Hepatectomy is the most effective method for the treatment of liver cancer. Asso-ciating liver partition and portal vein ligation for staged hepatectomy (ALPPS) provides resectable opportunities for patients with unresectable or borderline resectable liver cancer. Traditional ALPPS procedures involve a short interval between two stages of the surgery, leading to a higher incidence of perioperative complications and mortality. The authors present a case of two-stage hepatectomy. Initially, laparoscopic ligation of the right hepatic artery and portal vein was performed. To prevent tumor progression after the first stage of surgery, combined immunotherapy and targeted therapy were administered. Three months later, a successful right hemihepatectomy was performed. Postoperative histopathological examination revealed hepatocellular carcinoma with extensive tumor necrosis. A 15-month follow-up showed no tumor recurrence. This indicated that two-stage hepatectomy including simultaneous ligation of the hepatic artery and portal vein, combined with two-stage hepatectomy plus immunotherapy and targeted therapy, showed considerable promise for borderline resectable liver cancer.

Objective:To explore the effects of adriamycin（Adc）combined with hyperbaric oxygen（HBO）on the apoptosis of HepG2 cells and immunomodulatory factors in transplanted hepatocellular carcinoma（HCC）tissues in nude mice.Methods:The model of transplanted HCC was established in 20 nude mice，then the mice were divided into four groups：control group，HBO group，Adc group，and HBO + Adc group，with five mice in each group. The control group was reared normally. The HBO group was treated with HBO at 0.20 MPa for 1 h；the Adc group was treated with 10 mg/kg of Adc by gavage；the HBO + Adc group was treated with HBO at 0.20 MPa for 1 h and then given 10 mg/kg of Adc by gavage. All groups were treated once every other day for 21 days. After drug withdrawal，the tumors were dissected from the sacrificed mice，of which the tumor volume and weight were measured. The apoptosis of HepG2 cells was detected by TUNEL. The changes of apoptosis-related proteins in HepG2 cells were detected by western blotting. The changes of the contents of immunomodulatory factors in transplanted tumor tissues of nude mice were detected by ELISA.Results:After 21 days，the tumor volume and weight in the HBO + Adc group were lower than those in the other three groups（ P<0.05）. The proportion of apoptotic cells in the transplanted tumor tissues of nude mice of the HBO + Adc group was the highest. In the HBO + Adc group，the protein expression levels of Bax，caspase-3，and Cytochrome C were significantly increased；the protein expression of Bcl-2 was significantly reduced（ P<0.01）；and the IL-6 was significantly reduced；while the IL-18 and IFN-γ were significantly increased（ P<0.05）. Conclusion:The Adc combined with HBO can promote apoptosis of HepG2 cells in transplanted HCC tissues in nude mice，and effectively regulate the immunomodulatory factors to promote the recovery of the body’s immune function，suggesting obvious sensitizing and detoxifying effects.

Objective:To explore the effects of adriamycin（Adc）combined with hyperbaric oxygen（HBO）on the apoptosis of HepG2 cells and immunomodulatory factors in transplanted hepatocellular carcinoma（HCC）tissues in nude mice.Methods:The model of transplanted HCC was established in 20 nude mice，then the mice were divided into four groups：control group，HBO group，Adc group，and HBO + Adc group，with five mice in each group. The control group was reared normally. The HBO group was treated with HBO at 0.20 MPa for 1 h；the Adc group was treated with 10 mg/kg of Adc by gavage；the HBO + Adc group was treated with HBO at 0.20 MPa for 1 h and then given 10 mg/kg of Adc by gavage. All groups were treated once every other day for 21 days. After drug withdrawal，the tumors were dissected from the sacrificed mice，of which the tumor volume and weight were measured. The apoptosis of HepG2 cells was detected by TUNEL. The changes of apoptosis-related proteins in HepG2 cells were detected by western blotting. The changes of the contents of immunomodulatory factors in transplanted tumor tissues of nude mice were detected by ELISA.Results:After 21 days，the tumor volume and weight in the HBO + Adc group were lower than those in the other three groups（ P<0.05）. The proportion of apoptotic cells in the transplanted tumor tissues of nude mice of the HBO + Adc group was the highest. In the HBO + Adc group，the protein expression levels of Bax，caspase-3，and Cytochrome C were significantly increased；the protein expression of Bcl-2 was significantly reduced（ P<0.01）；and the IL-6 was significantly reduced；while the IL-18 and IFN-γ were significantly increased（ P<0.05）. Conclusion:The Adc combined with HBO can promote apoptosis of HepG2 cells in transplanted HCC tissues in nude mice，and effectively regulate the immunomodulatory factors to promote the recovery of the body’s immune function，suggesting obvious sensitizing and detoxifying effects.

Objective To compare salvage liver transplantation (SLT) with othotopic liver transplantation (OLT) in treatment of hepatocellular carcinoma.Methods A systematic literature search of PubMed,Embase,Cochrane Library,CBM,CNKI and Wanfang Med Online was performed from their dates of establishment to October 2017.The results were screened,data extracted and then analyzed with Stata 14.Results 23 studies with 4 161 patients were selected,including 579 patients in the SLT group and 3 582 patients in the OLT group.Compared with OLT,SLT was associated with a longer operative time (SMD =0.56,95％CI:0.29～0.83),higher intraoperative blood loss (SMD=1.56,95％CI:0.63～2.49),an increased risk of postoperative bleeding (OR =1.84,95％CI:1.08 ～ 3.14),a poorer overal survival rate (HR =1.29;95％CI:1.11～1.49) and disease free survival rate (HR=1.88;95％CI:1.26～2.81).The differences were all significant (all P＜0.05).The biliary complications (OR=1.25;95％CI:0.79～1.98),vascular complications (OR=1.41;95％CI:0.69～2.89),sepsis (OR=1.10;95％CI:0.60～ 1.99),acute rejection (OR =1.25;95％ CI:0.69 ～ 2.28) and perioperative mortality (OR =1.60;95 ％ CI:0.94 ～ 2.70) rates were not significantly different (all P＞0.05).Conclusions OLT is a better treatment strategy for patients with transplantable hepatocellular carcinoma (HCC) compared with SLT.However,severe organ limitation,and feasibility and safety of surgery make SLT a better option for patients with HCC recurrence after liver resection.

Objective To analyze the expression of activated T cell nuclear factor (NFAT) in hepatoeellular carcinoma (HCC) tissues and its correlation with clinicopathological factors.Methods Data of 105 patients including 87 males and 18 females,aged 55.1 ± 10.8 years old,diagnosed with HCC who underwent hepatectomy in hepatobiliary surgery department of the first central hospital of Tianjin from September 2014 to December 2016 were retrospectively analyzed,Immunohistochemical staining was used to detect the expression of NFAT subtypes in HCC tissues and adjacent normal liver tissues,and the differences in expression of NFAT subtypes and related factors were analyzed.Results HCC tissues had higher expression of NFAT4 and lower expression of NFAT1 compared to adjacent tissues (P＜0.05).NFAT1 positive group had higher HBV infected rate (93.1％ vs.78.7％) and lower microvascular invasion rate than that in NFAT1 negative group (24.1％ vs.46.8％) (P＜ 0.05).NFAT3 positive group had more younger patients (≤ 60 years old) (80.0％ vs.60.0％) and higher microvascular invasion rate (46.2％ vs.15.0％) (P＜0.05).NFAT4 positive group had higher microvascular invasion rate (43.3％ vs.22.2％) (P＜0.05).Conclusion HCC tissues had different expressions of NFATs.The expressions of NFAT1,NFAT3 and NFAT4 are related to microvascular invasion.