Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P

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 explore the changes of colon motility of the rats in multiple organ dysfunction syndrome (MODS) induced bacterial peritonitis and the effects of IL-6, TNF-? and induce nitricoxide synthase (iNOS) on colon motility. Methods Wistar rats were divided into two groups, which were the control group and the MODS group. The number of stool, the amplitude changes of circular smooth muscle strip, the length of smooth muscle cell, and the changes of serum NO in two groups were observed. The expressions of IL-6, TNF-? and iNOS protein and IL-6 mRNA, TNF-? mRNA and iNOS mRNA in distal colon were investigated by using immunohistochemical methods and RT-PCR. Results The numbers of stool and the amplitude in the MODS group were lower than those of the control group (P

Objective To evaluate the suitability of the biodegradable microsphere encapsulation of adenovirus as a targeting vector for gene therapy of hepatocellular carcinoma. Methods Encapsulate the recombinant adenovirus in PLG poly (lactic/glycolic) copolymer by the solution evaporation method, the release test and the bioactivity of viruses incorporated in vitro were studied. Results More than 19.3% of adenovirus was encapsulated in PLG microspheres. The release test shows that the adenovirus was released for more than 200 h, 50% were shed within the first 100 h, and their activity was retained. Conclusion Recombinant adenovirus can be formulated in a polymer preparation of PLG with retention of bioactivity. It may be a valuable vector for the gene therapy of liver cancer.

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 evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection.Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed.Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect.Liver function recovered uneventfully after transplantation in all cases.Alpha fetoprotein(AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation.Five cases(21.74%) had postoperative complications.Nineteen cases(82.61%) were followed up,average follow-up duration were 610 days.There were 5 cases(26.32%) of cancer recurrence and 6 deaths during follow-up,survival rate was 68.42%.Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.

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 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 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 investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide (ASODN) on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P 0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth.Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.