In clinical practice,regional portal hypertension is infrequent,but it is the only type which could be cured of portal hypertension.Pancreatic diseases are the chief pathogeny of regional portal hypertension,and the obstruction of spleen vein is the basic reason.The common clinical manifestation is isolatism varicose veins of pylorus.The golden standard of its iconography diagnosis is DSA,and the treatment should follow the individual principle.The splenectomy is the basic measure for them who have UGIB or hypersplenism.This is a review about recent advance in regional portal hypertension of etiology and classification,pathology and physiology,clinical manifestation,diagnosis,radiographic examination,cure,and so on.

Toil-like receptors (TLRs) present in the cell membrane and are transmembrane receptors.TLR4 is a key member of the TLRs family involved in inflammatory response and recognizing microbes. Gut barrier mainly include mechanical, immunological, chemical and biological barrier four major sections. Liver transplantation leads to intestinal ischemia-reperfusion (I/R) injury, then intestinal bacteria and endotoxin translocate into the blood circulation and at the same time, I/R injury stimulates the release of a large number of endogenous molecules. TLR4 is combined with both endotoxin and endogenous ligand and promotes the release of multi-kinds of cytokines and inflammatory mediators, causing a series of inflammatory reactions,and even leading to liver failure.

The incidence of primary nonfunction in the early period of liver transplantation,is reported to be 2%-23%,which is the main cause of death of liver transplant patients.It can be induced by many complicated factors and is particularly associated with the pathological changes caused by acute immunological rejection.Current studies of liver transplantation are focused on how to reduce the injury and improve the function of the liver graft and raise the success rate of liver transplantation.

Abdominal incisional hernia is a common complication of abdominal surgery,of which the two major direct causes are surgery wound healing and intra-abdominal pressure.Therefore,the factors causing poor wound healing and intra-abdominal pressure are incisional hernia incentives.Surgery is the only radical method to cure it,including open surgery and laparoscopic surgery.This review contains two contents,the summary of the current research and the prospects.

The most common site of hematogenous metastasis of gastric is liver,its prognosis is bad.It is a common cause of death in patients with gastric cancer.In the past few years,along with the development of molecular biology,the mechanism of tumor metastasis has been known gradually.Tumor metastasis is multistep process,the most important condition is cell invading and angiogenesis.Here the author summarize the mechanism of cell invasion and angiogenesis.

Colorectal cancer (CRC),a common gastrointestinal malignancy,has been a threat to the health and life of human being.CRC is concealed with no obvious clinical symptoms or signs.Therefore,most of the patients have been in the middle and advanced stage when CRC has been diagnosed.Thus it seriously affects the prognosis and life.Accordingly,early diagnosis is crucial in earlier treating,prognosis improving and survivability increasing.In recent years,the morbidity and mortality of CRC are still on the rise.Hence,how to improve the early diagnosis rate has been a research focus in clinical study.Based on this point,the author makes a literature review on the early diagnosis of CRC.

Objective To explore the effect of Radix Isatidis( indigowoad root,RI) polysaccharide on NO and ET-1 in orthopotic liver autotransplantation of rats.Methods The rats used in the experiment were randomly divided into three groups:normal control group (NC), autotransplantation group (AT) and RI polysaccharide group (RIPS).At 1, 6, 12 and 24 hours after autotransplantation, the content of NO,ET-1, alanine aminotransferase ( ALT), and aspartate amin-otransferase ( AST) in serum was assayed.Morphological observation of hepatic tissues was also performed.Results The serum level of ET-1 in RIPS group was significantly lower than that of AT group (P<0.05), and NO content in serum of RIPS group was increased significantly compared with AT group ( P<0.05) at 1, 6, 12 and 24 hours after autotransplanta-tion.The serum level of ALT and AST in RIPS group was lower than that of AT group (P<0.05) at each measurement point.The morphology of hepatocytes changed abnormally under light microscopy.The blood stasis and swelling of hepatic tissues, denaturalization and necrosis of hepatocytes in RIPS group were milder than that in AT group.Conclusion RIPS has a protective effect on hepatic ischemia reperfusion injury after orthotopic liver autotransplantation, which may be related to increased NO levels and lower levels of ET-1.

Intrahepatic cholangiocarcinomas is a type of biliary epithelial cell carcinoma.Hepatolithiasis,viral hepatitis,primary sclerosing cholangitis,Caroli disease,parasitic infections are its risk factors.In recent years,the incidence of intrahepatic cholangiocarcinomas is gradually increased.Ultrasound,CT,MRI can be used to diagnose.The main way to treat intrahepatic cholangiocarcinomas is comprehensive treatment based on liver resection.There is still some controversy in liver transplantation.Adjuvant therapy will play a more and more important role in patients who unable to accept surgery.

Objective To observe the effects of hypoxia preconditioning on the mitochondria ultrastructure of hepatocyte during liver transplantation in rats.Methods A modified orthopotic liver autotransplantation model was used to simulate liver transplantatation.Seventy two Sprague-Dawley rats were randomly divided into the following three groups:the normal control(group NC),the autotransplantation group(group AT),and the hypoxia preconditioning group(group HP),with twenty four rats in each group.Group HP were given an 8% oxygen atmosphere for 90 minutes before the operation.At 1,6,and 24 hours after the operation,the rats were killed and the following tests were conducted:1.The morphology of mitochondria was observed under transmission electron microscopy(TEM);2.Mitochondria were quantitatively analyzed by a MiVnt image analysis system.ResultsHepatic cells in group AT showed typical injury signs under TEM,the appearance of hepatocytes and mitochondria in group HP were much better than the group AT,and the areas,perimeters and diameters of mitochondria in group HP were much smaller than those in group AT by a significantly amount(P

Hypoxic preconditioning improves organism in stress response such as operation.This dissertation expound the effects of hypoxic preconditioning on hepatic carcinoma after hepatic resection.Hypoxic preconditioning protect remainder hepatocyte from ischemia reperfusion injury in the remaining liver by regulating HIF-1,nuclear factor-kappa B and being kind to our mitochondria; remote-ectopic hypoxic preconditioning and cross-pluripotential hypoxic preconditioning preserve residual liver.Hypoxic preconditioning can relieve liver from ischemia reperfusion injury after hepatocellular carcinoma hepatectomy,but no clear evidence demonstrate it improve residual liver regeneration.This need further experimental study.