随着对肝脏解剖认识的深入，CT、MRI等影像学技术的发展、新的断肝器械的应用以及外科技术的进步，肝切除的并发症和死亡率都明显下降; 随着腹腔镜技术在肝脏外科的应用，肝切除技术又有了新的发展空间，现仅就肝切除技术现状作简要回顾。
Objective To review the regulation of liver regeneration factors. Methods The literatures about liver regeneration related regulators in recent years were reviewed. Results With further advancement of researches on regulators of liver regeneration in recent years, there were more therapies for treatment of liver-related diseases. Regulators play important roles in the process of liver regeneration, as one of which, cell growth factor plays an essential role in liver cell proliferation, such as the proper expression of TNF-α and IL-6 promoting liver cell proliferation, HGF, TGF-α, EGF, ALR, FS, and others motivating liver cell proliferation, while TGF-β and IL-1 physically terminating liver cell proliferation. Conclusion By strengthening the studies on liver regeneration regulators, new methods may appear for treating liver-related diseases.
自1989年巴西医生Raia开展人类首例活体肝移植（living donor liver transplantation, LDLT）以来，LDLT受体的优良预后及供体的安全性逐步得到了公认，加之“脑死亡”供肝的严重匮乏，LDLT技术迅速发展并被公认为是缓解供肝来源匮乏最有效的方法之一［1，2］。LDLT技术的发展大致经历了三个阶段： ①成人→儿童间活体肝移植（简称儿童活体肝移植，pediatric living donor liver transplantation, PLDLT）； ②成人→成人间活体肝移植(adulttoadult living donor liver transplantation, ALDLT)； ③急诊活体肝移植(emergency or highurgency living donor liver transplantation, ELDLT )。LDLT技术发展的每一阶段均是对前一阶段技术的总结和升华，技术难度和复杂性也逐步增加。
ObjectiveTo summarize the clinical progress on living related liver transplantation (LRLT). MethodsThe latest progress were reviewed based on recent documents and the experience on LRLT in our department. ResultsLRLT made much progress on evaluation of donor, harvesting the graft liver, donor health assessment and outcomes after living donor liver transplantation, and main factors affecting the survival of liver graft and so on. Conclusion Living related liver transplantation has many unsurpassable advantages, which suits the situation of China and has capacious clinical application.
Objective To study the effects of peroxisome proliferators-activated receptor (PPAR) γ on the growth of human hepatocellular carcinoma cells and explore the roles of phosphatase and tensin homologue deleted on chromosome ten (PTEN) and phospho-Akt in this process. Methods SMMC-7721 cells were treated with 15-d-PGJ2 or pioglitazone, which were two kinds of PPARγ ligands, at different concentrations. The viability of SMMC-7721 cells was evaluated by MTT assay. The cell cycle was analyzed by flow cytometry. PTEN mRNA level was determined by RT-PCR. The protein expressions of PTEN and pAkt were measured by Western blot analysis. Results It was demonstrated through MTT assay that both 15-d-PGJ2 and pioglitazone had an inhibitory effect on the growth of SMMC-7721 cells in a time- and dose- dependent manner. According to flow cytometry detection, more cells were arrested in G0/G1 phase. Increased expression of PTEN mRNA was detected in 15-d-PGJ2 or pioglitazone-treated cells through RT-PCR. Increased expression of PTEN protein and decreased expression of pAkt were confirmed by Western blot analysis. Conclusion The ligands of PPARγ could inhibit SMMC-7721 cells proliferation in a time- and dose- dependent manner. The upregulation of PTEN may be involved in the underlying mechanism.
Objective To explore the liver regeneration following partial liver transplantation. MethodsPartial liver transplantation in the rats were established, three experimental groups were: Ⅰ=control, partial liver resection; Ⅱ=orthotopic liver transplantation (OLT); Ⅲ=partial orthotopic liver transplantation (POLT). Liver function test, morphological investigations and liver regeneration were performed in different time after transplantation. The regenerative response of transplanted partial liver graft in rats were evaluated by Flow Cytometry and compared it to liver regeneration following resection.Results The serum concentrations of ALT, BILI increased in one week, but returned gradually to normal level within one month after transplantation. Large numbers of mononuclear cells infiltrating into the portal areas. Hepatocyte necrosis was observed on day 14 after transplantation. On day 30, the parenchyma cell showed a nearly normal appearance, bile duct proliferation was seen in portal areas. In addition, after liver resection and POLT some diploid hepatocytes were found. Dilation of the central veins, adjoining sinusoids and interlobar veins were seen in group Ⅲ. The partial liver graft is capable of regeneration similar to the situation following partial hepatectomy. The peak of liver regeneration was seen on day 1,2,4 following a hepatectomy and POLT and OLT, respectively.Conclusion The transplanted liver shows the same and/or enhanced regeneration compared to controls. There are several possible explanations for the slight delay in achieving the maximal regenerative response in rats undergoing the POLT and OLT. These may include damage that is induced by the operation itself, preservation, and reperfusion injuries. These suggest that this be caused by activation of the immune system and it might be related to the regulation of cytokines and hormone.