Gene mutation is the molecular basis of the pathogenesis of primary liver cancer, and precise treatment based on gene mutation is an important direction for the treatment of liver cancer in future.This article introduces the current status, complexity, and prospects and future directions of precise treatment for liver cancer from the aspects of complex gene mutations in liver cancer, level of mutation detection, and limitations of clinical trials.It is pointed out that there are many challenges in precise treatment for liver cancer, but precise treatment still has a promising future.

Objective To investigate the clinical and pathological features of primary hepaticepithelioid hemangio endothelioma (EHE) and try to improve the understanding and diagnosis of this disease.Methods From January 2007 to January 2013,the data of 17 patients with hepatic EHE were retrospectively analyzed,which included clinical,pathological and radiological characteristics,treatment and survival condition of these patients.Results Among 17 cases of hepatic EHE,there were 11 female and six male with the mean age of 46.2 years.Seven patients had right upper quadrant pain of dull pain in liver and the left 10 cases were without any symptoms.The liver function of most patients (15 cases) was normal.The admission diagnosis was mostly misdiagnosed as hepatocellular carcinoma (metastatic liver carcinoma six cases,primary liver carcinoma four cases).Extrahepatic metastasis was found in three patients before operation.The major lesion of the tumor was multiple nodules (10 cases) and most of which were under liver capsule.Retraction of the liver capsule was found in the imaging examination.The features of pathology were intracellular lumen and vacuoles formed in small cells,in which single or couple red blood cells could be found.Nuclear deviation was found in single tumor cell which looked like signet ring cells.The results of immunohistochemistry indicated the positive rate of factor vimentin (4/5) antigen and CD34 (15/17) was high.Surgical resection (14 cases) was the main treatment of hepatic EHE.Fourteen patients were still alive followed up for two to 72 months after operation.Conclusions The incidence of hepatic EHE is low,and it was susceptible to middle aged women and without obvious symptom.No obvious abnormality is found in laboratory examination.Surgical resection is the main treatment which enabled a good prognosis.

Background and purpose:Norcantharidin(NCTD)can inhibit the growth of tumors.In this study,we presented the chorioallantoci membrane(CAM)model to evaluate the effect of NTCD on angiogenesis and to study the anti-angiogenesis of NTCD in the chicken embro implant model of human breast carcinoma MCF-7 cells.Methods:The method was based on the implantation of gelatin sponges on top of growing CAM.The sponges were treated with various amounts of NCTD and 0.9% NaCl.Blood vessels surrounding CAM mesenchyme were counted.Then we established the MCF-7 chicken embryo implant model.The chicken embryo CAMs was treated with 0.9% NaCl,Various amounts of NCTD(72,36,18 ?g per 20 ?l)and the inhibition rates were calculated.Results:NCTD can inhibit the new capillary vessels growing into gelatin sponges placed on the CAM in a dose-dependent manner,and the inhibitory rates were 77.7%,62.9%,50.6% and 33.0% respectively.NCTD at the dosages of 72、36、18 ?g were able to inhibit capillary growth regardless of the angiogenic process induced by xenograft tumor and had a significant inhibition as compared with the control group,and the rates were 66.2%,39.3%,22.8% respectively.Conclusions:NCTD has an anti-angiogenic effect for targeting tumor angiogenesis.NCTD may be a potential therapeutic candidate for clinical application.

Objective To choose the optimum extraction process for capsule of Buyang Huanwu.Methods With the orthogonal method,the main factors effecting the water-extraction process,such as the quantity of water,the time,pH and degree for decoction,were reviewed according the content of total glycoside and Astragalus Glycoside A.Results The optimum condition of water-extraction was extracting with 8 times amount of water for the first time and 4 times amount for the second and third time,1 hour for each time,pH was 12.Conclution The experimental results provide the basis for the water extraction process for capsule of Buyang Huanwu.

Children with biliary atresia generally present nutritional deficiency, and often have growth failure and neurodevelopmental impairments.Increasing evidence shows that malnutrition is not only a risk factor for growth failure and neurodevelopmental impairments in children with biliary atresia, but also a risk factor for morbidity and mortality.Nutritional support is extremely important to improve the prognosis.This article reviews the relationship between malnutrition, growth failure and neurodevelopmental impairments in children with BA, and discusses the timing and methods of nutritional support.

Objective To evaluate clinical application of phage amplified biologically assay (PhaB) in susceptibility test of Mycobacterium tuberculosis (MTB) in sputum. Methods The drug susceptibility of MTB was detected by PhaB in 143 patients with sputum-positive pulmonary tuberculosis (PTB),and the chemotherapy regimens were adjusted according to the results of susceptibility test.Independent samples t-tests were used for comparison of means.Count numbers were compared with Chisquare test.If there were count number of 0,Fisher probabilities should be used.ResultsThe total positive rate of PhaB was 94.4％ (135/143) with no differences between three types of PTB (x2 =1.886,P ＞ 0.05 ).The duration of testing for PhaB group was (6.6 ± 1.8) days,while for control was (29.4 ±8.7) days (t =29.01,P ＜ 0.01 ).Compared with control group,the 2-month negative-conversion rate (63.2％ vs.35.1％,x2 =3.989,P ＜ 0.05 ) and cure rate ( 100％ vs.78.4％,P ＜ 0.05 ) of PhaB group in type Ⅱ patients were significantly higher.But there were no differences between PhaB and control groups in type Ⅰ and Ⅲ PTB patients.ConclusionThe results of PhaB drug susceptibility test can be helpful for choosing effective chemotherapy regimen for PTB patients rapidly.

Objective:To observe the influence of isehemia-reperfusion(I/R)on hepatoma growth and on the expression of genes associated with tumor metastasis and recurrence(VEGF and MMP-9)in the adjacent tissues of cancer in nude mice. Methods:BALB/c nude mouse model bearing Hep3B-tumor in the liver was established and the model mice were evenly randomly into 5 groups:sham group and ischemia/reperfusion 1 h,6 h,5 d,and 7 d groups(n=8).I/R models were established by blocking porta hepatic;the sham group underwent the same treatment as the I/R model group except for blocking of porta hepatic.ALT and AST were detected in I/R 1 h and 6 h groups.Real-time-PCR was employed to detect the change of VEGF and MMP-9 in the adjacent tissues of cancer and the results were compared with that of the control group(n=6). Histopathological changes of liver were studied by H-E staining and necrotic areas were calculated in I/R 5 d and 7 d groups (n=6).The remnant tumor bearing mice were sacrificed 2 weeks after I/R to measure the volume and mass of the tumors. Results:Two weeks later,the tumor volume and mass in I/R group were increased compared with those in the sham group ([209.6?25.74]mm~3 vs[330.6?32.01]mm~3,[0.214?0.036]g vs[0.374?0.045]g,P

Objective To investigate the efficiency and safety of laparoscopic hepatectomy (LH) and open hepatectomy (OH) in patients with hepatocellular carcinoma (HCC). Methods A total of 45 HCC cases undergoing hepatectomy from January 2008 to December 2010 in our hospital were divided into LH group ( n =21 ) and OH group ( n =24 ).Their clinical efficiency and safety were compared and analyzed. Results The amount of intraoperative blood loss and blood transfusion in LH group were significantly higher than that of OH ( respectively x2 =3.973,x2 =4.862,all P ＜ 0.05 ).LH is associated with less postoperative complications and duration of hospital stay,compared with OH ( respectively x2 =4.746,t =-2.717,all P ＜0.05).Cumulative survival rates in both groups were not statistically significant ( x2 =0.172,P ＞ 0.05 ).However tumor-free survival rate in LH was significantly higher,superior to that of OH (x2 =4.543,P ＜ 0.05). Conclusions LH and OH are all safe and effective hepatectomy for HCC.LH has the advantage of less complication and shorter hospital stay.

Objective To establish a canine model of fulminate hepatic failure ( FHF) and study the treatment of FHF by partial orthotopic liver transplatation(POLT).Methods Carbon tetrachloride (CCL4) mixed with the same amount of peanut oil in the dosage of 0.9 ml per kilogram of body weight was injected intraperitoneally to canines. ALT,tolal bilirubine(TB), PT, NH 4,and blood suger(BG) were monitored. The pathological changes were observed when the canine died,remain alived animal were killed on 7th day and 14th day respectively. EEG was performed on 3rd day after the model eslablished. Results After CCl 4 was injected, the canine showed progressive hepatic failure, ALT, TB and NH rose persistantly, PT prolonged, and BG decreased (P

Objective To compare the operation effects of sensation restoration after tumor resection in the head and neck defects reconstruction by anterolateral thigh flap with or without sensory nerve transplantation.Methods The application of 76 cases anterolateral thigh flaps in head and neck defects reconstruction after tumor resection from May,2011 to May,2015 were observed.35 patients underwent simultaneous reconstruction with sensory nerve anastomosed perforator based anterolateral thigh flap and 41 patients underwent simultaneous reconstruction without sensory nerve graft based anterolateral thigh flap,which was named as group A and group B,respective ly.The treatment effectiveness of the two groups was compared and graded into First,Second and Third rate.Results All the 76 flaps survived.Satisfying morphology for the maxillofacial region and stage-one healing for the donor site was available.During the 24-week follow-up,group A were 65.71％ (First rate),28.57％ (Second rate),5.72％(Third rate) respectively,and the condition of group B were 31.70％,26.84％,41.46％.The treatment effectiveness of group A was better than that of group B.Postoperative complications were less than group B(P ＜ 0.05).Conclusion Compared with the loss of nerve transplantation of anterolateral thigh perforator flap,sensory nerve anastomosed perforator based anterolateral thigh flap is of great value to reconstruct the defect after resection of tumor in head and neck region and restore the sensation of flap.