Derived from embryonic stem cells, induced pluripotent stem cells, or adult stem cells, liver organoids not only mimic the tissue structure, gene expression patterns, and genetic characteristics of in vivo liver but also demonstrate significant potential in simulating liver diseases, drug screening, precision medicine, and regenerative medicine. This technology is particularly valuable in modeling various conditions such as malignant liver tumors, liver fibrosis, cirrhosis, viral hepatitis, and a range of genetic and metabolic liver diseases. However, challenges remain in enhancing the derivation and proliferation efficiency of organoids, constructing immune microenvironments, developing functional vascular networks, and achieving standardization and automation in the organoid preparation process. Looking forward, with continued technological advancements and innovations, these issues are expected to be resolved, paving the way for liver organoids to play a more substantial role in clinical and research applications, ultimately contributing significantly to public health. This review comprehensively explores the development and extensive applications of liver organoid technology in the field of biomedical science. The aim is to inform subsequent research.

Objective:To explore whether botulinum toxin A (BTX-A) can improve the retention rate of fat transplantation in fat breast augmentation.Methods:Each patient was divided into control side and experimental side according to the random number table in 14 patients studied. The experimental group received autologous fat and BTX-A combined transplantation on both sides of the breast, while the control side only received autologous fat transplantation. The fat was added with the same volume of normal saline as BTX-A in the control group. All patients were followed up and the effects of BTX-A were evaluated objectively via the comparison of the remained bilateral fat graft volumes that were obtained through a digital three-dimensional reconstructions technique. Moreover, the improvement of each breast appearance and complication were assessed by the physician and patients who were blinded to the recipient treatment assignment.Results:The outcome of the fat breast augmentation was evident for both groups at the follow-up with no evidence of fat embolism, vascular/nervous injury, infection and prolonged bruising. In one of the 14 patients (control group), fat liquefaction necrosis occurred in one side of the breast; after active treatment, it returned to normal, and three patients had different degrees of mass. The analysis on the three-dimensional reconstruction data and the assessments from both the physicians and patients showed significant differences in the fat graft retention volume between the BTX-A group (51.10±20.56)% and the control group (33.06±14.77)%. Nevertheless, there was no significant difference in the incidence of complications between the two sides.Conclusions:Autogenous fat breast augmentation is safe and effective. This study result has shown that BTX-A can significantly improve the retention rate of fat transplantation but cannot reduce the incidence of complications.

Objective To investigate the risk factors of malignancy from gallbladder polyps (GBPs).Methods The retrospective case-control study was conducted.The clinicopathological data of 604 patients with GBPs who were admitted to the Chinese PLA General Hospital between January 2011 and October 2016 were collected.There were 255 males and 349 females,aged from 19 to 88 years,with an average age of 47 years.There were 565 of 604 patients with benign GBPs and 39 with malignant GBPs.Observation indicators:(1) risk factors analysis of malignancy from GBPs;(2) the predictive ability of polyp diameter for malignancy from GBPs.Measurement data with normal distribution were expressed as Mean ± SD,measurement data with skewed distribution were described as M (range),and the univariate analysis was done using the t test or rank-sum test.Count data were described by the absolute amount,and the univariate analysis was done using the chi-square test or Fisher exact probability.The indicators with P＜0.05 in the univariate analysis based on clinical application were used in the Logistic regression models for multivariate analysis.The receiver operating characteristic (ROC) curve was drawn.The Youden index was calculated to analyze the predictive ability of polyp diameter for malignancy from GBPs.Results (1) Risk factors analysis of malignancy from GBPs:results of univariate analysis showed that age,polyp diameter,polyp number,chronic cholecystitis and carcinoembryonic antigen (CEA) level were related factors affecting malignancy from GBPs (t=-5.50,Z=-9.65,x2=15.92,312.65,Z=-1.78,P＜0.05).The results of multivariate analysis showed that age,polyp diameter and polyp number were independent factors affecting malignancy from GBPs (odds ratio =1.088,45.190,9.655,95％ confidence interval:0.974-1.159,4.312-121.139,0.890-117.551,P＜0.05).(2) The predictive ability of polyp diameter for malignancy from GBPs.The sensitivity and specificity predicting malignancy from GBPs were 94.9％ and 81.2％ in patients with polyp diameter =10 mm and Youden index =0.761,89.7％ and 90.6％ in patients with polyp diameter =12 mm and Youden index =0.803,84.6％ and 92.6％ in patients with polyp diameter =13 mm and Youden index =0.772,respectively.Conclusions The age,polyp diameter and polyp number are the independant factors affecting malignancy from GBPs.The malignancy possibility from GBPs is higher in patients with the age ＞ 50 years,polyp diameter ＞ 12 mm,solitary polyp,and should undergo surgical therapy actively.

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

Objective To explore the clinical significance of CT three-dimensional reconstruction visualization system for surgical planning and intraoperative guidance for primary liver cancer (PLC).Methods Clinical data of 46 patients with PLC admitted to Chinese PLA General Hospital from March 2016 to March 2017 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.All patients were divided into the visualization (n=23)and control groups (n=23).In visualization group,18 patients were male and 5 were female with an average age of (61±9) years.In control group,16 cases were male and 7 were female,aged (60±9) years on average.All patients were diagnosed with liver cancer before operation.In visualization group,CT 3D reconstruction visualization system was used for accessing the condition of patients before operation.The surgical procedure,operation time,intraoperative blood loss and postoperative complications of two groups were observed.The operation time and intraoperative blood loss were compare by t test.The rate comparison was conducted by Chi-square test.Correlation analysis was performed by Pearson correlation analysis.Results 3D reconstruction visualization system could precisely display the relationship between tumors and vasculature and identify the anatomical variations.In visualization group,the percentage of undergoing minimally invasive surgery was 48％ (11/23),significantly higher than 17％ (4/23) in control group (x2=4.85,P＜0.05).In visualization group,the intraoperative operation time,blood loss and length of hospital stay were (128±38) min,(135±67) ml and (7.7±2.3) d,significantly less than (205±56) min,(270±83) ml and (10.9±2.0) d in control group (t=-5.37,-3.31,-4.92;P＜0.05).The postoperative levels of ALT and TB in visualization group were (205±96) U/L and (12.2±2.4) μmol/L,significantly lower than (302±136) U/L and (18.5±3.8) μmol/L in the control group (t=-2.81,-6.67;P＜0.05).In visualization group,the estimated volume of resected liver before operation was (483±30) ml,where no significant difference was observed compared with the actual intraoperative resected liver volume (437±30) ml (t=1.13,P＞0.05),and a positive correlation was observed between them (r=0.814,P＜0.05).Conclusions CT 3D reconstruction visualization system is useful for preoperative safety assessment,locating the key anatomical parts,optimizing surgical plans so as to conduct the precise hepatectomy.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.

Aim To explore the role of Rho-kinase in remote ischemic postcondi-tioning and its possible mechanism.Methods Thirty male Sprague-Dawley rats were divided into five groups(n=6): sham group(Sham), ischemia/reperfusion group(I/R), remote ischemic postconditioning group(RIPostC), I/R with Rho-kinase inhibitor fasudil group(I/R+Fas) and RIPostC with Rho-kinase activator lysophosphatidic acid group(RIPostC+LPA).Throughout the whole process of experiment, mean arterial pressure(MAP), heart rate(HR) and Ⅱ lead electrocardiogram were continuously monitored.At the end of the reperfusion, plasma creatine kinase(CK) and lactate dehydrogenase(LDH) were measured.Myocardial histopathologic changes were observed by hematoxylin and eosin(HE) staining.Infarct size was measured using 2,3,5-triphenyltetrazolium chloride(TTC) staining.The expressions of phospho-myosin light chain(p-MLC) were detected with Western blot analysis.Results Compared with Sham group, the MAP and HR of other groups decreased, while the amplitude of ST segment increased.Compared with I/R group, MAP and HR increased, the amplitude of ST segment decreased, plasma CK and LDH activity decreased, myocardial pathological morphology and infarct size were improved significantly, infiltration of inflammatory cells was reduced, and the expression of p-MLC decreased in RIPostC and I/R+Fas group.Compared with RIPostC group, RIPostC+LPA group attenuated the effects of RIPostC, and the recovery of the above indicators were inhibited.Conclusion Rho-kinase signaling pathway might mediate remote ischemia postconditioning against myocardial ischemia/reperfusion injury.

Objective To explore the effect of ulinastatin on coagulation function of elderly patients after hip replacement.MethodsTotally 120 patients undergoing elective hip replacement in our hospital were chosen.According to the stratified randomization method, all patients were divided into observation group and control group with 60 in each.The control group received oral Xarelto combined with other conventional treatment, while the observation group received ulinastatin on the basis of the treatment regimen of the control group.The coagulation parameters and clinical manifestations were compared between two groups.ResultsTwo days after operation, the TT, APTT, PT, DD and FIB between the two groups showed statistically significant difference (t=-5.300,-2.319,-2.409,-2.325,-3.567;P<0.05).The hospital stay,CRP,TXB2 and total drainage volume in observation group 5d after operation were lower than those in control group, between the two groups showed statistically significant difference (t=-2.529,-2.082,-3.388,-2.887;P<0.05).The patients with elevated blood urea and serum creatinine in observation group were obviously less than that of control group, but the patients with nausea in observation group were obviously higher than those in control group,between the two groups showed statistically significant difference (χ2=5.217,5.926,8.571;P<0.05).The patients with deep vein thrombosis in observation group were obviously higher than those in control group,between the two groups showed statistically significant difference (χ2=8.571, P<0.05).ConclusionUlinastatin can significantly improve the hypercoagulable state of patients after hip replacement and reduce the incidence of deep vein thrombosis, and plays an important role in promoting wound healing and immunity recovery.

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.

Objective: To investigate the therapeutic efficacy and safety of laparoscopic radiofrequency ablation (LRFA) for specific-location hepatocellular carcinoma. Methods: To retrospectively analyze 496 patients with specific-location hepatocellular carcinoma treated with LRFA from January 2010 to January 2015 in our hospital. There was a total of 652 hepatic lesions with a mean diameter of (2.8±1.3) cm including 397 cases with single lesion and 99 cases with multiple lesions. The hepatic lesions were adjacent to major hepatic vessels, hepatic hilar region, diaphragmatic dome, gallbladder, or gastrointestinal tract and on the surface of the liver, respectively. Results: The 496 patients with 652 hepatic lesions were treated with LRFA successfully.The mean operation time was (48.2±9.6) minutes and the mean LRFA time per lesion was (30.3±8.6) minutes. No severe complications such as bleeding, bile leakage, gastrointestinal tract damage, diaphragmatic injury and liver function failure occurred after operation. The complete necrosis rate of the specific-location hepatocellular carcinomas was 78.4% (389/496) in one month after RFA, partially necrosis rate was 21.6% (107/496) and overall necrosis rate was 100%. In addition, the 1- and 3-year overall survivals (OS) were 95.6% and 88.5%, and progression free survivals (DFS) were 87.9% and 80.8%, respectively. Conclusions LRFA is a safe, effective, economic and minimally-invasive therapeutic approach for patients with specific-location hepatocelluar carcinoma and has good clinical application value.