Asialoglycoprotein receptor(ASGPR) is a specific receptor of mammalian hepatocytes.Reduction in ASGPR concentration has been proven to appear in liver cirrhosis and liver cancer.By liver ASGPR scintigraphy with 99mTcGSA,some indexes such as HH15、LHL15、[R]_0、R_0 can be obtained,which is useful for the evaluation of liver function.When combining with the techniques of functional scintigraphy and single photon emission computed tomography(SPECT),it becomes possible to functionally simulate the extension of hepatic resection and predict to some extent postoperative outcomes related to liver function.It is still a new professional field internationally,and almost absent domestically.It could be an important tool for quantificational evaluation of the risk of liver surgery and help determining the surgical procedures.We have here,with some of our research experiences in this field,written a review of ASGPR scintigraphy.

Malnutrition is common among patients with liver disease, and its severity directly influences the short-term survival. As an important approach for chronic liver disease, nutritional support is especially necessary for long-term rehabilitation and treatment. Many methods (e. g. direct human body measurement, biochemical indicator determination, immunological indicators, nutrition assessment tools, and human composition determination) can be applied for the nutritional status evaluation. Based on the specific disease condition and the patient's tolerance, nutritional supports (with proper nutritional substances and administrative route) should be provided individually.

Objective The purpose of this study was to examine the effects of pulsing electromagnetic field and calcitonin gene related peptide on colostomy induced colonic atrophy in rat. Methods Rats undergoing diverting colostomy with exclusion of distal colon received the stimulation of pulsing electromagnetic field or sham stimulation in a special device 30 min/day for consecutive five days. Results Electromagnetic stimulation significantly prevented the colonic atrophy, and elevated the colonic mucosal DNA and RNA contents compared to those without stimulation. Diverting colostomy reduced the concentration of calcitonin gene related peptide in serum, on which the application of electromagnetic stimulation had no effect. Conclusion Pulsing electromagnetic field prevents surgically induced intestinal mucosal atrophy. This stimulation does not change the concentration of calcitonin gene related peptide indicating the complexity of the mechanism of mucosal atrophy.

ObjectiveThis study was to investigate the effects of surgery and antibiotics on sub-type of lymphocytes and bowel microecology, and the possible beneficial effects of probiotics in protecting gut associated lymphoid tissue(GALT). Methods Male SD rats were subjected to receive gastrostomy and small bowel resection with or without treatment of antibiotics or antibiotics plus lactobacillus plantarum 299v postoperatively for a week. Each group consists of 6 rats. ResultsSurgery and antibiotics significantly reduced the total amount of lymphocytes especially the B cell and CD8 +T cell subtypes in Peyer′s patches(PP), and destroyed the microflora balance. Probiotics protect PP lymphocytes. Conclusions This study found the alteration in lymphocytes sub-types in PP following GI surgery and antibiotics administration. Probiotics has protective effects on GALT composition.

Suppressor of cytokine sigaling (SOCS) genes encode a family of protein recently identified as negative feedback inhibitors of signaling by eytokine receptors. We have previously shown that endotoxin markedly stimulates SOCS gene expression in rat liver, that correlates with observed resistance to growth hormone-signaling during endotoxemia. The objective of this study was to determine the expression of SOCS genes in state of fasting that have been shown to cause altered responses in pro-inflammatory cytokines and anzbolic hormones. Male Sprague-Dawley rats (～200g) were fasted for 1, 2 or 3 days, or refed for 3 days following a 3-day period of fasting. Liver and muscle mRNAs were determinedby Northern blotting using specific rat cDNA probes cloned in our laboratory. In liver, after a l-day lag period, there was a progressive 2-fold increase in SOCS-3 and 75% decrease in SOCS-2 mRNA afte 2 and 3 of fasting. Both SOCS mRNAs were normalized by 3 days of refeeding. There was no measurable changes in tyrosine phosphorylation of STAT1, STAT3, STAT5a or STAT5b, nor activation of MAP kinases including ERK 1/2, p38, and JUNK 1/2 in liver by 3 days of fasting. In muscle, there was a similar 75% decrease in SOCS-2 mRNA, but no change in SOCS-3 mRNA following 3 days of fasting. These data suggest that malnutrition regulates SOCS-2 and SOCS-3 in a different way, and this regulation is tissue specific. The changes of SOCS mRANs are independent of measurable phosphoryiation of multiple STATs and activation of MAP kinasea. The altered SOCS expressions during fasting may explain the changes of biological effects of multiple cytokines and anabolie hormones in malnutrition states.

Hepatic hemangioma is a common benign tumor of liver,while hepatic hemangioma with a diameter ＞ 3 cm is rarely seen in clinical practice.A female patient with a giant hepatic hemangioma (diameter =48 cm) received tumor resection via chest and abdomen joint incision at the Peking Union Medical College Hospital on April 10,2012.The patient received exploratory laparotomy for hepatic tumor via chest and abdomen joint incision 22 years ago,while the operation was failed due to intraoperative bleeding.The success of the operation benefited from comprehensive application of computed tomography angiography reconstruction technique,three-dimensional liver reserve function assessment,intraoperative controlled low central venous pressure,total hepatic vascular exclusion and precise hepatectomy technique.

Objective To observe the effects of atorvastatin and cytokine signaling inhibitor AG490 on the residual liver function and the survival time of 90% hepatectomy rats. Methods Rats were divided randomly into three groups after surgery: control group without treatment; Ato group administrated with atorvastatin (20 mg?kg -1?d -1) through NG tube one day before and three days after the surgery and AG490 group, intraperitoneally given AG490 (1 mg?kg -1?12h -1) beginning intraoperatively for 4 times. The health status and liver regeneration were observed and recorded. Results All rats in control group died within 24 hours. Both atorvastatin and AG490 significantly prolonged the survival time of rats after surgery (25.6 h & 30.6 h vs. 10.7 h,P

Objective To investigate changes of GP73 after hepatectomy and its correlations with hepatocellular carcinoma (HCC) recurrence. Methods Perioperative serum GP73 was monitored in hepatic hemangioma and HCC patients undergoing hepatectomy. Clinicopathologic features and follow-up results were collected to evaluate the relationship between serum GP73 level and patients' prognosis.Results There was no statistical difference between preoperative GP73 and postoperative GP73 in hepatic hemangioma group.While preoperative GP73 in HCC group was 9.9(3.7 - 15.8) relative unit (RU),and that on POD3 (postoperative day 3 ) was 9.1 ( 3.4 - 13.3 ) RU,on POD7 was 74.3 ( 1.7 - 9.0) RU,on POD14 was 3.3(2.1 -5.4) RU ( F =72.606,P ＜ 0.001 ).HCC recurred in 21 cases during follow-up,GP73 in recurrent cases [ 11.0 (8.4 - 13.8 ) RU ] was significantly higher than postoperative trough values while it was not different from their preoperative GP73 level [ 9.9 ( 2.9 - 15.0) RU ] ( Z =1.185,P ＞0.05). The preoperative GP73 level between recurrent subgroup and nonrecurrent subgroup was not significantly different (Z =- 1.546,P ＞ 0.05 ).Preoperative GP73 did not correlate to patients' survival.Conclusions Hepatectomy for HCC leads to a significant decrease of GP73 and postoperative HCC recurrence accompanies reelevation of GP73. GP73 could be used as a postoperative monitor for HCC recurrence.

Objective To evaluate permissive hypocaloric intake in postoperative patients by a prospective, randomized, controlled trial. MethodsForty-two postoperative patients were randomly assigned to receive 117kJ?kg~ -1?d~ -1in control group, and 75kJ?kg~ -1?d~ -1in experimental group intravenously. Blood routine, liver and renal functions were measured one day before and day 1, 3, 5 post operation. Blood glucose level, insulin intervention, infectious complications, hospital stay, and relevant cost were also evaluated. ResultsHypocaloric intake in the experimental group post-operatively did not influence the hemoglobin level, liver function, and other indicators in the serum. The fasting blood glucose and glucose levels after infusion, as well as the volume of insulin intervention were significantly higher in the control group during 4 days of parenteral nutrition. Experimental group had lower relevant hospital cost, while two groups had similar duration of hospital stay. ConclusionPermissive hypocaloric intake shortly after surgery does not influence the patient nutritional status, besides it avoids to some extent the hyperglycemia, reduces the need for insulin intervention .

Objective To investigate the effect of Ulinastatin, a urinary trypsin inhibitor on the outcome of patients undergoing liver resection. Methods In this prospective, randomized, and controlled clinical study, 42 patients undergoing hepatectomy were randomly divided into treatment group and control group. In treatment group Ulinastatin was given on the day of surgery and the three consecutive days. Blood was tested for biochemistry. ResultsSerum ALT and AST levels in treatment group were significantly lower than those in control group 12 hours post-operation, especially in patients undergoing multisegmentectomy. Difference became insignificant at the time point of 60 hours post-operation. Administration of Ulinastatin resulted in faster decrease of serum bilirubin level in patients undergoing small volume hepatectomy, and no effect on coagulative function was observed. Conclusions The protective effects of urinary trypsin inhibitor exist mainly in early stage of major liver resection.