S-adenosylmethionine(SAM) is a physiologically active molecule in all the organizations and the human body fluids, and it is important to participate in a variety of biochemical reactions, the regulation of liver regeneration, liver cells differentiation and various sensitivity of the injury. The SAM affects the liver through a variety of ways. It is confirmed that the SAM and MTA can block the LPS-induced TNF-α of Kupffer cells to protect the liver. In a word, S-adenosylmethionine may be beneficial to LPS-induced liver in-jury in clinical treatment.

Primary hepatic carcinoma is one of the common digestive tract tumors.Surgical operation in clinic is still the most effective way to treat it so far.The caudate lobe has often been considered the forbidden zone of hepatic operation in the past due to complicated anatomy.In resent years,with the deepening of knowledge of anatomy and advanced radiological technology,many new operative approachs and operation methods have been explored to improve the situation of caudate lobectomy which is already not rare in clinic now.This article summarized the anatomy of caudate lobe and reviewed the therapy progress of the hepatic carcinomas located caudate lobe.

Primary gallbladder cancer is a relatively common biliarv malignant tumor but with a high mortality rate.Most patients with this disease reach an advanced stage when late onset symptoms occtur, and the prognosis tends to be poor even after radical operation.Searching for new diagnostic approaches of primary gallbladder, standardizing treatment strategy, conducting multieenter clinical trials of new drug, developing preventive measures according to different situations are significant methodls to improve the treatment effect prognosis.In this article, we reviewed the research progress of high risk factors, diagnostics, and treatment strategies of primary gallbladder cancer.

Objective To investigate the role of glucocorticoid-induced tumor necrosis factor ligand (GITRL) in regulating the inflammatory reaction of kupffer cells.Methods The kupffer cells and T cells of mice were isolated and divided into 6 groups after being co-cultured:control group,kupffer cells and T cells were cultured in DMEM only; lipopolysaccharide (LPS) group,kupffer cells and T cells were cultured in media with LPS (1 mg/L) ; LPS + GITRL siRNA group,kupffer cells and T cells were cultured in media as the LPS group after transfected with GITRL siRNA ; LPS + control siRNA group,kupffer cells and T cells were cultured in media as the LPS group after transfected with control siRNA; LPS + pEGFP-N1 GITRL group,kupffer cells and T cells were cultured in media as the LPS group after transfected with pEGFP-N1 GITRL plasmid; LPS + pEGFP-N1 control group,kupffer cells and T cells were cultured in media as the LPS group after transfected with control plasmid.After 24 hours of treatment,the expressions of GITRL and PDL1 of kupffer cells were detected by immunofluorescence and western blot,respectively.The proliferation and apoptosis of T cells were measured by MTF assay and Annexin V/PI flow cytometry,respectively.The expression of tumor necrosis factor (TNF-α) in the supernatant fluid was measured by ELISA.All data were analyzed using the independent t test and one-way analysis of variance.Results The transfection efficiencies of GITRL siRNA and pEGFP-N1 GITRL were 90％ and 85％,respectively.Compared with normal kupffer cells,the protein expression of GITRL of kupffer cells transfected with GITRL siRNA was significantly decreased,while the protein expression of GITRL of kupffer cells transfected with pEGFP-N1 GITRL was significantly increased (t =41.72,13.10,P ＜ 0.05).There was no significant difference in the protein expressions of GITRL between normal kupffer cells and those in the control groups (F =2.27,P ＞ 0.05).The fluorescence intensity of GITRL in the LPS group was significantly higher than that in the control group (t =49.29,P ＜ 0.05).Compared with LPS group,the activation of GITRL expression by the LPS was significantly suppressed in the LPS + GITRL siRNA group (t =9.84,P ＜ 0.05),while the expression of GITRL in the LPS + pEGFP-N1 GITRL group was significantly increased (t =5.78,P ＜ 0.05).There was no significant difference in the GITRL expression among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =0.86,P ＞ 0.05).The expression of PDL1 in the LPS group was significantly lower than that in the control group (t =18.83,P ＜0.05).Compared with LPS group,the expression of PDL1 in the LPS + pEGFP-N1 GITRL group was significantly suppressed (t =11.79,P ＜ 0.05),while the expression of PDL1 in the LPS + GITRL siRNA group was significantly stronger (t =19.08,P ＜ 0.05).There was no significantly difference in the expression of PDL1 in the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =2.22,P ＞ 0.05).The proliferation of T cells was increased and the number of apoptotic T cell was decreased in the LPS group when compared with control group (t =49.43,40.11,P ＜ 0.05).Compared with LPS group,the proliferation and apoptosis of T cells in the LPS + pEGFP-N1 GITRL group had the same trend (t =5.77,12.64,P ＜0.05); while the proliferation of T cells was decreased and the apoptosis of T cells was increased in the LPS + GITRL siRNA group (t =17.00,49.90,P ＜ 0.05).There was no significant difference in the proliferation and apoptosis of T cells among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =1.87,1.35,P ＞ 0.05).The expression of TNF-α was significantly higher in the LPS group than that in the control group (t =125.68,P ＜ 0.05).Compared with the LPS group,the expression of TNF-α was significantly decreased in the LPS + GITRL siRNA group (t =119.65,P ＜ 0.05),while the expression of TNF-α in the LPS + pEGFP-N1 GITRL group was significantly increased (t =147.70,P ＜ 0.05).There was no significant difference in the TNF-α expression among the LPS + control siRNA group,LPS + pEGFP-N1 control group and LPS group (F =0.14,P ＞ 0.05).Conclusion Kupffer cells suppress the expression of PDL1 by upregulating GITRL,and thus activate the proliferation of T cells and promote the inflammatory reaction.The immunologic balance may be recovered after the interference of GITRL to restrain the inflammatory reaction.

Objective To study the protective mechanism of S-adenosylmethionine ( SAM) underlying liver injury induced by lipopolysaccharides ( LPS). Methods One hundred BABL/c mice were randomly divided into LPS group and SAM group. Mice in LPS group were intraperitoneally injected with 10 mg/kg LPS,and the mice in SAM group were injected with 100 mg/kg SAM 2 h before receiving the same dose of LPS. The survival rate of mice in 2 groups was recorded in 24,48,72 and 120 h after LPS injection. Histopathological changes in liver of mice were examined in 0,1,3,6,12 and 24 h after LPS injection. Tumor necrosis factor-? ( TNF-?) and interleukin-10 ( IL-10) levels in serum were measured by ELISA analysis at above time points. Expression of Toll-like receptor 4 ( TLR4) and liver X receptor ? ( LXR?) in hepatic tissues was detected by immunohistochemistry and Western blotting. Results SAM increased the survival rate of mice from 50. 0% ,40. 0% ,30. 0% ,and 30. 0% before LPS injection to 80. 0% ,70. 0% ,60. 0% ,and 50. 0% after its injection ( P

0.05).However,body mass index and hemoglobin level were significantly higher in the slow coronary flow group compared with the control group(26.9?3.2 kg/m2 vs.24.9?2.9 kg/m2,P

Objective To investigate the protective effect and the possible mechanism of lipopolysaccharide(LPS) preconditioning on ischemia/reperfusion injury of rat graft liver.Methods Male Sprague-Dawley rats were divided into three groups(n=30 in each group): sham operation group(Sham group),orthotopic liver transplantation group(OLT group) and LPS preconditioning group(LPS group).Only dissecting hepatoduodenal ligament was perfomed in Sham group.On day one,0.1 mg/kg LPS and on day 2,3,4,5,0.5 mg/kg LPS for LPS rats and 0.5 ml PBS pathogen-free solution for OLT rats was injected through caudal vein before OLT was performed by two-cuff method in the two group rats on day 8.The levels of tumor necrosis factor-?(TNF-?),ALT, AST in inferior caval vein blood and the activities of NF-?B in hepatic tissue were detected at 0,60,180 min after dissecting hepatoduodenal ligament in Sham group and after portal vein reperfusion in OLT group and LPS group.The morphological changes of hepatic tissue were observed through light microscope and electron microscope at different time points.Results As compared with Sham group at the different time points respectively,the activities of NF-?B and the levels of TNF-? were higher in OLT group and LPS group(P

Objective To investigate the effect of gadolinium chloride (GdCl3) on the H22 experimental hepatocarcinogenesis in mice. Methods Totally 80 mice were inflicted to experimental hepatoma by implanting H22 cells to their liver lobes, and then equally and randomly divided into experimental hepatoma group (B) and GdCl3 pretreatment group (10 mg/kg, C). Another 40 mice served as normal control group (A). Ten mice from every group were killed respectively 7, 14, and 28 d after implantation. The left 10 mice were used for recording survival time and measuring the mass weight. Hepatic pathological histology was observed, and the expression of TNF-? was detected by ELISA and RT-PCR. Results ①Survival time was obviously higher in group B than in group C (P

Objective To study the expression of lipopolysaccharide(LPS) receptor,CD14 in the liver tissue during acute biliary infection and its relation with production of cytokines.Methods Rat models of acute biliary infection were established by ligating the choledochus and injecting Escherichia coli O111∶B4 into the duct.The expressions of CD14 protein and mRNA in liver tissue,the plasma levels of endotoxin,TNF-? and IL-6,and phagocytosis activity of Kupffer cells(KCs) were assayed at 0,3,6,12 and 24 h after operation.Ultrastructural changes in KCs were observed by electron microscopy.Results With the course prolonging in acute biliary infection,the plasma endotoxin level was progressively increased,KCs were activated and the levels of TNF-? and IL-6 markedly were increased,while the CD14 expression obviously increased at mRNA and protein levels.Conclusion The CD14 expression is gradually increased in liver tissue during acute biliary infection.KCs are activated and releasing more and more cytokines.It might be one of the important mechanisms of that KCs improve inflammatory response during the infection.

Objective To assess the value of CT in diagnosis of recurrent rectal carcinoma.Methods Forty seven patients who had undergone locally curative surgery were examined by CT.All patients received intravenous contrast medium and two oral doses and a intrarectal doses of 500 ml 3% Ultravist were given.The characters of benign and malignant lesions were analysed in order to evaluate the value of the classification on CT in the differentiation of benign masses from malignant ones.Results 26 local recurrences occurred in 47 cases,including 13 cases with an round preasacral mass,8 cases with an irregular rectal wall thickening,2 cases with a flat preasacral mass,3 cases with a preasacral mass with low attenuation.The degree of enhancement of local recurrent masses was higher than that of benign masses.Conclusion The features of recurrence of rectal carcinoma on CT is an round or irregular asymmetrical preasacral mass or an irregular rectal wall thickening.It is useful way in diagnosis of recurrence of rectal carcinoma.