• Volume 26,Issue 7,2017 Table of Contents
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    • >指南解读
    • Interpretation of Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2016 edition)

      2017, 26(7):815-820. DOI: 10.3978/j.issn.1005-6947.2017.07.001

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      Abstract:

      Hepatocellular carcinoma has a propensity to invade the intra-hepatic vascular system, especially the portal vein system and, therefore, leads to the formation of the portal vein tumor thrombus (PVTT). Once PVTT occurs, the disease will progress rapidly with a dismal prognosis. Based on the existing data of evidence-based medicine, particularly the results from research on hepatocellular carcinoma complicated with PVTT achieved by Chinese scholars, the Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2016 edition) has been developed by the National Research Cooperative Group for Diagnosis and Treatment of Hepatocellular Carcinoma with Tumor Thrombus. Here, the authors interpret the consensus from the aspects of the PVTT classification and treatment selection for different types of tumor thrombus, etc.

    • Interpretation of update in Guideline for the Prevention of Surgical Site Infection, 2017

      2017, 26(7):821-824. DOI: 10.3978/j.issn.1005-6947.2017.07.002

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      Abstract:

      Surgical site infection (SSI) prevention is an essential component of surgical practice. The bullet points of Guideline for the Prevention of Surgical Site Infection have been updated for the first time in its 2017 edition, which adapted the levels of evidence and grades of recommendations mainly targeting toward 14 core areas of surgical practice based on the most comprehensive and extensive as well as the latest data of evidence-based medicine, and finally developed 42 sets of guideline recommendations that include the commonly used skin preparation, sterile surgical masks, and prophylactic use of antibiotics, etc.. The new guideline version relatively fully reflects the newest and most authoritative point of view on SSI prevention, and not only renovated the clinical procedure standards, but also may help frontline physicians renew their concept on surgical infections. So the authors interpret the important viewpoints of the new guideline.

    • >专题研究
    • Influential factors for liver function recovery from hepatectomy for liver cancer and risk prediction model establishment

      2017, 26(7):825-830. DOI: 10.3978/j.issn.1005-6947.2017.07.003

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      Abstract:Objective: To investigate the influential factors for recovery of liver function from hepatectomy for liver cancer and then to establish a risk prediction model. Methods: The relevant clinical data of 50 patients with liver cancer undergoing hemihepatectomy from February 2015 to September 2016 were retrospectively analyzed. The factors affecting postoperative liver function recovery of liver cancer patients were identified by univariate and multivariate analyses, and then, all the obtained factors and their statistical values were used to create the risk prediction model. Results: The preoperative 15-minute retention of indocyanine green (ICG R15), residual liver volume/standard remnant liver volume (RLV/SLV) and clearance index (HH15) are independent risk factors for recovery of liver function from hemihepatectomy (P=0.002. P<0.001 and P=0.007). The obtained risk prediction model was presented as follows: risk coefficient (R)=31.871×(RLV/SLV)–1.689×(ICG R15)–19.663×HH15. At the cut off value of R=0.90, the area under the ROC curve of this model for predicting postoperative liver dysfunction was 0.96, with the sensitivity and specificity of 97.5% and 90%, respectively. Conclusion: Lower RLV/SLV or higher ICGl5R and HH15 are risk factors for postoperative liver dysfunction in patients after hepatectomy for liver cancer, and the established prediction model may have certain value for risk assessment.

    • Application of 3D printing technology in preoperative assessment of precise hepatectomy

      2017, 26(7):831-837. DOI: 10.3978/j.issn.1005-6947.2017.07.004

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      Abstract:Objective: To investigate the value of medical 3D printing in preoperative assessment before precise hepatectomy. Methods: The clinical data of 7 patients with complex hepatic tumors from January 2016 to December 2016 in the Department of Hepatobiliary Surgery of General Hospital of Ningxia Medical University were retrospectively analyzed. Of the patients, 5 cases were male and 2 cases were female, with an average age of 55 years. All patients underwent upper-abdominal CT scan with three-dimensional reconstructions by three-dimensional visualization system (MI3DVS), which were imported into the 3D printer to create the exactly same size printed models of the livers. And then, the anatomical features of the livers were analyzed, preoperative simulations were performed and treatment plans were designed. Results: The 3D-printed liver models for all patients clearly showed the intrahepatic vasculature, anatomical morphology of hepatic and tumor tissues, and the adjoining relationship between the tumor and the intrahepatic vascular structures. The calculated average liver volume was (1 872.2±753.7) mL and median tumor volume was 316.96 mL. According to the results of 3D printing, one patient was not suitable for surgical resection due to portal vein tumor invasion, for whom transarterial chemoembolization was recommended, and all the remaining 6 patients underwent precise liver resection. All the actual surgical procedure was completely in accordance with the preoperative operation planning (6/6). No death occurred during the perioperative period. Conclusion: The medical 3D printing technology can be applied in surgical planning for liver tumors, and has certain guiding significance in preoperative evaluation of accurate liver resection.

    • Radiofrequency ablation versus surgical re-resection for postoperative recurrent hepatocellular carcinoma within the Milan criteria: a Meta-analysis

      2017, 26(7):838-846. DOI: 10.3978/j.issn.1005-6947.2017.07.005

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      Abstract:Objective: To compare the efficacy and safety of radiofrequency ablation (RFA) and surgical re-resection (SRR) in treatment of recurrent hepatocellular carcinoma (HCC) within the Milan Criteria. Methods: The clinical controlled studies comparing RFA and SRR in treatment of postoperative recurrent HCC published between January 2000 and January 2017 were collected by searching from national and international databases. The data from eligible studies were analyzed by Revman5.3 software. Results: Eleven clinical studies were included involving 1 079 patients, of whom, 560 cases underwent RFA (RFA group) and 519 underwent SRR (SRR group). The results of Meta-analysis showed that there was no significant difference in postoperative 1-, 3- and 5-year survival rates between the two groups (all P>0.05), but the incidence of postoperative complications was decreased (OR=0.25, 95% CI=0.14–0.44, P<0.00001) and the length of hospital stay was shortened (OR=–6.57, 95% CI=–7.74--4.09, P<0.00001) in RFA group compared with SRR group, while the 3-year recurrence-free survival in SRR group was superior to that in RFA group (OR=0.60, 95% CI=0.42–0.86, P=0.006). Conclusion: There is no significant efficacy difference between the two methods in treatment of postoperative recurrent HCC within the Milan Criteria, while RFA possesses the advantages of minimal invasiveness, repeatable operation and high safety level.

    • Comparison of Child-Pugh, MELD and ALBI scoring systems in predicting postoperative liver failure after liver cancer R0 resection

      2017, 26(7):847-854. DOI: 10.3978/j.issn.1005-6947.2017.07.006

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      Abstract:Objective: To compare the accuracy of the scoring systems of Child-Pugh (CP), model for end-stage liver disease (MELD) and albumin-bilirubin scoring model (ALBI) in predicting posthepatectomy liver failure (PHLF) in liver cancer patients after R0 resection. Methods: The data of 275 liver cancer patients undergoing R0 resection and meeting the study criteria from September 2010 to November 2015 were collected. The abilities in predicting the occurrence of PHLF among the three scoring systems were compared by using Receiver operating characteristic (ROC) curves. Results: According to 50-50 criteria, 43 cases in the 275 patients were diagnosed with PHLF; the area under the ROC curve (AUROC) (95% CI) for ALBI, CP and MELD in diagnosis of PHLF was 0.930 (0.893–0.957), 0.795 (0.743–0.841) and 0.736 (0.680–0.787), respectively (ALBI vs. CP: P=0.0003; ALBI vs. MELD: P=0.0001; CP vs. MELD: P=0.2420). According to criteria of International Study Group of Liver Surgery (ISGLS), 48 cases in the 275 patients were diagnosed with PHLF; the AUROC (95% CI) for ALBI, CP and MELD in diagnosis of PHLF was 0.884 (0.840–0.920), 0.828 (0.778–0.871) and 0.762 (0.707–0.811), respectively (ALBI vs. CP: P=0.1542; ALBI vs. MELD: P=0.0064; CP vs. MELD: P=0.2010). The results of subgroup analysis stratified by liver resection scope were generally consistent with those of whole group analysis. Conclusion: Among the three scoring system, ALBI scoring is superior to CP and MELD scoring in predicting the occurrence of PHLF in liver cancer patients after R0 resection, and MELD scoring (due to greater value of weighting coefficient of the creatinine in the scoring system) might not be applicable for early-stage patients with mild symptoms.

    • Comparison of influences between precise and conventional hepatectomy on changes of T lymphocyte subsets of liver cancer patients

      2017, 26(7):855-860. DOI: 10.3978/j.issn.1005-6947.2017.07.007

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      Abstract:

      Objective: To compare the influences between precise and conventional hepatectomy on changes of T lymphocyte subsets in liver cancer patients. Methods: Forty-seven liver cancer patients were randomly divided into two groups, and underwent precise hepatectomy (precise hepatectomy group, 26 cases) and conventional hepatectomy (conventional hepatectomy group, 21 cases) respectively. The main clinical variables, and the pre- and postoperative CD3+, CD4+ and CD8+ levels as well as CD4+/CD8+ between the two groups were compared. Results: In precise hepatectomy group compared with conventional hepatectomy group, the operative time was prolonged, but the amount of blood loss, length of hospital stay and incidence of postoperative bile leakage and intra-abdominal hemorrhage were all reduced (all P<0.05); the postoperative changes in liver function parameters in precise hepatectomy group were superior to those in conventional hepatectomy group (all P<0.05). At postoperative day (POD) 7, the values of CD3+, CD4+ and CD4+/CD8+ were significantly decreased in both groups compared with their preoperative levels, but the decreasing degrees of them in precise hepatectomy group were significantly less than those in conventional hepatectomy group (all P<0.05), and the CD8+ values were slightly increased in both groups compared with their preoperative levels (both P>0.05); at POD 14 the values of all these T lymphocyte subsets in both groups returned to their preoperative levels. Conclusion: Precise hepatectomy is superior to conventional hepatectomy in protection of immune function, which thereby benefits the recovery of liver function in liver cancer patients.

    • >基础研究
    • Expression of miR-376c in hepatocellular carcinoma cells and its relation with high mobility group A2

      2017, 26(7):861-869. DOI: 10.3978/j.issn.1005-6947.2017.07.008

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      Abstract:Objective: To investigate the miR-376c expression in hepatocellular carcinoma (HCC) and its clinical significance and action mechanism. Methods: The miR-376c expressions in HCC tissues and tumor adjacent tissues as well as in different HCC cell lines and normal hepatic cells were determined by real-time PCR, and the relations of miR-376c expression with the clinicopathologic features and prognosis of HCC patients were analyzed. After the HCC cells were transfected with miR-376c mimics or negative control sequence, the cell migration and invasion were measured by Transwell assay and wound healing assay respectively, and the protein expression of high mobility group A2 (HMGA2), a potential downstream target of miR-376c, was measured by Western blot analysis. The protein expressions of HMGA2 in HCC tissues were also examined by immunohistochemical staining, and then the correlation between miR-376c and HMGA2 expressions was analyzed. Results: Compared with tumor adjacent tissues or normal hepatic cells, the miR-376c expressions in HCC tissue and different types of HCC cells were significantly down-regulated (all P<0.05); the miR-376c expression was significantly related with the portal vein infiltration (P=0.019), advanced TNM stage (P=0.012) and advanced Edmondson degree (P=0.009); the 3-year survival rate in patients with low miR-376c expression was significantly lower than that in those with high miR-376c expression (P=0.0081). In HCC cells compared with HCC cells transfected with negative control sequence, the numbers of migrating and invading cells (56.00 vs. 26.00; 45.33 vs. 18.33) and wound healing rate (95.3% vs. 60%) were significantly reduced, and the HMGA2 protein expression was significantly down-regulated (all P<0.05); the HMGA2 protein expression in HCC tissues with high miR-376c expression was significantly lower than that in those with low miR-376c expression (P<0.05), and the miR-376c expression was negatively correlated with HMGA2 expression in HCC tissues (r=–0.541, P<0.01). Conclusion: MiR-376c is probably a tumor suppressor, and is down-regulated in HCC, which thereby weakens the inhibition on HMGA2 and promotes the migration and invasion of HCC cells.

    • Changes in CD8+CD28–Foxp3+ regulatory T cells in patients with hepatocellular carcinoma

      2017, 26(7):870-876. DOI: 10.3978/j.issn.1005-6947.2017.07.009

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      Abstract:Objective: To investigate the changes in CD8+CD28–Foxp3+ regulatory T cells (CD8+CD28–Foxp3+Tregs) in peripheral blood and tumor tissue of patients with hepatocellular carcinoma (HCC) and the significance. Methods: The ratio of CD8+CD28–Foxp3+Tregs to CD8+T cells (CD8+CD28–Foxp3+Tregs/CD8+T) in peripheral blood in 72 HCC patients and 22 healthy controls was determined by flow cytometry, and the relations of CD8+CD28–Foxp3+Tregs/CD8+T with clinicopathologic factors of the HCC patients were analyzed. The Foxp3 positive cells and Foxp3 protein expression in tumor tissues and their adjacent tissues from HCC patients were determined by immunohistochemical staining and Western blot analysis, respectively. Results: The peripheral blood CD8+CD28–Fop3+Tregs/CD8+T was significantly increased in HCC patients compared with that in healthy controls (P<0.05), and the peripheral blood CD8+CD28–Fop3+Tregs/CD8+T was significantly associated with the TNM stage, lymph node metastasis and degree of tumor differentiation of the HCC patients (all P<0.05). The average number of Foxp3 positive cells and Foxp3 protein expression level were significantly higher in tumor tissue than those in adjacent tissue (both P<0.05). The peripheral blood CD8+CD28–Fop3+Tregs/CD8+T, and number of Foxp3 positive cells and Foxp3 protein expression level in tumor tissue all presented an increasing trend in the order of well, moderately and poorly differentiated HCC, but all differences did not reach a statistical significance (all P>0.05). Conclusion: CD8+CD28–Fop3+Tregs are increased in the peripheral blood and tumor tissue of HCC patients, which may probably be related to tumor immunosuppression, and their detection may have certain value in assessing the disease states of the HCC patients.

    • Influence of miR-96 expression on migration and invasion of hepatocellular carcinoma cells

      2017, 26(7):877-882. DOI: 10.3978/j.issn.1005-6947.2017.07.010

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      Abstract:Objective: To investigate the miR-96 expression in hepatocellular carcinoma (HCC) cells and its actions. Methods: The miR-96 expressions in different HCC cell lines (HepG2, 7721 and huh7) and normal hepatic L02 cells were measured by qRT-PCR. The HepG2 cells were transfected with scrambled miRNA sequence (negative control group), miR-96 mimics (miR-96 mimics group) and miR-96 inhibitors (miR-96 inhibitors group) respectively, and then, the cell migration and invasion abilities were examined by cell wound scratch assay and Transwell assay, and the expressions of PTPN9 mRNA and protein were determined by qRT-PCR and Western blot, respectively. Results: The miR-96 expressions were significantly higher in all studied HCC cell lines than that in normal hepatic L02 cells (all P<0.01). Compared with negative control group, the wound healing rate was significantly increased in miR-96 mimics group, and was significantly decreased in miR-96 inhibitors group (both P<0.05); the number of invading cells was significantly increased in miR-96 mimic group, and was significantly decreased in miR-96 inhibitors group (both P<0.05); both PTPN9 mRNA and protein expression levels were significantly down-regulated in miR-96 mimics group, and were significantly up-regulated in miR-96 inhibitors group (all P<0.05). Conclusion: MiR-96 expression is increased in HCC cells, which may promote the migration and invasion abilities of HCC cells by down-regulating PTPN9 expression.

    • Relationship between promoter methylation and mRNA expression of NFAT2 gene in hepatocellular carcinoma cells

      2017, 26(7):883-888. DOI: 10.3978/j.issn.1005-6947.2017.07.011

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      Abstract:Objective: To investigate the methylation status of CpG islands in the promoter region of NFAT2 gene and its relation with the NFAT2 mRNA expression in hepatocellular carcinoma (HCC) cells. Methods: The methylation status of CpG islands in the promoter region of NFAT2 in HCC and the tumor-adjacent tissues as well as in different HCC cell lines and normal hepatic cells was examined by bisulfite-sequencing PCR. NFAT2 mRNA expression in HCC and the adjacent tissues was determined by qRT-PCR, and the correlation between NFAT2 promoter methylation and its mRNA expression was analyzed. Results: The CpG island methylation rate of NFAT2 gene in HCC tissue was significantly higher than that in tumor-adjacent tissues (33.0% vs. 21.6%, P=0.003); the CpG island methylation rate of NFAT2 gene in HCC cell line HuH7, HepG2 and Hep3B was 34.8%, 40.4% and 37.0% respectively, which were all significantly higher than that in human normal hepatic cell L02 (16.2%) (all P<0.05). The NFAT2 mRNA expression in HCC tissue was significantly lower than that in tumor-adjacent tissues (0.000 602 4 vs. 0.001 469, P<0.05), and there was a negative correlation between the NFAT2 mRNA level and the degree of NFAT2 promoter methylation (r=–0.661, P=0.027). Conclusion: Down-regulated NFAT2 gene expression is probably associated with hypermethylation of CpG islands in its promoter region in HCC cells.

    • Alteration of serum microRNAlet-7a level in patients with hepatocellular carcinoma and its significance

      2017, 26(7):889-894. DOI: 10.3978/j.issn.1005-6947.2017.07.012

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      Abstract:Objective: To investigate the alteration of serum microRNAlet-7a (let-7a) level in patients with hepatocellular carcinoma (HCC) and its diagnostic value for HCC. Methods: The let-7a expressions in 60 HCC patients and 46 healthy subjects undergoing health maintenance examination were measured by qRT-PCR. And then the relations of serum let-7a level with clinicopathologic factors of HCC patients were analyzed and the diagnostic efficacy of let-7a for HCC was determined by using a receiver operating characteristic curve (ROC). Results: The relative expression level of serum let-7a in HCC patients was significantly lower than that in healthy population (0.538 vs. 1.571, P<0.05). The serum let-7a level was significantly associated with the formation of tumor emboli (P<0.05), but was irrelevant to all other studied factors that included sex, age, HBV infection, cirrhosis, tumor diameter, tumor number, lymph node metastasis, TNM stage, pathological grade and AFP level (all P>0.05). At an optimal cut-off value of 0.529 of let-7a for diagnosis of HCC, the sensitivity was 79%, the specificity was 71% and the area under the curve (AUC) was 0.77 (95% CI=0.624–0.839) respectively; in combined detection of serum let-7a and AFP for diagnosis of HCC, the sensitivity was 83%, the specificity was 97% and the AUC was 0.92 (95% CI=0.866–0.987), respectively. Conclusion: The serum let-7a level is decreased in HCC patients, which may be potentially used as a new molecular marker for diagnosis of HCC, and its diagnostic efficacy for HCC can be enhanced by combination detection of AFP.

    • >临床研究
    • Analysis of clinicopathologic profiles and prognosis in patients with hepatocellular carcinoma and concomitant sarcopenia

      2017, 26(7):895-901. DOI: 10.3978/j.issn.1005-6947.2017.07.013

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      Abstract:Objective: To investigate the clinicopathologic features and postoperative prognosis in patients with hepatocellular carcinoma (HCC) and concomitant sarcopenia. Methods: The clinicopathologic and follow-up data of 139 HCC patients undergoing surgical resection in Renmin Hospital of Wuhan University from March 2010 to June 2016 were retrospectively analyzed. Results: Among the 139 patients, 56 cases (40.3%) had concomitant sarcopenia. In patients with concomitant sarcopenia compared with those without sarcopenia, the body mass index and skeletal muscle index were significantly decreased, and the portions of cases with advanced TNM stage and microvascular infiltration were significantly increased (all P<0.05); the incidence of postoperative infections (14.3% vs. 3.6%), major complications (Clavien-Dindo III and above) (19.6% vs. 6.0%) and overall complications (35.7 vs. 13.3%) were significantly increased (all P<0.05); the time for postoperative recovery (17.35 d vs. 11.33 d) was significantly prolonged and percentage of cases requiring ICU admission (12.5% vs. 2.4%) was significantly increased (both P<0.05); the overall postoperative survival time was significantly reduced (P<0.05). Results of Cox proportional hazard model showed that concomitant sarcopenia was an independent risk factor affecting the postoperative survival of HCC patients. Conclusion: HCC patients with concomitant sarcopenia may experience an increased incidence of postoperative complications and delayed postoperative recovery, and also may face an unfavorable postoperative prognosis.

    • Laparoscopic microwave ablation for giant hepatic hemangioma: a report of 86 cases

      2017, 26(7):902-906. DOI: 10.3978/j.issn.1005-6947.2017.07.014

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      Abstract:Objective: To investigate the efficacy and technical aspects of laparoscopic microwave ablation in treatment of giant hepatic hemangioma. Methods: The clinical data of 86 patients with hepatic hemangioma larger than 5 cm in diameter undergoing laparoscopic microwave ablation from January 2015 to December 2015 were retrospectively analyzed. Results: Laparoscopic microwave ablations were performed successfully in all the 86 patients without any open conversion. The average ablation time was (26.4±2.7) min, average blood loss was (27.6±5.2) mL and average length of postoperative hospital stay was (3.7±1.4) d. The complications included hemoglobinuria in 20 cases (23.3%), skin burns in 3 cases (3.5%), fever in 11 cases (12.8%), and pneumothorax in one case (1.2%), but no serious complications such as postoperative hemorrhage, bile leakage and adjacent organ injuries occurred. Postoperative follow-up was conducted for 6 to 12 months. There were 82 cases (95.3%) with residual hemangioma lesion of less than 10%, 3 cases (3.5%) with residual lesion ranging from 10% to 15%, and one case (1.2%) with residual lesion more than 15%. Conclusion: Laparoscopic microwave ablation is safe and effective in treatment of giant hepatic hemangioma, and it is recommended to be used in clinical practice.

    • Clinical efficacy of selective hepatic artery embolization for grade III or IV liver trauma

      2017, 26(7):907-912. DOI: 10.3978/j.issn.1005-6947.2017.07.015

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      Abstract:

      Objective: To investigate the clinical efficacy of selective hepatic artery embolization in treatment of grade III or IV liver trauma. Methods: The clinical data of 19 patients with grade III or IV liver trauma undergoing hepatic artery embolization (intervention group) from January 2006 to October 2016, and 19 comparable patients with grade III or IV liver trauma undergoing open surgery (laparotomy group) treated during the same period were retrospectively analyzed. The relevant clinical variables between the two groups of patients were compared. Results: Operations were successfully performed in both groups of patients. The postoperative serum transaminase and creatinine levels were significantly lower and the time for aminotransferase to return to normal was significantly shorter in intervention group than those in laparotomy group (all P<0.05); in intervention group compared with laparotomy group, the operative time (60.74 min vs. 128.11 min), postoperative fasting time (34.03 h vs. 56.00 h), length of hospital stay (13.58 d vs. 18.37 d) and hospitalization costs (34 860.90 yuan vs. 54 141.47 yuan) as well as incidence of complications (10.5% vs. 57.9%) were all significantly reduced (all P<0.05). No significant difference was noted in other clinical variables between the two groups (all P>0.05). Conclusion: Selective hepatic arterial embolization is a safe and effective method for grade III and IV liver trauma. For grade III or IV liver lacerations with stable hemodynamics or hemodynamic stability obtained after aggressive anti-shock therapy and blood or fluid transfusion, selection of interventional angiography is recommended.

    • >文献综述
    • Research progress of relationship between long non-coding RNA highly upregulated in liver cancer and hepatocellular carcinoma

      2017, 26(7):913-920. DOI: 10.3978/j.issn.1005-6947.2017.07.016

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      Abstract:Long non-coding RNAs (lncRNAs) are classified as RNAs greater than 200 nucleotides in length without protein coding capability, which exert multiple functions upon a wide range of biological processes. Highly upregulated in liver cancer (HULC) is an lncRNA that was found specifically overexpressed in hepatocellular carcinoma (HCC). Recent evidence has indicated that lncRNA HULC is closely related to HCC and other HCC-related diseases (such as viral hepatitis and posthepatitic cirrhosis), involving in the occurrence and development as well as prognosis of HCC by multiple mechanisms such as epigenetic regulation, abnormal lipid metabolism, and promotiing angiogenesis and epithelial-mesenchymal transition. Moreover, lncRNA HULC has a potential value of acting as a diagnostic biomarker or therapeutic target for HCC. Here, the authors review the research progress in relationship between lncRNA HULC and HCC.

    • Research progress of preoperative predicting microvascular invasion of hepatocellular carcinoma

      2017, 26(7):921-925. DOI: 10.3978/j.issn.1005-6947.2017.07.017

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      Abstract:Hepatocellular carcinoma (HCC) is one of the common malignancies, for which, surgical resection and liver transplantation may be potentially curative remedies but the prognosis remains poor due to a high likelihood of postoperative recurrence. Microvascular invasion (MVI) is an independent prognostic factor, and its preoperative diagnosis has become a hot topic in the field of research. Here, the authors review the current research progress in preoperative prediction of HCC with MVI.

    • Participation of intra- and extrahepatic stem/progenitor cells in liver regeneration: recent advances

      2017, 26(7):926-933. DOI: 10.3978/j.issn.1005-6947.2017.07.018

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      Abstract:Liver regeneration refers to the rapid proliferation of impaired liver tissue caused by injurious stimulus (surgery, trauma, poisoning, infection, and necrosis, etc.) to increase the volume and weight of the remnant liver. Liver regeneration can be divided into three major levels according to the cause and severity of the injury: hepatocyte dominant regeneration, intrahepatic stem/progenitor cells mediated regeneration, and extrahepatic stem/progenitor cells participative regeneration. Liver regeneration is usually completed by division of the mature liver cells after the liver undergoing mild to moderate injuries. However, when the liver is severely damaged or the proliferation of hepatocytes is strongly inhibited, liver stem/progenitor cells will participate in the liver regeneration process. Besides the participation of the intrahepatic stem cells, the extrahepatic bone marrow-derived stem cells and stem cells reprogrammed from endothelial progenitor cells are also involved in liver regeneration, but the detailed mechanism remains unclear. Here, the authors address the latest focuses on liver regeneration, especially on the stem/progenitor cells participated liver regeneration and its potential clinical application.

Governing authority:

Ministry of Education People's Republic of China

Sponsor:

Central South University Xiangya Hospital

Editor in chief:

WANG Zhiming

Inauguration:

1992-03

International standard number:

ISSN 1005-6947(Print) 2096-9252(Online)

Unified domestic issue:

CN 43-1213R

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