Vascular injury is a severe complication when combined with biliary injuries in laparoscopic cholecystectomy. The most frequent injury is damage to the right branch of the hepatic artery. The incidence ranges between 6. 7% and 61.1%. When bile duct transection is combined with vascular injury, the clinical course is complicated by liver ischaemia or necrosis, biliary stricture, and liver lobar atrophy which sometimes necessitating liver resection or even transplantation. Reconstruction of vascular injury is helpful when the injury is identified early.

To investigate the cause of donor death in living donor liver transplantation(LDLT), we reviewed all published articles in English on LDLT from the Foreign Medical Journal Full-Text Service (FMJS) and searched the literature for donor deaths before 2008. We identified 12 donor deaths. The rate of donor death is 0.2%. Any donor death would be a catastrophe for the donor's family and for the medical team. It is imperative to avoid donor death in LDLT.

Telomeres are the unique structure at the end of chromosomes,which pose two special challenges for the cellular DNA replication and repair machinery.Because of the inability of lagging strand synthesis to fully replicate a linear template,the chromosome ends is progressively shortening at each replication cycle.The tandem DNA repeats must maintain enough length to allow the cell dividing and mitosing,otherwise the cells would lose the dividing ability and undergo replicative senescence.There are two special pathways to regulate telomere length,which consist of telomerase and alternative lengthening of telomeres(ALT).SUMO is an evolutionarily conserved protein,which is covalently attached to target proteins and alters their conformation,stability,interaction and localization.Currently,a lot of proteins have been proved to be the substrates of SUMOylation.A growing body of evidence implicate that SUMOylation plays a very important role to elongate telomeres in both telomerase and ALT.The Rad5 and Rad52,as well as BLM have been showed either to be modified by SUMO or to interact with SUMO.SUMOylation positively modifies the activity of telomere.

AIM:To investigate the effects of xeroderma pigmentosum D ( XPD) and p53 on the replication of hepatitis B virus ( HBV) .METHODS:Recombinant plasmid pEGFP-N2/XPD and vacant vector plasmid pEGFP-N2 were transfected into HepG2.2.15 cells by liposome.On the next day, these cells were incubated with pifithrin-α, a p53 inhibi-tor, at a concentration of 20 μmol/L for 24 h.The cells were divided into 5 groups: blank control group, pEGFP-N2 group, pEGFP-N2/XPD group, pEGFP-N2/XPD+pifithrin-αgroup and pifithrin-αgroup.The mRNA expression of XPD, hepatitis B surface antigen ( HBsAg) , hepatitis B e antigen ( HBeAg) and hepatitis B virus X protein ( HBx) was detected by RT-PCR.The content of HBsAg and HBeAg in the supernatants of culture medium was measured by ELISA.The con-tent of HBV-DNA in the supernatants of culture medium was examined by fluorescence quantitative PCR.Using the method of bDNA, the content of HBV-DNA in the core particles was assessed.RESULTS:The expression of XPD mRNA was ele-vated by the transfection of recombinant plasmid pEGFP-N2/XPD.The increase in XPD expression significantly down-regu-lated the mRNA expression of HBsAg, HBeAg and HBx.The content of HBsAg and HBeAg in the supernatants of culture medium was significantly decreased by the increase in XPD expression.The results of fluorescence quantitative PCR showed that the content of HBV-DNA in the supernatants of culture medium was significantly down-regulated by the increase in XPD expression.bDNA results showed that the content of HBV-DNA in the core particles was significantly decreased by the increase in XPD expression.Pifithrin-αabolished the above-mentioned effects of XPD (all P<0.01).CONCLUSION:XPD inhibits the replication of HBV through p53 pathway.Therefore, XPD and p53 may be the targets for antiviral therapy of hepatitis B.

miR-224 is a small noncoding RNA that usually binds to response element of target mRNA through the seed sequences,leading to the suppression of translation or mRNA degradation. Recent researches indicate that miR-224 not on?ly aberrantly expresses in multiple tumors(hepatocellular carcinoma,gastric carcinoma, diffuse large B-cell lymphoma, prostatecancer,colorectal cancer, etc),playing an important role in tumor suppressor or oncognen,but also has an effect on the chemosensitivity of tumor.In this article,we review recent studies about the mechanism of miR-224 in the tumor develop?ment ,progression and chemosensitivity.

Objective To explore the safety and effectiveness of using low molecular weight heparin (LMWH) in place of warfarin for anticoagulation in patients with a previous cardiac valve replacement. Methods We reviewed 70 patients hospitalized from Jan 2002 to Apr 2009 undergoing abdominal surgery who have had a previous cardiac valve replacement and had been on warfarin anticoagulation therapy. LMWH began to replace warfarin for anticoagulation 3 clay before the surgery in 33 cases, while the other 37 patients simply ceased to use any anticoagulant since 3 days before the surgery. Postoperative bleeding and embolism risk were compared between these two groups. Results There were 2 patients suffering from postoperative bleeding in the operative field in LMWH group, while there was no postoperative bleeding in patients on anticoagulant suspension group (χ~2=0.641, P>0.05). There was no valve embolism occurred in these two groups. Conclusions It is a safe way to stop using warfarin with LMWH taking the task for perioperative anticoagulation in patients with a history of cardiac valve replacement 3 days before an elective abdominal surgery. This protocol decreases the risk rate of valve embolism not at the expense of increasing postoperative bleeding.

Objective: To study the impact of vascular injury on neointimal hyperplasia and the expressions of nuclear transcription factor-κb (NF-κb), tissue factor (TF), endothelin-1 (ET-1) and matrix metalloproteinase-3 (MMP-3) in experimental rabbit model.
Methods:A total of 32 male New Zealand big-eared white rabbits were used to establish vascular injury model by femoral artery puncture, balloon was sent to abdominal aorta via the wire followed by balloon dilatation to strain abdominal aorta. Blood sample was taken from femoral artery sheath 1 minute after operation, and the rabbits were killed at 4 weeks after operation, meanwhile blood sample was taken from the heart. Injured arteries were isolated, ifxed and embedded; slices were stained by HE, basic fuchsine and NF-κb immunohistochemical methods for light microscope observation; slices were also stained by lead and uranium for transmission electron microscope observation. Neointimal thickness was measured by computer analysis, vascular injury integral and NF-κb positive cell rate were determined, blood levels of TF, ET-1 and MMP-3 were examined by ELISA. The relationship between vascular injury integral and the contents of TF, ET-1, MMP-3 and NF-κb positive cell rate were analyzed by SPSS statistical software.
Results: The optimal iftting curve between vascular injury integral and neointimal thickness was S-shaped cubic curve. NF-κb was mainly expressed in neointima, vascular injury integral was positively related to NF-κb positive cell percentage, Pearson correlation coeffcient was 0.916,P<0.05. Vascular injury integral was positively related to the contents of 1 min post-operative TF; 1 min and 4 weeks post-operative ET-1; 1 min and 4 weeks post-operative MMP-3; Pearson correlation coeffcients were 0.925, 0.957, 0.947, 0.914 and 0.940 respectively, allP<0.05.
Conclusion: Vascular injury may activate NF-κb pathway, promote ET-1 and MMP-3 expression, therefore accelerating neointimal hyperplasia, leading negative vascular remodeling, TF was an initiating factor for neointimal hyperplasia. Internal elastic lamina was the key structure reflecting vascular injury, it is the only barrier hindering neointimal hyperplasia in experimental rabbit model.

Obesity is a rapidly growing international health problem. The association of fat mass and obesity associated(FTO) gene and obesity is becoming the hot topic in the gene research. FTO is a member of the nonheme dioxygenase [Fe(Ⅱ) and 2-oxoglutarate-dependent dioxygenases]superfamily. FTO levels in the brain,especially in the hypothalamus,participate in the central control of food intake. The mutation of FTO gene accentuates body mass index,hip circumference and total weight,leading to obesity.

The serine protease HtrA2/Omi is released from the mitochondrial intermembrane space following apoptotic stimuli.Once in the cytosol,HtrA2/Omi has been implicated in promoting cell death in caspase-dependent or caspase-independent pathway.On the other hand,HtrA2/Omi can refold and degrade misfolded proteins in the mitochondria during cell stress.

Complement receptor of the immunoglobulin superfamily ( CRIg) can regulate immune reactions via T cells and cy-tokines and is involved in various diseases .The effect of CRIg on the pathogenesis of immunological liver injury , intestinal ischemia-reperfusion injury , type Ⅰdiabetes mellitus , experimental autoimmune uveoretinitis , and rheumatoid arthritis etc .in animal models of disease are reviewed in this article .