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Hepatocellular carcinoma(HCC) is one of the most common malignant tumors of the digestive system in the clinic. In recent years, the proposal and development of immunotherapy have set off a worldwide anticancer upsurge. In particular, programmed death receptor 1(PD-1) and programmed death receptor ligand 1(PD-L1) inhibitor have been used in a wide variety of tumor diseases and achieved good curative effect. However, the application of PD-1 or PD-L1 inhibitors in HCC is mostly still at the stage of clinical trials, and some clinical trials have shown gratifying results in patients with advanced HCC and postoperative recurrence. More studies have shown that PD-1 or PD-L1 inhibitors combined with radiofrequency, chemoradiotherapy, and molecular targeted drugs can bring greater benefits to patients.

Liver transplantation(LT) is the "crown" of surgery and is also an important manifestation of national medical standards. In the past half century, China has made remarkable progress in LT. Currently, China is the second largest country of LT world widely and presents an international advanced level in the efficacy of LT. However, it is notable that there are still many bottlenecks to be solved in China. In the era of precision medicine and big data, the basic research of LT is largely lagging behind and unable to meet the rapid development of clinical needs. Strengthen the basic research of LT is a breakthrough strategy in rejuvenating the country through science and technology in the new era. A high-quality professional research team should be built through multi-disciplinary cooperation and superior resources gathering. Researcher's innovative thinking and strategic vision should be cultivated via the learning of new technologies (e.g., single-cell exploration and multi-omics analysis) and new courses (e.g., transplant oncology and transplant immunology). Government investment also needs to be increased to speed up the nurturing of high-level talents and get great achievements. Basic research is the driving force for China to become a leading country in LT.

Objective: To study the clinical features and treatment of recurrent hepatocellular carcinoma after liver transplantation., Methods: Clinical data of 95 patients with recurrent hepatocellular carcinoma (HCC) after liver transplantation from January 2003 to November 2005 were analyzed retrospectively., Results: During follow-up, 42 patients (43.2%) were diagnosed HCC recurrence. The predominant sites of recurrence were liver graft (32 cases), lung (21 cases), bone (7 cases). Tumor size, tumor distribution, liver cirrhosis, pre-transplant AFP level, tumor differentiation, macrovascular invasion were considered risk factors of both post-transplant survival and HCC recurrence in univariate analysis. Tumor distribution, tumor differentiation, macrovascular invasion were considered independent risk factors of both overall post-transplant survival and HCC recurrence in multivariate analysis. Intervention therapy and internal radiation of recurrent HCC could delay tumor progression and resection of recurrent HCC in selected patients can significantly prolong post-recurrence survival., Conclusions: Carefully selection of HCC patients as candidates for liver transplantation can significantly reduce HCC recurrence. At the present stage, surgical resection of recurrent HCC is the best treatment method in selected patients.

Objective: To investigate the intestinal microflora status and bacterial translocation in rats after liver transplantation., Methods: Male Brown-Norway (BN) rats were randomly divided into 4 groups: group I (n = 8) for liver transplantation; group II (n = 8) for simulated liver transplantation; group III (n = 8) for sham operation and group IV (n = 8) for normal group. Caecal bacterial counts, plasma endotoxin, intestinal mucosal ultrastructure and bacterial translocation to liver, spleen, kidney, and mesenteric lymph node were studied 24 h after surgery., Results: The numbers of Bifidobacterium and Lactobacillus per gram of wet feces were significantly decreased in group I compare with those in the group III and group IV, while Enterobacteriaceae and Enterococcus counts were increased markedly compare with those in the group III and group IV, but no different was found between group I and group II. Impaired intestinal mucosa integrity were found in the group I and group II. In group I, the levels of plasma endotoxin increased after the transplantation when compare with group III and group IV. Increased incidence of bacterial translocation to liver, spleen and mesenteric lymph node were also observed after the transplantation (compare with those in the group IV, P < 0.01; compare with those in the group III, P < 0.01, P < 0.01, P < 0.05, separately). The increased rate of the bacterial translocation in liver was also found in transplantation group as compare with group II (P < 0.05)., Conclusions: Liver transplantation may lead to disturbance of intestinal microflora and impairment of intestinal mucosal barrier function, and this dysfunction might be caused by the process of intestinal ischemia-reperfusion injury in transplantation.

Objectives: To study the expression of Polo-like kinase 1 (PLK1) and E-cadherin in the tissues of hepatocellular carcinoma, and to discuss the relationship between them and clinical-pathological features, and to evaluate their prognostic value of hepatocellular carcinoma after liver transplantation., Methods: mRNA and protein expression of PLK1, E-cadherin were detected by RT-PCR and immunohistochemistry method respectively, the correlations of them with clinical-pathological data, tumor free time, recurrence rate were compared and analyzed., Results: The mRNA expression was observed in 90.0% for PLK1 and 96.0% for E-cadherin, and higher in cancerous' tissues than paracancerous' of all cases for PLK1 but no trend for E-cadherin. The positive and decreased expression rate for PLK1 and E-cadherin was observed in 60.0% and 50.0% respectively, the positive PLK1 expression was correlated with preoperative serum alpha-fetoprotein (AFP) only (chi2 = 4.433, P = 0.035), while E-cadherin expression was associated with none of the clinical-pathological features. There was a correlation between the positive PLK1 and decreased E-cadherin expression (chi2 = 5.333, P = 0.021). PLK1 (P = 0.006), E-cadherin (P = 0.019) and larger tumor (P = 0.019), portal vein tumor thrombi (P = 0.030), Edmondson grading (P = 0.019), preoperative serum AFP (P = 0.020) were all correlated with recurrence rate under Kaplan-Meier analysis, while only PLK1 (RR = 3.104, P = 0.009) had significant difference under Cox regression analysis., Conclusions: The positive PLK1 expression and the decreased E-cadherin expression indicate higher recurrence rate of HCC after liver transplantation, and PLK1 is a independent risk factor.

Objective: To investigate the prevalence and associated risk factors of bacterial translocation (BT) in patients with cirrhosis after liver transplantation and analyze the effect of BT on bacterial infection after the surgery., Methods: Mesenteric lymph nodes (MLN), portal vein blood, and peripheral blood were collected during the liver transplantation for microbiological culture from 78 patients with cirrhosis. And meanwhile, all related clinical data were analyzed to investigate the risk factors of BT and its relationship with post-liver transplantation infections., Results: BT was occurred in 8 of 78 cirrhotic patients (10.3%) and positive-rate of MLN culture was 5/8. Gram-negative aerobic bacillus was the main causative bacterium of BT (5/9), followed by Gram-positive aerobic enterococcus (22.2%, 2/9). Total bilirubin level in patients with BT was significantly higher than that in patients without BT., Conclusions: It suggests that hyperbilirubinemia is the only risk factor for BT, and BT is associated with an increased infectious rate after liver transplantation.

Objective: To analyze the prognostic value of hepatocyte growth factor (HGF) and c-met for patients with hepatocellular carcinoma (HCC) after hepatectomy., Methods: Twenty-five patients undergoing partial hepatectomy for HCC were studied. Serum HGF level was determined using ELISA kit before and after operation respectively. c-met protein and mRNA expression in cancerous and paracancerous tissues were detected by immunohistochemical and RT-PCR methods respectively. The correlations of clinical-pathologic parameters with the HGF level in serum and c-met expression in cancerous tissue were analyzed respectively., Results: HCC patients had a significantly higher concentration of serum HGF than normal controls and chronic hepatitis B respectively [(1.03 +/- 0.09) ng/ml vs (0.69 +/- 0.02) ng/ml and (0.74 +/- 0.09) ng/ml]. No significant difference in serum HGF was observed between HCC and cirrhosis patients with Child-Pugh score B/C [(1.03 +/- 0.09) ng/ml vs (1.04 +/- 0.11) ng/ml]. Serum HGF concentrations were positively correlated with tumor size (> 5 cm), node cirrhosis, portal vein tumor thrombi (PVTT) and preoperative alpha-fetoprotein (AFP) level (> or = 400 microg/L). After the resection of tumor, serum HGF concentration had a peak on the third postoperative day (POD), and then declined, but did not return to normal level on the tenth POD. From preoperative day to third POD, HGF concentration had a higher elevation in patients with major resection than with local resection. Moderately or strongly positive expression of c-met protein was observed in 21 cancerous regions (21/25), and only in 5 paracancerous regions. The intensive expression of c-met mRNA was 100% (25/25) detectable in the cancerous tissues, but only 24% (6/25) in the paracancerous tissues. The expression extent of c-met protein was correlated with portal vein tumor thrombi (PVTT). In paracancerous tissues, the expression of c-met protein was more intense in patients with cirrhosis than those without cirrhosis. The patients with recurrence or metastases after operation had a higher level of serum HGF and more intensive expression of c-met than other patients. No significant association was observed between HGF in serum and c-met expression in cancerous tissue., Conclusions: The over-expression of HGF and its receptor c-met indicate an adverse prognosis for HCC patients. The sustained high level of serum HGF after hepatectomy may be a factor related to early tumor recurrence and metastasis.

Objective: To summarize the experience of liver retransplantation for patients with poor graft function., Methods: The clinical data of 9 patients undergone liver retransplantation at our center from April 1993 to April 2005 were retrospectively analyzed. The main indications for liver retransplantation at our center were early hepatic artery thrombosis (2/9), early portal vein thrombosis (1/9), and biliary tract complication (6/9). Of the 9 patients received liver retransplantation with cadaveric allografts, 3 received classic orthotopic liver transplantation, and 6 piggyback liver transplantation. Roux-en-Y biliary tract reconstruction was performed in 6 patients, Donor spleen vein was used as a conduit between donor portal vein and recipient portal vein in 1, and donor spleen artery as a conduit between donor hepatic artery and recipient aorta in 1., Results: No perioperative mortality occurred. Of them, 5 had no complications after the operation, 1 had stricture in anastomotic stoma of portal vein, and 3 died in 6 months after the operation., Conclusions: Poor graft function due to biliary tract complications and vessel complications after primary liver transplantation are the chief indications of liver retransplantation. Liver retransplantation is the only suitable treatment of poor graft function.

Objective: To investigate the influence of aerosols on the expression of cyclin B(1), cyclin C and proliferating cell nuclear antigen (PCNA) in wound tissue healing of burned rat models., Methods: Sprague Dawley (SD) rats were inflicted as the deep partial thickness burn models. Rats were randomly divided into experimental group and control group. The experimental group were treated with aerosols. Samples were collected in 1 approximately 10 postburn days. Immunohistochemistry and image analysis methods were conducted to examine the expression of cyclin B(1), cyclin C and PCNA in both experimental and control groups., Results: The expression of cyclin C in experimental group was detected in nucleus of skin basal cell on the second postburn day, increased evidently at the fifth days and sustained at high expression level up to the tenth days after treatment. The expression of cyclin C in experimental group was significantly higher than control group (P < 0.05). The expression of PCNA was first observed in skin basal cell nucleus and hair follicle cell nucleus in both experimental and control group on the third postburn day. The expression of PCNA increased evidently at the fifth days in experimental after treatment and that increased evidently at the seventh days in control group, which showed there were lots of active proliferation cell. And the difference of the expression of PCNA between experimental and control group was significant (P < 0.01). The expression of cyclin B(1) was detected in nucleus and cytoplasm of skin basal cell in both groups on the third postburn day, and no difference between the experimental and control group (P > 0.05)., Conclusions: Aerosols can up-regulate the expression of cyclin C and PCNA in skin basal cell nucleus. Therefore the aerosols can accelerate wound tissue healing.

Objective: To document the indication and value of orthotopic liver transplantation (OLT) for the patient with Klatskin tumor., Methods: Forty patients of Klatskin tumors, including 5 patients with liver transplantation (LTx) and 35 without LTx (WLTx) from Jan 1992 to Dec 2003 were enrolled for analysis retrospectively. The TNM stages were comparable in both groups. In LTx group, 4 patients were Klatskin tumor including 1 recurrence 5 months later after resection, and 1 cancerization from Caroli's disease. Biliary duct anastomosis was performed by Roux-en-Y choledochojejunostomy in two, end-to-end choledochocholedochostomy in 3 cases., Results: In LTx group, the total resection rate and radical resection rate were both 100%. Four cases survived for 48, 38, 21 and 5 months, respectively, except that the other one died from bile leakage at the 40th day after transplantation. All 4 survivors had good life quality without tumor in local or distant site, even though 3 of 4 cases developed biliary stricture, which was cured by radiological intervention therapy. The overall 1, 3-year survival rates were both 4/5 in LTx. The total resection rate and radical resection rate in the WLTx group were 63.0% (17/27) and 40.7% (11/27) and, the 1, 3, 5-year survival rates were 32.2%, 8.0% and 0, respectively. There was significant difference between the two groups in radical resection rate and survival rate (P = 0.016). In the routine radical resection group, the 1, 3-year survival rates were 54.5% (6/11) and 18.% (2/11), which were not significantly different from those in LTx., Conclusion: OLT is a good choice for the patients with advanced stage of unresectable Klatskin tumor by routine modalities, and the prognosis was exciting.

Objective: To observe the effects of local co-transfection vascular endothelial growth factor165 (VEGF165) and tissue-type plasminogen activator genes on inhibiting intimal hyperplasia and restenosis in rabbits artery after operation injury and possible mechanisms., Methods: Micrology operation injury was used to establish the model of intimal injury of right external iliac artery in rabbits. To select 120 male New Zealand rabbits and were randomly divided into 3 groups (n = 40, in each group): Group A (physiological brine control group), Group B (pBudCE4.1 group), Group C (pBudCE4.1/VEGF165-tPA group). The vas-wall of micrology operation injury were infused respectively physiological brine, pBudCE4.1 and pBudCE4.1/VEGF165-tPA transfection solution by micro-injector. Each group were divided into 5 subgroups (n = 8, in each subgroup) randomly according to the sacrifice times (2 d, 1 week, 2 week, 4 week and 8 week after operation). The injured vascular specimen were harvested for pathology test, electric microscopy study, reverse transcription-PCR examining and immunochemistry detecting., Results: The intimal area and narrow ratio of vases in Group C at every time point after operation were significantly lessened than that in Group A and Group B (P < 0.01). The narrow ratio of vases in Group C at 8 week after operation were decreased respectively by 57.9% and 59.0% than that in Group A and B. The expression of VEGF165 mRNA in Group C were increased significantly than that in Group A and B at every time point after operation (P < 0.01), the expression reached the peak at 1 week and continued to 4 week after operation. Immunohistochemical identified that tPA positive cell in Group C were significantly increased than that in Group A and B (P < 0.01) at every time point after operation., Conclusion: Local co-transfection VEGF165 and tPA genes could restrain intimal hyperplasia and restenosis of vas, which lay a foundation for future multi-gene therapy of vascular intimal hyperplasia.

Objective: To review diagnosis and treatment experience of cytomegalovirus (CMV) infection after liver transplantation., Methods: The clinical data of 96 patients receiving liver transplantation in our hospital from January 2001 to December 2002 were analyzed retrospectively., Results: CMV infection occurred in 19 patients, blood IE-E antigen of CMV and PP65 antigen of CMV was detected in all the patients with CMV infection, 8 patients with CMV-IgM positivity, 3 of them presented with dyspnea, 4 with fever and 2 with jaundice, 14 patients had no symptoms of CMV infection. IE-E antigen of CMV and PP65 antigen of CMV in blood of 18 patients became negative after treatment with ganciclovir, 1 patients died from interstitial pneumonitis., Conclusions: Cytomegalovirus infection after liver transplantation is associated with many factors, the key point of CMV infection is prevention actively and early treatment after operation. The detection of blood antigen of CMV is necessary for early diagnosis and guiding treatment of CMV infection, ganciclovir is effective for treatment of CMV infection.

Objective: To summarize the experience of liver transplantation (LT) for hepatocellular carcinoma (HCC) in one center and identify prognostic factors for survival., Methods: The clinical data and survival results of 89 patients with HCC receiving LT from January 1999 to December 2003 were retrospectively analyzed and various clinicopathologic risk factors for actuarial survival and tumor free survival were evaluated by univariate and multivariate analysis., Results: Six-month, 1-, and 2-year survival rates were 81.8%, 55.3% and 43.7%, respectively. The 6-month, 1-, and 2-year tumor free survival rates were 62.4%, 35.6% and 24.9%, respectively. The overall tumor recurrence and metastasis rate was 52.8%. In the univariate analysis, portal vein tumor thrombi (PVTT) (chi(2) = 15.14, P = 0.0001), tumor size (chi(2) = 15.05, P = 0.0001), hepatic cirrhosis background (chi(2) = 6.14, P = 0.0132), preoperative alpha-fetoprotein (AFP) level (chi(2) = 5.82, P = 0.0159) and histopathologic grading (chi(2) = 4.61, P = 0.0319) were found to be significantly associated with actuarial survival rate. Seven factors influencing tumor free survival included PVTT (chi(2) = 26.30, P < 0.0001), tumor size (chi(2) = 25.25, P < 0.0001), preoperative AFP level (chi(2) = 14.83, P = 0.0001), histopathologic grading (chi(2) = 12.54, P = 0.0004), tumor distribution (chi(2) = 12.73, P = 0.0004), number of nodules (chi(2) = 9.81, P = 0.0017) and cirrhosis background (chi(2) = 9.76, P = 0.0018). In the multivariate Cox regression analysis, the prognostic factors independently associated with patient survival were identified to be PVTT (RR = 4.721, P = 0.001), age (RR = 3.282, P = 0.007) and histopathologic grading (RR = 2.368, P = 0.037). For tumor free survival, histopathologic grading (RR = 3.739, P < 0.0001), PVTT (RR = 4.382, P = 0.001), cirrhosis background (RR = 0.421, P = 0.011), age (RR = 2.312, P = 0.027) and AFP (RR = 2.301, P = 0.047) were identified as prognostic parameters., Conclusions: LT is a good therapeutic option for strictly selected patients with HCC. PVTT and histopathologic grading are the most important factors of predicting outcomes of HCC patients undergoing LT. Further studies should be strengthened to establish a reliable and feasible selection criteria and an optimal prognosis scoring system for LT.

Objective: To study the effect of platelet-derived growth factor (PDGF) and proliferating cell nuclear antigen (PCNA) antisense oligodeoxynucleotides (AODN) together on inhibiting the proliferation of the stenosis of transplanted vascular., Methods: The left and right external iliac arteries (length 1.0 cm) of rabbits were transplanted reciprocally. The transplanted vascular were respectively soaked in liposomes, PDGF-AODN, PCNA-AODN and PDGF-AODN adding PCNA-AODN solution about 20 minute, the vascular anastomotic were sutured by 8/0 suture of soaked in AODN solution. Four weeks later, the specimens were harvested for microscopy. The pathological morphology of transplanted vascular were observed under microscope (HE). The intimal thickness and area, stenosis ratio(%) of transplanted vascular were calculate and analysed statistically among group by computer system. The number of positive cells of PDGF's mRNA in transplanted vascular wall were counted with in situ hybridization histo-cytochemistry and the number of positive cells of PCNA's protein in transplanted vascular wall were counted by S-P immunochemistry., Results: The intimal thickness and area, stenosis ratio of transplanted vascular, the number of PDGF and PCNA positive cell in PDGF-AODN adding PCNA-AODN group were significantly lower than those in other group (P < 0.01), and that were lower evidently than PDGF-AODN group and PCNA-AODN group., Conclusion: PDGF and PCNA antisense oligodeoxynucleotides together could significantly inhibit the proliferation of vascular smooth muscle cell and stenosis of transplanted vascular.

Objective: To sum up the clinical characteristics of patients with central pontine myelinolysis (CPM) after orthotopic liver transplantation (OLT) and to document the possible causes on CPM., Methods: 142 patients' data with OLT between January 1999 to May 2003 were analyzed retrospectively. The following risk factors during preoperation were analyzed between patients with and without CPM: primary liver disease, preoperative serum sodium level, magnesium level and plasma osmolality, fluctuation degree of serum sodium concentration, and immunosuppressive drugs level etc., Results: A total of 13 (9.2%) neurologic symptoms appeared in 142 patients post operation, including 5 cases (3.5%) with CPM and 8 cases (5.6%) with cerebral hemorrhage or infarct. 2 patients who developed CPM after OLT had hyponatremia history before operation (serum sodium <130 mmol/L), and the mean serum sodium level was (130.6 +/- 5.54) mmol/L. The serum sodium level was significantly lower in CPM than that of patients without neurologic complication or with cerebral hemorrhage/infarct (P <0.05). The rises of serum sodium perioperative 48 h after OLT in patients with CPM was significantly greater than that in patients with cerebral hemorrhage/infarct or no neurologic complication (19.5 +/- 6.54) mmol/L, (10.1 +/- 6.43) mmol/L, (4.5 +/- 4.34) mmol/L, respectively, (P < 0.05). Plasma osmolality increased greatly postoperatively in patients with CPM. Hypomagnesemia was noted in all patients perioperatively, but there was not significant difference among groups. The duration of operation in CPM was longer than in others (492 +/- 190.05) min (P <0.05). Cyclosporin A (CsA) levels were normal in all patients, but there was significant difference between patients with and without neurologic complication (P <0.05)., Conclusions: CPM may be more prevalent following liver transplantation. Although the diagnosis of CPM after OLT can be made by complete neurologic evaluation including magnetic resonance imaging (MRI) of the head, the mortality is still very high. The occurrence of CPM may be associated with hyponatremia, rapid rise of serum sodium concentration, postoperative increase of plasma osmolality, the duration of operation and high CsA levels.

Objective: To investigate the relation between the activity of nuclear factor kappaB (NF-kappaB) and the expression of interferon (IFN)-gamma gene transcription with or without ciclosporin treatment after liver transplantation., Methods: Orthotopic liver transplantation was performed in this study. Group I: syngeneic control (Wistar-to-Wistar); Group II: acute rejection (SD-to-Wistar); Group III: acute rejection treated with ciclosporin by intramuscular route (SD-to-Wistar + ciclosporin). Electrophoretic mobility shift assay and reverse transcriptase polymerase chain reaction were used to analyze NF-kappaB activity of splenocytes and IFN-gamma gene transcription expression of grafted liver with or without ciclosporin treatment after liver transplantation. Histopathological examination was also used in this study., Results: Low NF-kappaB activity was only detected at day 5 and day 7 in Wistar-to-Wistar group after transplantation, meanwhile low IFN-gamma mRNA expression was detected at any time in this group. In contrast, high NF-kappaB activity was detected in SD-to-Wistar group and high level IFN-gammamRNA expression was detected at all time points in this group. The activity of NF-kappaB and IFN-gammamRNA expression were significantly inhibited in SD-to-Wistar + ciclosporin group which was significantly lower than that of SD-to-Wistar group (P < 0.001). A good correlation was found between activity of NF-kappaB and IFN-gamma mRNA expression in this study (r=0.815, P <0.01)., Conclusions: The change of expression IFN-gamma mRNA is at least partially due to the activity change of NF-kappaB after orthotopic liver transplantation. CsA down-regulates NF-kappaB activity and further inhibit IFN-gamma gene transcription.

Objective: Carcinoma of the gallbladder is an uncommon, but patients with the disease are associated with a dismal prognosis. The purpose of this study was to analyze the characters, prognostic factors of gallbladder carcinoma and investigate the measures of diagnosis and treatment., Methods: 98 patients admitted into our hospital from January 1992 to July 2000 were followed up, with a mean follow-up time of 478 days (1 - 2,280 days). All statistical analyses were performed with SPSS10.0 statistical package. Survival curves were estimated by the Kaplan-Meier method and differences among groups were tested by the log-rank test. The Cox multivariate analysis was performed to determine prognostic factors on survival., Results: Among 98 patients, 31 with radical resection, 29 with palliative resection, 18 with exploration and 20 with chemo- and/or radiotherapy, The overall 5-year survival rate of the gallbladder carcinoma was 6.67%, The 1-, 3-, and 5-year survival rate following radical resection for gallbladder cancer was 77.29%, 34.37%, 21.48% respectively, The survival rate in radical resection group was remarkably higher than that of the others (P < 0.01). Multivariate analysis revealed that tumor, node, metastases (TNM) stage and therapeutic interventions had significantly higher risk ratios for gallbladder cancer., Conclusions: With careful patient selection, aggressive resection may help to improve the prognosis, although the disease with ominous reputation. Resection alone is inadequate for a significant improvement in survival, so there is a need to evaluate more effective adjuvant therapy in the form of radiotherapy or newer chemotherapeutic agents. Emphasis to improve the long-term survival should be pay on early diagnosis and early management.

Objective: To exploration the endothelialization of prostheses with bone marrow CD(34)(+) cells., Methods: CD(34)(+) cells were isolated from bone marrow of carine by an immune magnetic cell sorting system and induced into endothelial cells with VEGF. Seeding the cells to PTFE prostheses which implanted the abdominal aorta artery (AAA) and inferior vena cava (IVC)., Results: The isolated cells from bone marrow were CD(34)(+) by flow cytometer which could differentiate into endothelial cells in vascular endothelial growth factor (VEGF). The endothelial cells were identified by immunostaining and transmission electron microscope. The obliteration rate of the seeding grafts implanting AAA was 0%, the stenosis rate 12.5%; the obliteration rate implanting IVC 12.5%, the stenosis rate 25%., Conclusion: CD(34)(+) cells were isolated from bone marrow by an immune magnetic cell sorting system and were able to be induced into endothelial cells with VEGF in vitro. PTFE prostheses seeding CD(34)(+) cells have the ideal endothelialization and patency.

Objective: To elucidate the profile of serum cytokines and adhesion molecules in stable survivors with clinical liver transplantation., Methods: Flow cytometric analysis was used to analyse the phenotype of T cell subsets in peripheral blood mononuclear cells (PBMCs) from group of liver transplantation (LTx) (n = 22), primary liver carcinoma (PLC) (n = 13) and healthy control (n = 12). Enzyme-linked immunoabsorbent assay (ELISA) was used to determine the serum cytokines and adhesion molecules profiles in stable survivors with clinical liver transplantation., Results: Percentage of CD3(+) T cell and CD8(+) T cell, as well as ratio of CD4(+) to CD8(+) revealed no difference among three groups. The percentage of CD3(+)CD25(+) T cells in LTx group was found higher than that in healthy group (P = 0.022). Th1 cytokines (IL-2, IFN-gamma) and Th2 cytokines (IL-4, IL-10), as well as TNF-alpha displayed no significant difference among three groups. The levels of IL-6, ICAM-1 and P-selectin in serum were not found any difference between LTx group and PLC group, while the levels of IL-6, ICAM-1 and P-selectin in serum shown significant difference between LTx and healthy groups (P = 0.048, 0.000 and 0.025, respectively)., Conclusions: Our data demonstrates that effector T-cells can also be activated and exert immunoresponse to grafts permanently under the treatment of immunosuppressant. Adhesion molecules (ICAM-1, P-Selectin) and pro-inflammatory cytokines (IL-6, TNF-alpha) might be involved in the process of chronic graft damage induced by allo-immunoresponse.

Objective: To investigate the effect of combined CsA and FK506 with 5-FU on hepatocellular carcinoma rats., Methods: A syngeneic rat model of hepatocellular carcinoma was used. Control group (A) underwent 4 ml 5% GS. Treatment group was divided into 3 groups namely, group B: only 5-FU and 5% GS; group C: 5-FU, CsA and 5% GS; group D: 5-FU, FK506 and 5%GS. Cell cycle, apoptosis, necrosis and mitochondrial transmembrane potential were measured by flow cytometry, laser scanning confocal microscopy, and electron transmission microscopy. Statistical analysis was performed by SPSS 10.0 for Windows software. Statistical comparisons were made with ANOVA followed by Dunnett's T3 or LSD test., Results: Compared to the control group, the percentage of apoptotic cells including trifle necrotic cells was significantly higher, and among the treatment group, group D was the highest, and group C was higher than group B. In the treatment group, cell cycle of hepatoma cells was mainly arrested at S phase, but in group D, G0/G1 phase cells were significantly decreased and S phase cells significantly increased. Compared to the control group, mitochondrial transmembrane potential was significantly decreased in the treatment group, among with, group B was the lowest, group C was higher than group D. Morphological changes demonstrated by electron microscopy included dispersed nuclear chromatin, loss of nucleoli, membrane bleeding, cell shrinkage, typical apoptotic bodies and marked swelling of mitochondria in the treatment group. In the control group, however, they were characterized by normal cell ultrastructure., Conclusions: The present study reveals that 5-FU combined with CsA or FK506 demonstrated a synergistic effect on hepatocellular carcinoma rats. For FK506, the powerful mutual effect is related to the increase of tumor cell's quantity in S phase. Both CsA and FK506 can provide protection on mitochondrial transmembrane potential reduction against hepatoma cells damage from 5-FU.

Objectives: To explore the relation between tumor TNM of pancreatic cancer and treatment, and to summarize the experience in diagnosis and treatment of pancreatic cancer., Methods: The data on 321 patients with pancreatic cancer treated at our hospital between January 1990 and December 2000 were reviewed retrospectively. Radical resection and survival for various TNM stages were analyzed., Results: The rates of radical resection for stage I, stage II, stage III, stage IVA, and stage IVB were 100%, 100%, 82.6%, 12.3% and 2.1% respectively. The 1-, 3- and 5-year survivals of stage I, II were 73.3%, 40.0% and 30.0% respectively, and higher than those of other groups., Conclusions: The patients with pancreatic cancer diagnosed early can undergo radical resection. The elevation of early diagnosis rate is significant for the improvement of survival.

Objective: To summarize our clinical experience in liver transplantation while considering the background in this field in China., Methods: Ninety-five patients who had received liver transplantation from April 1993 to March 2002 were analyzed retrospectively. Three periods were defined objectively as period I (1993 - 1997), II (1999) and III (2000 - 2002). Operative techniques, recipients, original diseases, complications and survival rates were compared among the three periods., Results: Malignant liver lesions were the main cause for liver transplantation in period I and II. The ratio of number of malignant disease to total recipients decreased gradually from period I to III (100%, 53% and 35%, respectively). The 1-year survival rate in patients with benign liver disease was 85% and the total operative mortality was 5% in period III. The incidence of hepatitis B virus reactivation or reinfection was 24% twelve months after liver transplantation. Vascular complication decreased but biliary complications did not and remained a major long-standing problem. No veno-venous bypass technique was used in period III, and its advantages were obvious when comparing with those with veno-venous bypass in period I and II., Conclusions: Strict selection of recipients, fine operative technique, familiarity with various complications and correct therapeutic methods, prophylaxis of recurrence of hepatitis B and hepatocellular carcinoma are necessary to improve long-term results of liver transplantation in China.

Objective: To study the real effect of IL-15, a kind of T lymphocyte activators which were derived from lymphocytes, on the acute rejection process in heart and liver transplantation in rats., Methods: Male (body weight 200 - 250 g) 1A (RT1(a)) and LEW (RT1(l)) rats were selected as donors and recipients, respectively. Heterotopic heart transplantation (in abdomen) and orthotopic liver transplantation were performed as the acute rejection model group (experimental group); LEW (RT1(l))-->LEW (RT1(l)) as donors and recipients to establish isografts transplantation as the control group. Animals were sacrificed on day 1, 3, 5, 7 and graft specimens were collected. Microarray, immunohistochemistry and Western-blotting methods were used to detect the expressions of IL-15, IL-2 and IFN-gamma, etc. 48 rats were divided evenly into two groups and each time-point consisted of 6 rats., Results: Acute rejections which were clarified by pathological findings and animal manifestations were found 3 days after operation in the experimental group. The early expression of IL-15 was found on endothelial cells in allografts 1 day after operation in contrast to IL-2, which expressed lately and only be found on inflammatory cells including lymphocytes and Kupffer cells 3 days after graft implantation. The result of INF-gamma was the same as that of IL-2., Conclusions: IL-15 appeared earlier in heart and liver allografts than IL-2 and IFN-gamma in rat acute rejection model, and the expression site differed from the later two. IL-15 participated in acute rejection reaction earlier in this process and the pathway may be different from IL-2 and IFN-gamma. Early blocking this pathway combined with other blockade would have a promising result in control of the progression of acute rejection.