Objective To evaluate the prognostic value of combined analysis of the biomarker Krüppel-like factor 4 (KLF4) and the Milan criteria in hepatocellular carcinoma (HCC) patients treated by orthotopic liver transplantation (OLT).Method The clinicopathological data and outcome of the recruited 105 HCC patients undergoing OLT from October 2001 to April 2009 were retrospectively analyzed.KLF4 expression in HCC and paired non-tumor tissue was detected by immonohistochemistry and confirmed by Western blotting analysis.Five-year overall survival (OS) and recurrence-free survival (RFS) rate and survival curves of the grouped patients were calculated and plotted by Kaplan-Meier method.Result The level of KLF4 expression was lower in HCC than that in paired non-tumor tissue (P＜0.05).KLF4 expression was significantly lower in poorly differentiated HCC than that in well-moderately differentiated HCC (P =0.008).Loss of KLF4 was an independent risk factor for predicting tumor recurrence and survival of HCC after OLT (HR =0.459 and 5.42,respectively,P＜0.001).The level of KLF4 expression could not differentiate the OS and RFS rate in the patients with tumors meeting the Milan criteria,whereas the OS and RFS rate in the patients with tumors exceeding the Milan criteria differentiated according to KLF4 expression.The patients with tumors beyond the Milan criteria and exhibiting moderate to high KLF4 expression had unexpectedly favorable 5-year OS (91.7％) and RFS (70.5％) rate.Conclusion KLF4 is a useful biomarker for prognostication of HCC patients undergoing OLT.Integrated use of KLF4 biomarker and the Milan criteria improves accurate prediction of survival and tumor recurrence for HCC patients after OLT.

Objective To explore reasonable application of antibiotics in the peri-operative period of the general surgery.Methods 121 cases who were admitted from Nov. 1998 to Jun. 2000 were divided into three groups including deep-vein group, biliary culture group and drainage-rube group. The antibiotics were Cefradine, Cefuroxime, Cefoperazone, Ceftriaxone, Imipenem, Ciprofloxacin and Metronidazole. We recorded the dosages and applying-time of the antibiotics. We also carried out the culture of the blood, cut-secreta and drainage tube at the same time.Results The clinical doctors applied the antibiotics with excess of indications and applying-time. That brought about more and more drug-fast bacteria, even multiple drug-fast bacteria.Conclusion We must apply the antibiotics reasonable in the peri-operation.

Liver transplantation (LT) is one of the most important curative treatment for hepatocellular carcinoma (HCC).In the past decade,great achievements have been made in the field of liver transplantation in China.The incidence of postoperative complications and hospital mortality have significantly decreased due to growing experience and maturity of surgical techniques.However,tumor relapse after LT still negatively impact on the long-term outcome of patients with HCC.HCC recurrence and patients' survival after LT are closely related to preoperative screening of patients,listing priority,local treatment and postoperative management.Successful management of these procedures determines the final therapeutic effect of LT on patients with HCC.In this article,the above issues were explored and discussed according to the current situation of domestic transplant community through revision of the literatures in combination with the clinical experiences.

Colorectal cancer is induced by multiple factors.Multiple genes should be considered for the research of colorectal cancer.Single nucleotide polymorphisms,a new tumor gene researching method,play a key role in colorectal cancer researching.Finding colorectal cancer special SNP is vital for selecting high risk population and predicting the risk of developing colorectal cancer.

Objective To investigate the indications and results of combined liver-kidney transplantation.Methods From Jan. 2001 to Dec. 2003, 15 patients were subjected to combined liver-kidney transplantation in our department. The underlying diseases included hepatitis B viral cirrhosis complicated by HRS ( n= 8), hepatitis B viral cirrhosis complicated by uremia ( n =2), hepatitis B viral cirrhosis complicated by diabetic nephropathy ( n =1), polycystic liver and kidney disease ( n =2), Caroli's disease and polycystic kidney ( n =1), alcoholic liver cirrhosis complicated by uremia ( n =1). The surgical procedure, perioperative complications, acute and chronic rejection, the recurrence of hepatic viral B hepatitis, and the result of follow-up were analyzed.Results The graft function in 15 cases of combined liver-kidney transplantation was restored well after operation. The 6-month and one-year survival rate was 100%. One patient was supported by respiration machine for 48 days. The complications occurred in 3 patients after operation, including one case of gastroenternal bleeding repeatedly and one case of postoperative wound bleeding subject to non-surgical treatment, and one case of stenosis of biliary anastomosis subject to ERCP. Only one patient experienced a rejection episode of the liver. No acute rejection of the kidney graft occurred. One patient was died from liver graft function failure by recurrence of hepatitis B after 30 months.Conclusions Combined liver-kidney transplantation is only radical treatment method for patients with end-stage liver disease with chronic renal dysfunction or chronic renal failure. In the patients with hepatitis B,lamividine and hepatitis B immunoglobin can prevent the recurrence of hepatitis B.

ObjectiveTo enrich and quantitatively analyze peripheral circulative carcinoma cells by magnetic activated cell sorting (MACS) in colorectal cancer patients.MethodsBlood samples, preoperatively collected from 21 patients with colorectal cancer and 9 healthy volunteers, were labeled by anti-cytokeratin (CK) with magnetic microbeads, and passed through magnetic columns; CK +carcinoma cells were separated from the samples, and quantified by flow cytometry.ResultsCK +CD45 -cells could not be detected from the samples without MACS; in the sample undergoing MACS, the concentrations of CK +CD45 -cells were significantly higher in patient group than in control group(P

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P

Liver transplantation may be the best curative treatment for patients with cirrhosis and primary hepatocellular carcinoma. However, tumor recurrence and metastasis is still a difficult problem of liver trans-plantation. Postoperative adjuvant chemotherapy has been employed in an attempt to eliminate micrometasta-ses, and could improve long-term survival after LT for hepatocellular carcinoma. Although the specific chem-otherapy and its efficacy remain controversial, it has been widely used as a safe, feasible and effective meth-od in several clincial institutions.

Objective To refine the loss of heterozygosity(LOH) on chromosome 20q11-13 and identify the new tumor suppressor gene(s) in colorectal tumorigenesis. Methods From 1998 to 1999, 83 patients with colorectal cancer had been admitted to Shanghai First People's Hospital. Tumor tissues and adjacent normal mucosal tissues were collected. Ten polymorphic microsatellite markers were analyzed on chromosome 20 and another 10 markers were applied on chromosome 20q11-13 in 83 cases of colorectal and normal DNA by PCR. PCR products were eletrophoresed on an ABI 377 DNA sequencer. Genesean 3.1 and Genotyper 2.1 software were used for LOH scanning and analysis. Results We observed a distinct region of frequent allelic deletions on chromosome, another 10 polymorphric microsatellite markers were applied to 20q11-13 and 2 minimal regions of frequent LOH were established, that is to say 20q11.2, 20q12. Tumor suppressor genes E2F1, PMP24 and MAFB were found in the regions of 20q11.2 and 20q12. Conclusion Through our detailed deletion mapping studies, we have found 2 critical and precise regions, which must contain one or more unknown tumor suppressor gene (s) on colorectal cancer.

Objective　To study chemotherapy sensitivity and apoptosis in tumor cell line.Methods　Two different human colon carcinoma cell lines, LoVo and Ls-174-t were incubated with DDP,MMC,5-FU，EPI at various peak plasma concentrations (PPC), 1/10PPC，1/5PPC，5PPC and 10 PPC. Apoptosis was detected by FACScan and TUNEL technique after 24 hours and 48 hous. Cell growth inhibition rates were assessed by MTT, DNA ladder were examined by agarose electrophoresis.Results　At 48 hours, the highest cellular apoptosis rates were observed with PPC which was assessed by FACScan technique. There was a positive linear correlation between apoptosis assessed by TUNEL technique and growth inhibition rates of cells determined by MMT(P＜0.05).Conclusion　Using Annexin-V-Fluos staining FACScan technique to assess apoptosis of tumor cells is an exploring and useful method which can be used to choose both kinds and doses of chemotherapeutic drugs.