Objective To explore the relationship between mdr1 gene expression of hepatocellular carcinoma (HCC) and pathological characteristics,chemotherapy and prognosis. Methods The mdr1 gene expression of HCC in 56 patients with the methods of immunohistochemistry was studied. The results were analysed with the pathological data by statistic methods. Results The positive expression of mdr1 gene in cancer tissues and pericancerous tissues of HCC were 30/56(53.6%) and 19/56 (33.9%) respectively. The difference was statistically significant (? 2=4.39, P

Objective To review the advances in overcoming multidrug resistance of tumors caused by mdr1 gene. Methods Different ways of overcoming multidrug resistance of tumors caused by mdr1 gene in the literatures were reviewed. Results One of the important reasons causing multidrug resistance was due to the overexpression of mdr1 gene and its product P-glycoprotein. There were two ways to overcome multidrug resistance of tumors through mdr1 genes mRNA and its product P-glycoprotein effectively.Conclusion The clinical test of the unitary way to overcome multidrug resistance of tumors is unsatisfactory, combining different ways to overcome multidrug resistance of tumors will be the hot spot of tumors research in the future.

Objective To report the diagnosis and treatment of hilar cholangiocarcinoma.Methods The relevant information about the hispathological feature, transfer ways, clinical manifestation, laboratory examination, imaging feature, immunohistochemical examination and treatment ways were gathered from previous original articles, and checking the latest issues of appropriate journals.Results The clinical manifestation, laboratory examination, and imaging feature of hilar cholangiocarcinoma were due to the neoplasm obstructing bile duct and sequent infection of bile duct. The diagnosis was depanded on the combining clinical manifestation, laboratory examination and imaging feature. The value of immunohistochemical examination was not clear. Radical surgery was the best treatment of unique curing the neoplasm. By-pass surgery was used in the late phase patients to solve the obstruction of bile and digest duct. The effect of unique chemical treatment was not perfect. It did’t generally propose the treatment of orthotopic liver transplantation.Conclusion The perfect prognosis of hilar cholangiocarcinoma is depended on early diagnosis and redical surgery.

Objective To introduce the birth and development of model of end-stage liver disease(MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system.Methods Literatures of MELD applied in LT were analyzed retrospectively.Results MELD scoring system was used for predicting the prognosis of patients with end-stage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results.Conclusion MELD has been had a successful initial implementation for predicting the short-term survival probability and mortality in patients with end-stage liver disease,and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time,which has been proven to be a powerful tool for auditing the liver allocation system.

Objective To review the advances in techniques of hepatic blood occlusion in hepatectomy.Methods The related literatures were reviewed and analysed.Results There were many techniques of hepatic blood occlusion.The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion.Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged.Total vascular exclusion and other techniques were rarely used.Conclusion To reduce blood loss in hepatectomy and make patient safe,based on the situation of the patient,the technique should be ingeniously selected.

Objective To summarize the application and advancement of liver transplantation for hepatic metastasis from neuroendocrine tumor. Methods Domestic and overseas publications on the study of liver transplantation for hepatic metastasis from neuroendocrine tumor in recent years were collected and reviewed. Results Liver transplantation can offer good relief of symptoms, long disease-free intervals, and potential cure in individual patients with hepatic metastatic tumor. Important selection criteria are well-differentiated tumors and a low proliferation rate (Ki67

Objective To study the advances in use of imaging in the evaluation of living donor liver.Methods The literatures in recent years on the use of imaging in evaluation of living donor liver were reviewed.Results Preoperative computed tomography(CT) and magnetic resonance imaging(MRI) in the donor allowed accurate determination of liver volume and rough determination of macrovesicular hepatic steatosis of the liver.CT angiography could assess the anatomy of hepatic artery,portal vein and hepatic veins.Intraoperative cholangiography allowed detection of the anatomy of the biliary tree.Conclusion Imaging techniques are widely used in the evaluation of liver volume,vasculature and biliary system in the living donor liver.

Objective To investigate the clinical choice on graft size and the type of donor's hepatectomy in adult living related partial liver transplantation. Methods The literatures in recent years on the donor's evaluation, the size of liver grafts, the types of donor hepatectomy and safety of donor in adult living related partial liver transplantation were reviewed.Results The size of liver graft is a crucial factor related to the safety of donor and the prognosis of the recipient. GW/ESLW≥30%, GW/BW≥0.8% may be the lowest limits. Left lobe contained middle hepatic vein, extended left lobe with left-side caudle lobe, right lobe or extended right lobe contained middle hepatic vein may be the practical choice.Conclusion It is important to make a reasonable choice of liver graft according to the estimation of GW/ESLW or GW/BW, and the anatomy of liver in adult living related partial liver transplantation.

Objective To establish an efficient, effective hepatocyte isolation technique in order to increase cell production and decrease the prime cost. Methods The inferior vena cava below diaphragm was dissected and ligatured, and the inferior vena cava below liver was separated. Subsequently, the liver was perfused with EGTA through the portal vein while the inferior vena cava below liver was opened, and then the liver was harvested. The liver tissue was cut into 1 mm?1 mm?1 mm and digested at 37 ℃ water bath with Ⅳ collagenase for 30-40 minutes, then the hepatocytes were purified and cultured in CO 2 incubator. The production and function of hepatocytes were assessed. Results The isolated hepatocytes using this technique were more than 95% among the all isolated cells. No statistic difference was found in cell production and cell function comparing with traditional technique. But this technique was simplified and more economically. Conclusion This modified hepatocyte isolation technique is efficient and effective. It can ensure the amount of production and purity of hepatocytes.

Objective To investigate the feasibility of a new clinical staging of primary liver cancer (PLC). Methods 1*!038 PLC cases were surgically treated in our hospital from January 1990 to December 1998. Of those, 504 patients receiving liver resection were classified with the TNM staging and new clinical staging. Both staging systems were correlated with survival rates. Results In TNM staging, 24 cases (4 8%) were in stage Ⅰ, 66 cases (13 1%) in Ⅱ, 385 cases (76 4%) in Ⅲ, and 29 cases (5 8%) in Ⅳa. The 5 year survival rates were 79 2%, 62 1%, 32 2% and 0, respectively. As with the new clinical staging, 27 cases (5 4%) were in stage Ⅰa, 81 cases (16 1%) in Ⅰb, 224 cases (44 4%) in Ⅱa, 141 cases (27 9%) in Ⅱb, and 31 cases (6 2%) in Ⅲa. The 5 year survival rates were 70 3%,53 1%,40 2%, 22 7% and 0 respectively. Conclusion While both the TNM staging and new clinical staging have significant correlation with the selection of treatment and evaluation of prognosis, the new staging is more useful in clinical practice.