肝切除是一项需由有经验的外科医生完成的高风险手术。肝切除术在治疗肝恶性疾病中的地位在过去100年里随着并发症、病死率不断地减少及生存率的提高而发生了改变。对肝解剖新的认识，不断提高的围手术期治疗，麻醉技术和技术上的进步已使患者的治疗效果得到改善。随着技术的进步，从前被认为肿块不可切除的患者有了接受根治性手术的机会。该篇综述描述了针对肝切除的不同方法及技巧。文中对肝切除相关解剖、手术命名，解剖肝切除与非解剖肝切除的地位进行了讨论。分析了不同血管控制方法及对不同的肝实质横断策略进行了对比，同时涉及到了微创手术技术。最后，介绍了作者对肝切除的有关技术经验。

尽管近来在化疗药上取的了很多进步，但是对于转移性的结直肠癌治疗预后仍然很差，就过去20年而言，肝脏转移灶切除术已作为一种有希望的术式，它能改善结直肠癌肝转移患者的生存率，而且该技术在某些案例中显示出长期的治愈效果。为了扩大转移灶切除术的安全性及功效，合适的术前影像是必须的。CT，MRI，PET方面的进步已经改善了隐蔽病灶的探测而且获得更为清晰解剖形态。而CT，PET，MRI在探查大的肝转移瘤上有相似的敏感性，相对于CT及FDG-PET而言，MRI更擅于探知厘米级以下的肝转移灶，特别是与弥散加权成像（DWI）及肝细胞特异性对比剂结合时效果更显著，CT或许可用来作为一种筛选模式或术前计划制定如剩余肝体积的计算或显露肝动脉灌注分布的动脉解剖情况，而技术进步已经带来了史无前例的高画质与高清晰度的图片，但它仍然无法取代专业的，娴熟的具有丰富经验的影像学专家的角色。

Objective: To investigate the role of hypoxia inducible factor 1α (HIF-1α) in epithelial-mesenchymal transition (EMT) process of hepatocellular carcinoma. Methods: HIF-1α inducible liver cancer cell line HepG2Tet-on-HIF-1α cells were used. First, the mRNA and protein expressions of EMT-related molecules (E-cadherin, vimentin and FSP-1) and HIF-1α in HepG2Tet-on-HIF-1α cells under hypoxia were determined by real-time PCR and Western blot analysis, respectively. Then, under normoxia condition, the expressions of above molecules were determined in HepG2Tet-on-HIF-1α cells with HIF-1α overexpression induced by doxycycline (Dox), and HepG2Tet-on-HIF-1α cells transfected with HIF-1α siRNA after Dox treatment. Results: After hypoxia treatment, the mRNA and protein expressions of EMT-related molecules and HIF-1α in HepG2Tet-on-HIF-1α cells were all significantly increased compared with normoxia status (all P<0.05). Under normoxia condition, HIF-1α was overexpressed, and the EMT-related molecules expressions were simultaneously increased significantly in HepG2Tet-on-HIF-1α by Dox exposure (all P<0.05), but the above effect of Dox was abolished by HIF-1α siRNA transfection. Conclusion: HIF-1α can promote EMT process in HepG2 cells, and probably may be an effective target for liver cancer gene therapy.

Objective: To observe the expression of the glucose-regulated protein 78 (GRP78), an endoplasmic reticulum stress (ERS) related molecule, in the rat liver tissues injured by ischemia-reperfusion. Methods: Twenty-four healthy male SD rats were equally randomized into sham operation group, hepatic ischemia alone group (30 min hepatic ischemic followed by no reperfusion), 6-h reperfusion group (30 min hepatic ischemic followed by 6-h reperfusion) and 12-h reperfusion group (30 min hepatic ischemic followed by 12-h reperfusion). The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of each group of rats were measured, and the pathological changes, apoptosis and GRP78 mRNA expression in rats’ liver tissues were also determined. Results: Compared with control group, all the experimental groups presented obvious hepatic tissue injuries after ischemia, and the injuries were exacerbated with the prolongation of reperfusion period, as evidenced by the increased serum levels of ALT and AST, remarkable pathological changes in the hepatic tissues, and elevated apoptotic rates, with all the differences for the quantitative parameters among groups reaching statistical significance (all P<0.05). The GRP78 mRNA expression in rats’ liver tissues, similar to the patterns of the above parameters, was significantly increased after hepatic ischemia and aggravated as reperfusion time went on, with the differences reaching statistical significance among groups (all P<0.05). Conclusion: The GRP78 expression is up-regulated in the liver tissue injured by ischemia-reperfusion, however, its exact role in this process remains to be verified.

Imaging examination techniques play very important roles in diagnosis of liver diseases, among which CT or MRI imaging has the most practical value, and has become a routine examination for diagnosis and differential diagnosis of liver diseases. The application value of MRI imaging becomes increasingly important in diagnosis of liver diseases, due to its excellent tissue discrimination and a variety of contrast agents for use. Here, the authors address the application of Primovist, a liver-specific contrast agent for MRI, in diagnosis of liver diseases.