Objective To compare the differences between MELD and Child-Pugh grading in assessing of hepatic functional reserve in patients with cirrhosis,and analyse the correlation of two systems.Methods Retrospective analysis was made on 92 cases of hepatitis cirrhosis hospitalized with the MELD and Child-Pugh score by ROC curve,the difference and relation between two systems were compared.Results MELD and Child-Pugh system were significantly correlated(r=0.669,P < 0.000),3-month survival in patients with two systems ROC curve areas was significantly different(P < 0.05),while the MELD in patients survived more than 6 months was not significantly different compared with Child-Pugh(P>0.05).ConclusionMELD and Child-Pugh can accurately assess the prognosis of survival for patients with hepatic cirrhosis,and MELD is suitable for assessment of risk,heavy patients,not for those survived more than 6 months.

A series of gene function devitalized increase gradually because of tumnr-suppressing gene endogenous deactivation while not classic mutation or absence. Unlike mutation devitalizalion, methylation devitalization is reversible.Gene silencing because of high methylation of promoter has many potential clinical uses.For example, it's in favor of early diagnosis, prognosis and therapy of tumors such as lung caneer, breast cancer,renal cancer, gastric cancer, bladder cancer and so on. RASSF1A belongs to the gene thatalways due to methylation deactivation not mutation deactivation. And this gene is similar to Ras receptor of mammalian. RASSF1A suppressed tumor growth in vivo and in vitro. This further supports it could be one tumor-suppressing gene. It plays an important role in cell cycle regulation, apoptosis, and micropipe stabilization. This review mainly summarizes information and advancement about RASSF1A tumor-suppressing gene in genetic structure, endogenous gene inactivation, and functional analysis.

Objective To analyze CT features of gastrointestinal stromal tumors(GIST) and to evaluate its value in diagnosis of thedisease.Methods Both plain and enhanced CT findings in 32 cases with GIST pathologically-proved were retrospectively analyzed.Gastrointestinal air-barium double contrast radiography was performed in 15 patients . Results The tumors originated from the stomach (n=18),jejunum(n=4),ileum(n=3),esophagus(n=2),mesentery(n=2),ascending colon(n=1),rectum(n=1) and greater omentum(n=1).Of 32 GIST,12 were benign and 20 were malignant.In benign GIST ,the diameter of the tumor was less than 5cm,with clear margin and homogeneous density.In malignant GIST,the diameter of the tumor was more than 7 cm,the tumors were lobular in shape ,with necrosis within the tumor ,the tumor had large and deep ulcers,invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GTST was 96.9%(31/32),the positive predictive value of CT for differentiation of benign and malignant GIST was 93.8%(30/32).Conclusion CT is of great value in diagnosis of GIST.It can be considered as a supplement to X-ray barium meal examination and can provide useful informations for early diagnosis and for the evaluation of the treatment and prognosis.

Objective To investigate appropriate use of radiofrequency thermal ablation (RFA) in treatment of liver cancer.Methods Fouty-one patients with hepatic cancer were entered into two trials. The liver tumors were treated with percutaneous radiofrequency ablation (PRFA) or intraoperative radiofrequency ablation (IRFA). All patients were followed up postoperatively to assess complications, treatment response, and local recurrence of tumor.Results PRFA and IRFA were performed on 32 tumors in 18 patients and 43 tumors in 23 patients, respectively. Treatment-related complications occurred in 6 of the 18 patients treated with PRFA (33.3%). In contrast, there was only 1 complication after IRFA (4.3%, P

Objective To study the significance of ?-catenin expression in human gastric carcinomas, colorectal carcinomas and human hepatic carcinomas.Methods S-P immunohistochemical method was used to detect ?-catenin expression in 80 cases of human carcinomas of alimentary system and corresponding tumor-adjacent normal tissues by ?-catenin polyclonal antibody. The results were analyzed using densitometrically semiquantitated .Results ?-catenin were normally expressed in all tumor-adjacent normal tissues of digestive system. ?-catenin expression was reduced or negative in human carcinomas of alimentary system (P

Objective To systematically the efficacy of transcatheter arterial chemoembolization (TACE) conbined with percutaneous microwave coagulation therapy (PMCT) in treatment of advanced liver cancer.Methods A search was performed by retrieving the domestic and foreign literature database,including WanFang Data,VIP,CNKI,PubMed,Cochrane Library,CBM,EMBASE,Medline,between January 2005 and May 2015.These documents were about the analysis of the efficacy of TACE combined with PMCT in treatment of advanced liver cancer,including complete response(CR),partial response(PR),total effective rate,the levels of AFP declining,1,2,and 3 year survival rate and all the trials must be randomized controlled trials.Meta-analyses were conducted using the Cochrane Collaboration's RevMan 5.2 software.Results Fourteen documents were retrieved,including 989 patients,conbined treatment group 470 patients,simple treatment group 519 patients.The results of Mete-analysis shows that the total effective rate of TACE combined with PMCT is higher than TACE alone in treatment of advanced liver cancer.AFP declining ＞ 50％ of TACE combined with PMCT more obvious than TACE alone.1,2,and 3 year survival rate of TACE combincd with PMCT higher than TACE alone.These differences were statistically significant.Conclusion TACE combined with PMCT might be more effective than TACE alone in treatment of advanced liver cancer.

Objective To study the relationship between the microvessel damage and the death rate of tumor cells and determine role of microvessel damage in the tumoricidal effect of hyperthermia.Methods H22 hepatoma cells were inoculated in the right hind legs of KM mice with immunosuppression.Local hyperthermia was administered to these mice which were divided randomly into 10 groups (8 in each group),which included groups of 3,6,12,24,48,72 and 96 h after hyperthermia for 30 min and groups of hyperthermia for 15,30 and 45 min.The tumor tissues were analyzed by flow cytometry(FCM)and immunohistochemistry.The cultured H22 cells were also given hyperthermia for 15,30,45 min and analyzed by FCM.Results The apoptotic rate(0.115±0.008)was higher in the initiation phase of hyperthermia in vitro,then the necrotic rates rose gradually.The difference between in vivo and in vitro was significant in hyperthermia of the same time about death rate(P＜0.05).A strong positive linear correlation(r=0.844)was observed between the death rate of tumor cells and MVD.Conclusion Microvessel damage plays the cardinal role in tumoricidal effect of hyperthermia.

Objective To investigate the preoperative biliary drainage on the effect of surgical treatment for hilar cholangiocarcinoma patients.Methods A total of 52 hilar cholangiocarcinoma patients who underwent resection operation in Renmin Hospital of Wuhan University from January 2005 to December 2015 were divided into preoperative biliary drainage group (24 cases) and non-preoperative biliary drainage group (28 cases).To compare the operation time,intraoperative blood loss,hospital stay,perioperative changes in liver function,and incidence of postoperative complications,tumor recurrence rate,1-,3-,and 5-year survival rate and some other indicators.The data was analyzed using SPSS 19.0 software.The patients of two groups were followed up by telephone,out-patient review and hospital examination.Patients were followed up for 8-60 monthes.Results The hospital stay for biliary drainage group was longer than that in non-preoperative biliary drainage group and the difference was statistically significant (P ＜ 0.05).The differences of operation time,intraoperative blood loss,postoperative tumor recurrence rate,postoperative complications (including bile leakage,blooding,fever,pleural effusion,abdominal infection,wound infection,pulmonary infection,liver failure and some others) and 1-,3-,and 5-year survival rate were not statistically significant (P ＞ 0.05).Alanine aminotransferase,aspartate aminotransferase,total bilirubin and direct bilirubin in preoperative biliary drainage group before biliary drainage were(98.0 ± 51.7) U/L,(94.2 ± 44.2) U/L,(177.5 ± 64.1) μmol/L and (160.2 ± 61.9) μmol/L,respectively,and after biliary drainage were (71.2 ± 13.8) μmol/L,(60.0 ± 12.1) μmol/L,(93.5 ± 20.7) μmol/L and (76.3 ± 18.1) μmol/L,respectively.The differences of the above parameters before and after biliary drainage were statistically significant (P ＜ 0.05).However,the changes of albumin before and after biliary drainage were not significant (P ＞ 0.05).The follow-up patients of biliary drainage group were 21 cases and the follow-up patients of non-preoperative biliary drainage group were 25 cases.The differences of 1-,3-,and 5-year survival rate between the two groups were not statistically significant (P ＞ 0.05).Conclusions Preoperative biliary drainage for hilar cholangiocarcinoma patients may improve the liver function to a certain extent.However,preoperative biliary drainage cannot improve the prognosis of the hilar cholangiocarcinoma patients.Therefore preoperative biliary drainage is not suggested for patients with good general conditions.

Background and purpose: E-cadherin (EC) is a type of glycoprotein, which could maintain epithelial polarity and cell-cell junction. It is thought to be associated with the development and progression of hepatocellular carcinoma (HCC). The study aimed to detect expression of uniting detection sEC and AFP before and after operation in patients, and to monitor recurrence of postoperative. Methods:The levels of sEC and AFP in 105 HCC patients were tested by enzyme linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) before and after operation as well as in 70 healthy controls. Theirs correlation with clinical and pathological factors was analyzed. We analyzed the level of plasma sEC and AFP of 47 patients who had been suffered from the hepatocellular carcinoma operation and relapse. Results: The levels of sEC and AFP in HCC patients before operation were significantly higher than in controls, which declined significantly one week after operation. The sEC level before operation showed significant correlation with TNM staging (P<0.01), edmondson grade, the carcerous thrombi within the portal vein and the capsule of carcinoma (P<0.05), but not with age of patients or the tumor size (P>0.05). While AFP only correlation with TNM staging (P<0.05), not with others factors (P>0.05). When the recurrence was confirmed, the level of sEC was much higher significantly than the level postoperation (P<0.01). Conclusion:The levels of sEC in HCC patients before operation are closely related with prognosis and recurrence of HCC. The unites detection of sEC+AFP may be a predictive factor for recurrence of postoperation.

Objective To investigate the effects of 17-β estradiol on hepatocyte apoptosis and the expression of Bcl-2 and Bax in hepatic tissue after reduced-size ischemia reperfusion injury and its mechanism in liver protection.Methods A rat model of reduced-size hepatic ischemia-reperfusion injury was established in 75 male Sprague-Dawley rats.They were randomly allocated into three groups:Sham group,ischemia-reperfusion(IR)group,and 17-β estradiol(E2 + IR)group.Liver functions,liver histology and hepatocellular apoptosis rates were observed after reperfusion.Hepatocellular ap optosis was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)method and the expression of Bcl-2 and Bax were determined by Western blotting.Results The levels of ALT and AST were higher and peaked after 12 h of reperfusion in the IR group compared with the sham group.The histological changes in the liver of the IR group consisted of hepatocyte swelling,hepatic sinusoids narrowing,inflammatory cell infiltration and hepatocyte necrosis in some areas of the livers.The IR group also exhibited an increased rate of hepatocellular apoptosis at 12 h after reperfusion.The protein expression of Bcl-2 decreased while the expression of Bax increased.In the 17-β estradiol group,the levels of ALT and AST were lower,the pathological changes were milder and the rate of hepatocellular apoptosis was lower at 12 h in comparison to those of the IR group.The expression of Bcl-2 was higher and the expression of Bax was lower in the 17-β estradiol group in comparison to those of the IR group.Conclusions 17-β estradiol can relieve the hepatic ischemia reperfusion injury in rat livers.17-β estradiol may inhibit apoptosis in hepatic tissue by up regulating Bcl-2 and down-regulating Bax,thus producing a protective effect on hepatic ischemia-reperfusion injury.