?-L-fucosidas:-(AFU)activity was determined by referring to Troost's method in sera, liver tissues and lesions from patients with htpatocellular carcinoma (HCC), other liver space-occupying lesions (SOL)and diseases.The results showed that the sensitivity and specificity for the diagnosis of HCC were 81.2% and 83.3% respectively with the assay of serum AFU activity, and the sensitivities in the diagnosis of AFP-negative and early HCC were 76.1% and 70.8%, respectively.The AFU activity in the HCC tissues and their peri cancerous liver tissues was twice as much as controls, and consisted with their serum AFU activity (r= 0.742, P

Transforming growth factor β( TGF-β) plays an important role in regulating cell proliferation , differentiation and apoptosis , and also in the carcinogenesis .Unlike its tumor suppressor function in normal tissue , continuous activation of TGF-βsignaling pathway in inflammatory microenvironment and cancer tissue promotes the progression of hepatocellular carcino-ma ( HCC) .Loss of Smad4 and epithelial to mesenchymal tran-sition ( EMT ) may be the potential mechanisms how TGF-βtransforms from a tumor suppressor to a tumor promoter .Further studies on regulatory mechanism of TGF-βsignaling pathway are of great significance , which could provide new evidence for pre-venting and treating HCC .

Hepatocellular carcinoma (HCC) with a diameter > 5 cm is defined as large HCC. Hepatic resection is the first choice for solitary large HCC with intact capsule and without satellite nodules. The key to successful large HCC resection is to judge the resectability and estimate the remnant liver function preoperatively. Moreover, the liver must be exposed and dissociated adequately, and familiarity with the anatomy of the liver is crucial. Choosing the right technique of hepatic blood flow occlusion and avoiding excessive resection of the liver are important elements. Special attention should be paid to the efficacy of liver transplantation for patients with large HCC exceeding Milan criteria, h is advisable to resect large HCC actively.The hepatic resection is safe and feasible in selected patients with large HCC.

Objective To explore the relationship between anomalous pancreaticobiliary ductal junction(APBDJ) and gallbladder carcinoma. Methods The current related literatures were reviewed.Results APBDJ was associated with gallbladder carcinoma development. A proposed mechanism was free reflux of pancreatic juice into the gallbladder and molecular alterations of gallbladder epithelial cells.Conclusion APBDJ is a high risk factor for gallbladder carcinoma. Prophylactic cholecystectomy is recommended for patients with APBDJ.

Statins, hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors , are widely used as a class of lipid-lowering drugs in clinic. Recent studies have shown that the use of statins can be anti-inflammatory, anti-fibrosis and reduce the incidence of hepatocellular carcinoma (HCC), which may provide a new method for the preventive treatment of HCC. This article will review the current research progress of statins, including the clinical evidence, the molecular mechanisms of anti-inflammatory, anti-fibrosis and anti-tumor in liver.

Background and purpose:New treatment methods should be explored for non-small cell lung cancer (NSCLC) patients with acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). This study compared the curative effect of pemetrexed with geiftinib or pemetrexed alone in advanced NSCLC with acquired resistance to EGFR-TKI.Methods:This study included 62 NSCLC patients with advanced EGFRgene mutation and acquired resistance to EGFR-TKI. Among those, 32 patients were treated with pemetrexed and geiftinib, and 30 patients treated with geiftinib alone. The differences in outcomes between the two strategies were assessed.Results:Objective response rate (ORR) was 46.9% for those treated with pemetrexed and geiftinib and 20%for those treated with pemetrexed alone(χ2=4.933,P<0.05). There was no signiifcant differences between the two groups on disease control rate (DCR) (P>0.05). The median progression-free survival (PFS) was 8.0 months on pemetrexed and gefitinib group and 6.3 months on pemetrexed alone (χ2=8.063,P<0.05). There was no significant differences between the two groups on overall survival (OS) (P>0.05). Higher occurrence of leukocytopenia and rash was observed in the pemetrexed and geiftinib group than in the pemetrexed group (P<0.05). There was no signiifcant differences be-tween the two groups on grade 3-4 toxicities (P>0.05).Conclusion:This study was to demonstrate that continuation of EGFR-TKI with pemetrexed in patients with acquired resistance improves outcomes compared with pemetrexed alone. An improved response rate and PFS were observed in this study. A larger prospective clinical trial is needed to further evaluate this promising strategy.

Objective To study the efficacy of complete hemihepatic vascular exclusion (CHVE) in the prevention of tumour dissemination during liver resection for hepatocellular carcinoma (HCC).MethodsA case-control study was carried out on 281 patients who underwent liver resection for HCC between February 2006 and April 2010.89 patients underwent hepatic resection using CHVE (group A) and 192 using Pringle maneuver (group B).The postoperative 1-,2-,3 year rates of intrahepatic recurrence and lung metastasis,and the overall disease-free survivals were compared between the two groups.ResultsThe incidence of lung metastasis at 1 year after operation was significantly lower in group A than group B (6.7％ vs.15.1％,P=0.048).There were no signilicant differences in the incidences of lung metastasis at postoperative year 2 and 3 between the two groups (15.7％ vs.25.0％ and 32.6％ vs.30.7％ ; P＞0.05).The differences in the postoperative 1-,2-,3- year intrahepatic recurrence rates were not significant between the two groups (20.2％ vs.31.8％,51.7％ vs.60.3％,68.5％ vs.79.2％,respectively; P＞0.05).The median survivals of the two groups were 25.9 months and 21.7 months,respectively.Patients in group A had a significantly higher overall disease-free survival rate than patients in group B (P=0.035).ConclusionsCHVE was efficacious in reducing the incidence of lung metastasis and in improving the overall disease-free survival in patients after liver resection for HCC.CHVE contributed in preventing intraoperative tumour dissemination and in improving prognosis.

Objective To review the recent studies regarding etiology and management of diarrhea after liver transplantation. Methods The current related literatures about the etiology and management of diarrhea after liver transplantation were reviewed. Results There were approximately 10.00% to 35.44% recipients developed diarrhea after liver transplantation. Other symptoms such as severe body fluid and electrolyte loss, discomfort, and increase blood level of immunosuppressive drug can be caused by diarrhea as well. Clostridium difficile, cytomegalovirus, rotavirus infection and immunosuppressant were main etiological factors. It is important to find out the inducement of diarrhea and work out the corresponding management and other supportive care on the basis of the etiology. Conclusion Diarrhea is a common complication of liver transplantation whose etiology is complex. Appropriate approaches may be helpful to decrease the risk of this complication.

Evidence-based medicine emphasizes making project of diagnosis and therapy on the basis of the most objective research results. The current condition in which domestic medicine is dominant in hepatobiliary surgery and teaching needs to be changed urgently. The procedure of application of evidence-based medicine in teaching of hepatobiliary surgery is explained by an actual example. Evidence-based medicine plays an important role in teaching and quick progress in all of the hepatobiliary surgery.

Objective To investigate the adenoviral vector encoding the whole humanized antibody gene of pres_2 antigen for preventing the liver graft from infection by the hepatitis B virus. Methods The whole humanized antibody gene to pres_2 antigen was cloned into type 5 adenoviral shuttle plasmid pDC315. The corresponding recombinant virus was obtained by homologous recombination in 293 packaging cells. The virus containing the whole humanized antibody gene of preS_2 antigen was transfected into the rat liver graft during cold preservation. The effect of the recipient serum containing preS_2 antibody protecting human hepatocytes from hepatitis B virus infection was observed. Results The viral titer determined by TCID50 analysis was 5.1 ?10 10 PFU/ml. The concentration of preS_2 antibody was ( 16.7 ? 10.5 ) mg/L on the day 3 and ( 30.9 ? 13.6 ) mg/L on the day 7. The serum containing preS_2 antibody could protect human hepatocytes from hepatitis B virus infection in vitro when the concentration of the preS_2 antibody was more than 0.5 ?g/ml. Conclusions The adenoviral vector encoding the whole humanized antibody gene of preS_2 protein were constructed successfully. The whole humanized antibody was expressed. The preS_2 antibody in recipient serum protecting human hepatocytes from hepatitis B virus infection was observed, which might be a new method to prevent hepatitis B re-infection after liver transplantation.