Abstract:To evaluate the survival and prognostic factors of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).
Methods :Eighty-nine HCC patients who underwent OLT in our hospital from August 2000 were followed up more than 6 months, and their clinical and follow up data were retrospectively analyzed.
Results:The 1-, 2-, and 3-year cumulative survival rate of the 89 patients was 91.2%，68.5% and 59.4% respectively. Univariate analysis revealed that the size, the presence of portal vein tumor thrombus, histological differentiation and pTNM stage were statistically significant factors affecting survival. Multivariate analysis using Cox proportional hazards regression model demonstrated that the size and the presence of portal vein tumor thrombus were independent and statistically significant factors affecting survival.
Conclusions:OLT is an effective treatment for HCC patients. Tumor diameter >5 cm, poor histological differentiation and high pTNM stage significantly affect the survival of these patients.

Abstract:To investigate the alteration of lymphocyte P-gp expression level and function in liver transplant recipient and its effect on immunosuppressive therapy.
Methods :Using flow cytometry, the level of lymphocyte P-gp and analyzed the P-gp function in 53 cases of liver transplant recipieints was observed.
Results:Among 53 cases, the preoperative mean level of lymphocyte P-gp was (10.34±4.0)%, P-gp level began to increase in the 1st month postoperatively（17.8±8.0)%, peaked in the 3rd month（27.5±13.3)%， and then was stable at this level thereafter.There were no significantly difference between different sex of age group.But the P-gp level in CD+4T cells was significantly higher than that in CD+8T cells and B cells,RH123test showed that high P-gp expression of lymphocyte enhanced its transport activity of medical agents,and decreased the intracellular accumulation of drug more significantly than that of low P-gp expression (P＜0.05).
Conclusions:The P-gp expression of lymphocyte is overexpressed in some liver transplant recipients, and transport activity of P-gp was increased. There is a possibility that high P-gp expression of lymphocyte in the liver trasplant recipients may attenuate the therapeutic efficacy of immunosuppressants.

Abstract:To investigate the pathogenesis and the selection of treatment of Iiver abscess after orthotopic Iiver transplantation(OLT).
Methods :Of 558 recipients of OLT in 4 years in our transplant center，liver abscess was identified in 10 recipients (1.8％) at 1-18 months after operation,and these causes were analyzed.
Results:There were 7 cases of postoperative hepatobiliary complications, 2 cases of radiofrequency ablation (RFA) for hepatoma recurrence, and 1 case of unidentified cause of infection. The chief clinical presentation included fever, hepatic dysfunction, hypoalbuminemia and anemia.The diagnosis was made mainly according to the clinical presentation and ultrasonography or CT scan.The treatments included aspiration and drainage of abscess，extermal or internal drainage with PTCD, antibiotics and supportive therapy and liver retransplantation. Eight of 10 patients were cured, 6 cases by drainage and 2 cases by retransplantation, but 2 cases died of sepsis.The cure rate was 80.0％.
Conclusions:The etiology of liver abscess after OLT is complicated.It may be related to hepatobiliary anastomotic stoma stenosis or obstruction, hepatobiliary ischemia or necrosis, interventional therapy for hepatoma recurrence, hepatic artery thrombosis or stenosis and methylprednisone pulse therapy.Liver abscess after OLT carries a poor prognosis, and early diagnosis and treatment is most important.

Abstract:To study the protective effect of deferoxamine preconditioning on transplanted liver and its possible mechanism.
Methods :SD rats are randomly divided into four groups: sham operation group(S), autologous liver transplantation group(AT), deferoxamine preconditioning AT group(DP) and deferoxamine irrigation AT group(DI).At 24 hours after operation, several factors of each group were measured respectively, including deterioration of histomorphology, serum hepatic enzymes,and hypoxia inducing factor-1（HIF-1α）and malonaldehyde（MDA）in hepatic tissue.
Results:The levels of alanine aminotransferase(ALT), glutamic oxalacetic transaminase(AST) and alkaline phosphatase (ALP) in AT group, DP group and DI group were higher than those of S group.In the DP and DI groups, abnormal changes in liver morphology were milder,the level of HIF-1α in hepatic tissue was increased and MDA content was decreased (P﹤0.05),as compared to the AT group.
Conclusions:Deferoxamone preconditioning of graft before liver transplantion or deferoxanine inrigation of liver during operation has protective effect on donor liver, and protective effect of the former method is better than the latter.The mechanism of this preconditioning may be related to increacing HIF-1α and reducing lipid peroxidation in hepatic tissue.

Abstract:To study the surgical technique of construction of orthopic liver transplantation model in mice by a single operator.
Methods :On the basis of two-cuff technique,running suture was used to reestablish the suprahepatic vena cava(SHVC),"two-cuff"technology to reestablish the portal vein（PV） and infrahepatic vena cava（IHVC）,and"stent"to reestablish the bile duct.Operation was performed in 70 mice, the 24 h,1 week,1M postoperative survival rate were noted, and hepatic function and pathological change were observed.
Results:The 24 h,1 week and 1M survival rate was 95.7%, 90.9%, 85.1%，respectively. The ALT increased gradually in the first postoperative week,and dropped to normal level in the first month. Pathology showed the structure of liver tissue was fine.
Conclusions:The method is an ideal mothod to establish the orthotopic liver transplantation model in mice, because it has high survival rate, good stability and is easily replicated.

Abstract:To explore the value of transarterial chemoembolization (TACE) and portal vein immuno-chemotherapy on the prevention of recurrence after resection of primary hepatic carcinoma and survival.
Methods :The clinical data and outcome of 168 patients with primary hepatic carcinoma from 2004 to 2007 in Taihe Hospital were analyzed,Among them, 47 underwent hepatectomies plus adjuvant transarterial chemoembolization and immuno-chemotherapy via portal vein (group A); 52 cases had hepatectomies plus transarterial chemoembolization (group B); 42 cases had hepatectomies plus immuno-chemotherapy via portal vein (group C),and 27 cases had hepatectomies plus systemic vein chemotherapy (group D).
Results:The recurrence rate of the A, B,C and D groups was 53.2%(25/47)，65.4%(34/52)，73.8%(31/42) and 85.2%(23/27) respectivly,（χ=9.065, P=0.028）. The mean recurrence time (tumor free survival time) after operation in group A, B,C and D was (18.1±9.5), (15.2±7.6), (13.3±5.4) and (10.0±3.7) months respectively (P<0.001), while the survival time was (24.8±10.2), (19.6±6.8), (9.0±5.5) and (14.4±3.7) months respectively (P<0.001), and the time between the confirmed recurrence and the studied end-point was (12.6±7.7), (6.8±2.4), (7.7±3.8) and (5.2±2.9) months respectively (P<0.001).
Conclusions:For primary hepatic carcinoma,after hepatectomy, using transarterial chemoembolization combined with immuno-chemotherapy via portal vein could decrease the recurrence rate,delay the time of recurrence and prolong the survival time,and more effectively than either transarterial chemoembolization or immuno-chemotherapy alone.

Abstract:Objective:To study the risk factors for spontaneous rupture of primary hepatic carcinoma.
Methods :The clinical data of 31 patients with spontaneous rupture of primary hepatic cancer admitted to our hospital from Jan 1999 to Dec. 2008 were retrospectively analyzed, and compared with 31 randomly selected concurrent patients without rapture of HCC.
Results:Three factors were shown to be the risk factors for spontaneous rupture of primary hepatic carcinoma.Those were APTT，HBeAg and the greatest height of tumor protrusion above the surface of liver.
Conclusions:APTT，HBeAg and the greatest height of tumor protrusion above the surface of liver are risk factors for spontaneous rupture of primary hepatic carcinoma.

Abstract:Objective:To investigate the feasibility and significance of the re-operation for patients with recurrent primary liver cancer.
Methods :The clinical data of 58 patients with post-operative recurrence after initial operation for primary liver cancer in our hospital from January 2003 to December 2008 were analyzed. They were divided into re-operation group and the other treatment group, and the 1-and 3-year survival rates were compared.
Results:The 23 cases of re-operation group were all treated by local radical resection plus hepatic arterial chemotherapy pump implantation, and postoperative chemotherapy was given via hepatic artery chemoembolization pump line.The 35 patients of the other treatment group underwent radiofrequency ablation plus transcatheter hepatic arterial chemoembolization via femoral artery.The 1-and 3-year survival rates in re-operation group was 100% and 82.6% respectively, which was significantly higher than that of the other treatment group (82.9% and 45.7% respectively).
Conclusions:Re-operation is the treatment of choice for patients with tumor recrrrencr after radical resection of primary liver cancer, provided that the conditions are suitable and the timing of operation is appropriate.

Abstract:Objective:To study the effect of allicin on the growth of hepatocellular carcinoma cells and the relevant mechanism.
Methods :(1)The action of allicin on hepatocellular carcinoma cell line HepG2 was assayed by MTT. The expression of VEGF mRNA and ICAM-1 mRNA of HepG2 was detected by fluorescent quantitation ploymerase chain reaction(FQ-PCR). (2)Twenty four nude mice bearing subcutaneous xenograft human hepatocellular carcinoma(HCC) were randomly divided into 3 groups： the control group, the allicin group I［allcin 1 mg/(kg·d)］ and group II［allcin 10 mg/(kg·d)］. The effect of allicin on the tumor growth was evaluated 4 weeks later,including the tumor volume and weight.
Results:(1)MTT showed allicin inhibited the proliferation of hepatocellular carcinoma cell line HepG2 at the concentration of 10-5 000 μg/L,and high concentration of allicin could kill HepG2 cells（P＜0.01). The expression of VEGF mRNA and ICAM-1 mRNA was down-regulated significantly by allicin（P＜0.01). (2)Tumor volumes of the control group, allicin group I and group II were (1923.44±101.25) mm,(918.43±90.65) mm and (604.28±77.41）mm respectively,（P＜0.01).
Conclusions:Allicin can inhibit the growth of hepatocellsular carcinoma cells in vitro and in vivo,and the mechanism may be related to its inhibition of hepatocellular carcinoma cells proliforation and downregulation of transcription of VEGF mRNA and ICAM-1 mRNA.

Abstract:Objective:To study the effect of rapamycin on the biological characteristics of human hepatocellular carcinoma (HCC).
Methods :Eighty nude mice bearing orthotopic human HCC were divided randomizely into 4 groups: control group, cyclosporine (CsA) treatment group, and rapamycin (routine dose) treatment group, and rapamycin (high dose) treatment group. Two weeks after treatment, the influence of rapamycin on the growth of hepatocellular carcinoma was observed, and RT-PCR was used to detect CD44v6 mRNA expression in the hepatocellular carcinoma tissues.
Results:As compare with control group,the tumor volume significantly decreased in routine dose rapamycin group and high dose rapamycin group, but increased in CsA group, The expression of CD44v6 mRNA was downregulated in routine dose rapamycin group and high dose rapamycin group, but upregulated in CsA group, as compared with control group.
Conclusions:CsA can promote the growth and metastasis of hepatocellular carcinoma cells. Rapamycin can inhibit the growth and invasiveness of hepatocellular carcinoma cells. Rapamycin also can inhibit CD44v6 gene expression.

Abstract:Objective:To investigate the effect of hepatocyte growth factor （HGF）on the proliferation of human hepatocellualr carcinoma cells, and the mechanism of HGF-induced proliferation inhibition.
Methods :Human hepatocellualr carcinoma cell line HepG2 were treated with different concentrations of HGF for different time periods, and the proliferation of these cells was examined by colorimetric BrdU cell proliferation enzyme-linked immunosorbent assay. The expression of S-phase kinase associated protein 2(Skp2) was examined using Western blot and RT-PCR. Plasmids pcDNASkp2 was introduced into HepG2 cells, then the clones showing up-regulation of Skp2 were selected, and the effect of HGF on the proliferation in these clones was investigated.
Results:HGF inhibited the proliferation of hepatoma cells in a dose and time dependent manner. The expression of Skp2 was significantly suppressed by HGF. Furthermore, HGF did not suppress the proliferation of HepG2 cells transfected with Skp2.
Conclusions:This study suggests that HGF could inhibit HepG2 cell proliferation, and the down-regulation of Skp2 could be closely related to this suppressed proliferation.

Abstract:Objective:To study the effects of lentiviral vector of microRNA targeting IGF1R gene on growth of liver cancer cells.
Methods :The complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed, synthesized and cloned into the pPRIME vector, named pPRIME-IGFIR-miR30-shRNA. The viruses were propagated on 293T cells. Viruses were purified by CsCI gradient according to standard techniques, and functional PFU titers were determined by plaque assay on 293 cells. The effect of pPRIME-IGFIR-miR30-shRNA on IGFIR expression of Hep3B、SMMC7721 cells was detected by RT-PCR and Western blot. The antitumor potential of PRIME-IGFIR-miR30-shRNA to Hep3B、SMMC7721 cells was evaluated by CCK-8 assay and Tunel.
Results:PRIME-IGFIR-miR30-shRNA was constructed successfully. Functional PFU titers of pPRIME-IGFIR-miR30-shRNA were 4.58×109PFU/ml. PRIME-IGFIR-miR30-shRNA inhibited IGFIR expression and the proliferation of Hep3B、SMMC7721 cells.
Conclusions:PRIME-IGFIR-miR30-shRNA expressing IGFIR-siRNA can inhibit IGFIR expression and may be used for further investigation of gene therapy of liver cancer.

Abstract:Objective:To investigate the effect of mitofusin-2 gene (mfn2) transfection on the proliferation and chemosensitivity of hepatocellular carcinoma cell line HepG2.
Methods :The experiment were divded into three groups: pEGFPmfn2 transfected cells, pEGFP-N2 transfected cells and HepG2 cells. The mRNA expression in cells was detected by RT-PCR and protein expression by Western-blot assay. Cell counting method and MTT assay were used to detect the cell proliferation of HepG2 cells. Cell cycle of HepG2 cells was observed by flow cytometry, and chemosensitivity observed by MTT assay.
Results:The viable count of pEGFPmfn2-transfected cells was less than that of pEGFP-transfected cells and untransfected cells at 48 h after transfection (P<0.05). Flow cytometry assay showed that in the cell cycle, the G0/G1 phase proportion was significantly higher in pEGFPmfn2-transfected cells［(83.2±1.5)%］ than in pEGFP-transfected cells and untransfected cells after transfection (P<0.05), and MTT assay showed that mfn2 gene could increase their chemosensitivity to 5-FU.
Conclusions:Mfn2 could inhibit the proliferation of HepG2 cells, which might result from blockage of the cell cycle. It also could increase the chemosensitivity of HepG2 cells.

Abstract:Objective:To investigate the killing effect of lipofection-mediated herpes simplex virus-thymidine kinase (HSV-TK) gene combined with hyperthermia on hepatocellular carcinoma HepG2 cell line in vitro.
Methods :HepG2 cells were transfected with HSV-TK gene by lipofection and used for in vitro study. The killing effect of GCV combined with hyperthermia on HepG2/tk cells was observed.
Results:The cell apoptotic rate of the hyperthermia combined with GCV treatment group was significantly higher than the control group and the single GCV treatment group (P<0.05). As the temperature increased, the effect was more and more obvious. The proliferation inhibition rate was (78.8±7.5)% and apoptotic rate of HepG2/tk cells reached (42.8±3.6)% when treated by hyperthermia at 44 ℃.
Conclusions:HSV-TK gene was transfected into HepG2 cells by lipofection and expressed stability. Hyperthermia can significantly enhance the sensitivity of killing effect of GCV on HepG2/tk cells.

Abstract:Objective:To explore the protective effect of terlipressin on portal hyperperfusion syndrome in the early phase of posthepatectomy.
Methods :Thirty-six rats were randomly categorized into two groups for the study of hemodynamics of portal hyperperfusion injury after hepatectomy: 18 rats in Group Th (terlipressin treatment group for hemodynamics) and 18 rats in Group C (control group for hemodynamics). The hemodynamic parameters were detected before administration of terlipressin, and 30 min, 1 hour, and 2 hours after reperfusion. The Group T was subgrouped into subgroup Th1/2, Th1 and Th2 group in terms of different timepoints, and the Group Ch was also subgrouped into subgroup Ch1/2, Ch1 and Ch2 group respectively. Each subgroup consisted of 6 rats. Twenty rats were randomly categorized into two groups for survival study: 10 rats in Group Ts (Terlipressin group for survival) and 10 in Group Cs (control group for survival). All rats underwent major hepatectomy(90%) with Pringle maneuver for 30 minutes. Terlipressin was injected into the penile dorsal vein just before appliance of Pringle maneuver in rats of Group Th and Ts. The same amount of sterilized normal saline was injected at the same step in rats of Group Ch and Cs. The survival rate and hemodynamics of rats with small-for-size liver were studied.
Results:All rats survived more than 24 hours. The 10-day survival rate of Group Ts (80%) was significantly higher than that of Group Cs(P＜0.05). The portal pressure of subgroup Th1/2［（13.21±0.32）cm H2O）］was significantly lower than that of Subgroup Ch1/2［（16±1.03）cm H2O］(P＜0.05). The portal pressure reached its trough level［（11.52±0.17）cm H2O］ in subgroup Th1, which was significantly lower than that in subgroup Ch1［（13.5±0.18）cm H2O］(P＜0.05). The portal pressure of subgroup Ch1/2 was significantly higher compared to its corresponding basic portal pressure(P＜0.05). The portal blood flow of subgroup Th1/2［（7.21±0.21）mL/min］and Th1［（6.11±0.28）mL/min］was significantly lower than their corresponding subgroup Ch1/2［（9.50±0.35）mL/min］and Ch1［（6.99±0.19）mL/min］(P＜0.05). Meanwhile, the portal blood flow of subgroup Ch1/2 was significantly higher compared to its corresponding basic portal blood flow (P＜0.05). The mean blood pressure of subgroup Th1/2［（88.12±1.28）mmHg］, Th1［（80.83±1.79）mmHg］ and Th2［（76.29±0.89）mmHg］was significantly higher than that of subgroup Ch1/2［（57.97±2.01）mmHg］,Ch1［（59.86±1.75）mmHg］and Ch2［（63.71±1.37）mmHg］(P＜0.05). Meanwhile, the mean blood pressure of subgroup Th1/2, Th1 and Th2 was significantly higher than their corresponding basic mean blood pressure(P＜0.05). There was no significant difference of central venous pressure among all of the subgroups in Group Th and Group Ch. Also there was no significant difference of central venous pressure among all of the subgroups in each group compared to their corresponding basic central venous pressure.
Conclusions:Portal hyperperfusion state is transient in the early phase after major hepatectomy with reperfusion. Terlipressin ameliorates portal hyperperfusion injury by effectively reducing portal pressure and portal blood flow. The survival rate of rats with small-for-size liver after major hepatectomy can be significantly increased by administration of terlipressin.

Abstract:Objective:To investigate the effect of curcumin on hepatic fibrosis (HF) in rats and its molecular mechanism.
Methods :Rat hepatic stellate cells were cultured and activated with ConA and processed with different concentration of curcumin. Models of hepatic fibrosis in rats induced by subcutaneous injection of CCl4 were treated with different concentrations of curcumin. The levels of HA, LN, PCⅢ and Ⅳ.C in serum and histological changes in liver tissues were determined to reveal the extent of liver fibrosis. Matrixmetalloproteinase-2 (MMP-2) expression in liver tissues and HSC was determined by Western blot and RT-PCR.
Results:Curcumin significantly reduced the levels of HA, LN, PCⅢ and Ⅳ.C in serum of HF rats(P<0.05). the score of hepatic fibrosis in curcumin group was reduced significantly(P<0.05), Curcumin also inhibited MMP-2 expression in liver tissues(P<0.05) and activated HSC in a dose-dependent way(P<0.05).
Conclusions:Curcumin can inhibit hepatic fibrosis in rats by reducing MMP-2 expression.

Abstract:Objective:To investigate the value of quantitative assessment of hepatic fibrosis and indocyanine green measurement in predicting hepatic functional reserve in rats with liver cirrhosis.
Methods :Female Wister rats were divided into normal control and cirrhotic group,and cirrhotic models were established. Quantitative assessment of hepatic fibrosis was done by use of computer-assisted digital image analysis, and R15ICG was measured.
Results:Differences of R15ICG and quantitative assessment of hepatic fibrosis between the two groups at 8 and 10 weers after hepatic fibrosis model was established were statistically significant (P＜0.01). Quantitative assessment of hepatic fibrosis had a positive correlation（r=0.75 and 0.533，P＜0.05）with R15ICG and Child-Pugh score.
Conclusions:Combining quantitative assessment of hepatic fibrosis with indocyanine green measurement is helpful for total assessment of liver functional reserve.

Abstract:Objective:To investigate the protective effect of Calcitonin Gene-related Peptide (CGRP) on ET-1 mediated injury of human hepatocyte.
Methods :Human liver tissues obtained from patients undergoing partial hepatectomies were randomly divided into five groups:control group, liver perfused with D-Hank′s solution group;liver perfused with ET-1 group and three liver perfased with ET plus CGRP (10-6M,10-7M,10-8M) treated groups. Collagenase digestion method was used to isolate human hepatocytes, then hepatocytes were cultured, and the level of MDA and TNF-α, the viability and proliferation of hepatocyte, and the hepatocyte function (ALT, Alb, Urea and LDH) were determined.
Results:As compared with control group, in ET-1 group, the viability and proliferation of hepatocytes, the level of Alb and Urea declined significantly (P<0.05), and the concentration of ALT, LDH, MDA and TNF-α increased markedly (P<0.05). In CGRP groups, the viability and proliferation of hepatocytes, the level of Alb and Urea increased significantly (P<0.05), the concentration of ALT and LDH, the level of TNF-α and MDA markedly decreased with concentration(all P<0.05).
Conclusions:CGRP has protective effect on injury of hepatocytes induced by ET-1,which may be through decrease the release of MDA and TNF-α.

Abstract:Objective:To study the expression of cyclooxygenase2 in hepatic inflammatory reaction of rats with sepsis and its effect on metabolism.
Methods :Fifty-four Wistar rats were randomly divided into 3 groups: Sham (A) group, sepsis model (B) group,and NS398 intervention (C) group.The rats were subjected to cecal ligation and puncture(CLP) for sepsis model or sham operation.RT-PCR was used to determine COX-2 mRNA expression,serum prealbumin (PA) and transferrin (TF) by radioimmunity.At the same time, ALT,AST,albumin determination and liver pathological changes were determined.
Results:(1)The expression of COX-2 mRNA was low in A group,higher in B and C groups,and higher in B than C group at each time period(P＜0.05); (2)Serum ALT and AST were markedly increased in B than in A and C groups(P＜0.05); (3)Pathologic ally, hepatic injury was severe in B group, but mild in C group; (4)The levels of PA,IF and Ab were higher in A group than in B and C groups，but was lower in B group than C group（P＜0.05）.
Conclusions:COX-2 plays an important role of hepatic injury in sepsis,and can promote catabolism and inhibit anabolism. The selective cox-2 inhibitor,NS398, can effectively protect hepatic cell in sepsis and attenuate albuminolysis.

Abstract:Objective:To study the mechanism of chloroquine(CQ) on relief of liver injury in severe acute pancreatitis(SAP).
Methods :Sixty Wistar male rats were randomized into sham-operated, SAP, L-Arg-treated, L-NAME-treated, CQ-treated and CQ+ L-NAME-treated group. Expression of TLR4 was detected using RT-PCR and Western Blot.
Results:TLR4 expression was markedly increased in SAP(P<0.05). Liver injury was increased, and NO concentration was decreased(P<0.05). When TLR4 was inhibited by L-Arg or stimulated by L-NAME, liver injury was relieved or increased (P<0.05). CQ inhibited expression of TLR4,increased production of NO,and subsequently relieved liver injury (P<0.05). When rats with SAP were injected with CQ and L-NAME, NO concentration was markedly decreased, the effect of CQ on inhibiting TLR4 expression was markedly weakened (P<0.05),and liver injury was increased.
Conclusions:TLR4 expression might play an important role in pathogenesis and development of liver injury in SAP. The inhibition of TLR4 expression from CQ could be via the pathway of increasing production and release of NO, which can result in relief of liver injury in SAP rats.

Abstract:Objective
To study the modulation of EPC by p38 mitogen activated protein kinase (MAPA) mediated TNF-α and the pathogenesis in multiple organ dysfunction syndrome.
Methods :Twenty porcines were divided into control (C) group and MODS (M) group. After establishment of MODS model, the fumction of main organs was determined. In vivo, the p38MAPK phosphorylation in the peripheral blood mononuclear cell was monitored with Western-blot, and TNF-α mRNA measured with RT-PCR, plasma TNF-α was measured with ELISA and EPC with FCM.
Results:The mobidity in group M was much higher than that in group C. In vivo the peripheral monocellular p38MAPK phosphorylation was much more intense, the synthesis and secretion of TNF-α was markedly increased, and the quantity and function of EPC was markedly decreased.
Conclusions:The peripheral monocellular p38MAPK phosphorylation can induce TNF-α mRNA transcription and increase its synthesis, and TNF-α of the peripheral blood mononuclear cell is increased, The increased TNF-α of the peripheral blood plasma could result in decrease of the quantity and function of EPC, and aggravate the inflammatory response of MODS，which could be the pathogenesis of MODS.

Abstract:Objective
To study the diagnosis and treatment of focal nodular hyperplasia(FNH).
Methods : The clinical data of 28 patients with FNH treated by nonanatomic liver resection in our hospital were retrospectively analyzed.
Results:Among the 28 patients, 20(71.4%) were asymptomatic, 24(85.7%) had normal liver function,and 3(11%) were HBsAg positive.The AFP and CEA levels were normal in all of the patients. On ultrasound, 20（75%）were hypoechoic lesions,and 3（75%）showed a typical hypervascular pattern in the arterial phase and slow wash out in the delay phase on contrast enhanced ultrasound. Multiphasic liver CT and MR imaging demonstrated characteristic features in most patients. All of the patients were treated by nonanatomic liver resection.Twenty-four patients were followed up for 3 months to 6 years.The postoperative outocme was satisfactory and had no recurrence in all the cases,including 4 lesions with dysplasisa on pathologic examination.
Conclusions:FNH has nonspecific clinical manifestations. The imaging findings are of great value in diagnosis,and surgical resection is the optimal treatment for patient with distinct indications of surgery.

Abstract:Objective:To investigate the methods of diagnosis and treatment of splenic aneurysms(SA).
Methods :Clinical data of 7 SA cases was retrospectively analyzed.
Results:Preoperatively, preliminary diagnosis was made based on type-B ultrasonic scanning in 6 cases, diagnosis was confirmed by CT angiogrophy(CTA) in 4 cases, by digital substraction angiography(DSA) in 2 patients and magnetic resonance angiography(MRA) in 1 case， but no case was confirmed solely by clinical symptoms. Of the 7 cases, 1 underwent splenic aneurysm resection, 1 combined resection of splenic aneurysm and spleen, 1 had resection of splenic aneurysm and reconstruction of splenic artery, 1 ligation of proximal and distal splenic arteries, 2 endovascular embolization, and 1 endovascular embolization and resection of spleen. All patients were followed up for 2 months to 3 years, but no mortality or serious complications were found.
Conclusions:It is difficult to diagnose splenic aneurysm based solely on clinical symptoms, but CTA, MRA and DSA are importtant for diagnosis. B-mode ultrasond is of help for screening. Endovascular embolization or surgical procedure should be employed once the diagnosis is confirmed.