoA mRNA in the primary lesion was higher in patients with venous invasion (t = 2.667, P = 0.009), microscopic satellite lesions (t=2.172,P =0.038), and advanced pTNM stage (stage Ⅱ/Ⅳ; t=2.551,P=0.013) than in those without. There was a significant difference between high RhoA protein levels in the tumor tissues and noncancerous liver tissues in HCC patients (t = 3.532, P = 0.0002), and there was a significant association between high tumor RhoA protein levels and the presence of venous invasion (t = 2.087, P = 0.042), microscopic satellite lesions (t = 2.254, P = 0.031), and advanced pTNM stage (t = 2.812, P = 0.007). Conclusions There is a significant correlation between RhoA expression, tumor stage, and intrahepatic metastasis. The expression of RhoA could be used as a good tumor marker for invasive and advanced carcinoma as well as a prognosis predictor.

Objective To explore the optimized range of normal tissue ablation around the tumor by HIFU in combination with UCA for VX2 liver tumors in rabbits. Methods In this study,51 rabbit models with implanted fiver VX2 tumors were randomly divided into 3 groups:ablating the tumor only(group A)、ablating the tumor and 2 mm eircumferential normal tissue(group B)、and 4 mm normal tissue around the tumor(group C).After HIFU+UCA treatment,the pathology of the targeting tissues,the level of serum ALT,the metastases in the liver、lungs and abdominal cavity,and the survival time were compared with each other. Results After treatment coagulative necrosis was observed in all the target tissues.Serum ALT level between each two groups were statistically different on d3 and d5(F=12.933、18.37,P＜0.01、＜0.01),and the level of ALT in group C was the hightest.The ALT level in group A was significantly higher than group B or group C on the 14th day(F=17.2,P＜0.01).Metastases in group A was significantly higher than group B or group C,and there were no statistically different between group B and C (P=0.353、0.332、0.380).The survival time both in group B and group C were significantly longer than group A(48±13.6,51±12.1 vs 29±5.4),and there were no statistically difference between group B and C(P＞0.05). Conclusions Tumor eradication can be significantly promoted when 2mm normal liver tissue around the tumor is ablated by HIFU+UCA.

Objective To investigate the relationship between β-fibrinogen (β-Fg) gene -455G/A,- 148C/T polymorphisms and atrial fibrillation (AF) with cerebral infarction.Methods Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of -455G/A and -148C/T in 97 patients with AF with cerebral infarction (AF with cerebral infarction group),80 patients with AF alone (AF group),and 98 health subjects (healthy control group).Results The A allele frequencies of -455G/A in the AF with cerebral infarction group and the AF group were 0.304 and 0.344 respectively.They were significantly higher than 0.179 in the healthy control group (all P＜0.05).The T allele frequencies of - 148C/T in the AF with cerebral infarction group and the AF group were 0.348and 0.369,respectively.They were significant higher than 0.240 in the healthy control group (all P＜0.05).Conclusions The A allele of -455G/A and the T allele of -148C/T were associated with AF with cerebral infarction and AF.

Objective To investigate whether IL-24 can inhibit the growth of pancreatic cancer in immune-competent mice,which could be mediated by tumor-targeting oncolytic adenovirus (ZD55-IL-24).Methods Crystal violet staining assay was used to evaluate the anti-proliferative influence of ZD55-IL-24 on Panc02.The tumor growth curve,the tumor formation curve,TUNEL assay,cytotoxic T lymphocyte (CTL) killing assay and serum cytokines detection were used to assess anti-tumor efficacy of ZD55-IL-24 for pancreatic cancer in immune-competent mice.Results ZD55-IL-24 significantly inhibited the growth of pancreatic cancer cells in vitro.Lower tumor formation and slower tumor growth were identified in ZD55-IL-24 group,compared with ZD55-EGFP group or PBS group.ZD55-IL-24 induced pancreatic cancer cells'apoptosis,and mediated anti-cancer immunity by increasing killing responses of CTL to cancer cells and up-regulating serum γ-IFN and IL-6 levels.Conclusion ZD55-IL-24 can induce anti-tumor immunity and suppress pancreatic cancer growth in immune-competent mice.

OBJECTIVETo understand and improve the transdifferentiation of pancreatic stem cells into islet cells through isolation, cultivation and transdifferentiation of adult human pancreatic duct cells.

METHODSA portion of adult human pancreas was digested with collagenase, followed by incontinuous density gradient to separate islets from the acinar and ductal tissue. Duct epithelial cells were cultivated in CMRL1066 and then in serum-free DMEM/F12 medium with the addition of growth factors for 27 days. Samples were taken at different time points for light and electron microscopic examination and for immunocytochemical study with antibodies against transdifferentiation gene PDX-1 and protein CK-19. Amylase and insulin contents in the medium were assayed.

RESULTSA large number of duct epithelial cells were harvested after the isolation of islets. Some duct epithelial cells were PDX-1 and CK-19 positive at day one and duct epithelial cells proliferated and expanded rapidly and then transdifferentiated into stem cells and finally 3D islets. 760 islets were harvested from each gram of pancreatic tissue on day 27.

CONCLUSIONSAdult pancreatic duct cells are potential stem cells and could be transdifferentiated into islet cells in vitro under appropriate conditions.

Adult ; Cell Differentiation ; physiology ; Humans ; Islets of Langerhans ; cytology ; Pancreas ; cytology ; Stem Cells ; cytology

Objective This study was to evaluate the usefulness of the model of end-stage liver disease (MELD) score in comparison with the Child-Pugh classification to predict postoperative mortality and short-term survival in liver transplant patients. MethodsMELD score and Child-Pugh score were computed for each patient according to the original formula on admission day. Kaplan-Meier survival curves were made using the cut-off points calculated by Youden index. ResultsSix out of 40 patients died within three months, MELD scores and Child-Pugh scores for non-survivors (32.2?8.0, 12.3?2.0) were higher than those for survivors (13.4?6, 9.12?2.31) significantly (P