Caudate hepatocellular carcinoma is a special type of malignant tumor located in the caudate lobe of the liver. Surgical resection is difficult to perform because of specific anatomic structure with complex vascular and biliary duct adjacent to the tumor. At present，surgical treatment，interventional therapy，local ablation and radiologic treatment are often selected，but all treatment is less effective. In this paper，we discussed the concept and method of minimally invasive treatment dealing with patients with caudate hepatocellular carcinoma.

Endoplasmic reticulum（ER） homeostasis is perturbed by various pathological conditions,and a given new synthesized unfolded proteins might accumulate in the ER and result in endoplasmic reticulum stress（ERS）. ERS is related to the pathogenesis of the various liver diseases,and some scholars believe that the intervention of ERS will provide new choices for prevention and treatment of liver diseases. This paper will review the unfolded protein response due to ERS,which might be the target for medical intervention for liver diseases.

Copper chelators,such as penicillamine,trientine and dimercaptosuccinic acid,ets,has been commonly used in treatment of patients with Wilson's disease（WD）. We summarized some different types of adverse reactions often occurredin clinical practice and introduced some pharmacokinetic data,which might be useful for clinicians.

Objective To compare the value of contrast-enhanced CT and contrast-enhanced ultrasonography in the diagnosis of patients with focal liver lesions. Methods 81 patients with focal liver lesions were recruited in our hospital between March 2012 and May 2015. All the patients underwent contrast-enhanced CT check-up and contrast-enhanced ultrasonography. The imaging characteristics and the imaging parameters of ultrasonic contrast of benign and malignant liver lesions were recorded. Then，a comparison of the diagnostic efficacy of the two Methods was conducted. Results This study included 41 patients with hepatocellular carcinoma（HCC） and 40 with benign liver lesions. The quantitative analysis of the Results of contrast-enhanced ultrasonography revealed that time to peak，rise time and mean transit time in patients with malignant liver lesions were significantly shorter than those in patients with benign lesions [（33.2±5.8） s vs. （48.6±13.2） s，（24.1±4.9） s vs. （38.7±11.5） s，（108.5±21.3） s vs. （156.7±35.6） s，respectively，P<0.05 for all]，while the perfusion index in patients with malignant liver lesions was significantly higher than that in patients with benign lesions[（145.3±39.2） vs.（83.6±17.9），P<0.05]；The sensitivity，specificity，and accuracy of the contrast-enhanced ultrasonography were 97.1%， 92.3% and 96.3%，while those of contrast-enhanced CT were 80.3%（P<0.05），91.2%（P>0.05）and 85.2%（P<0.05）. Conclusion Contrast-enhanced ultrasonography could provide abundant imaging information of hepatic lesions in terms of morphology and data measurement，with high sensitivity and diagnostic accuracy in diagnosis of patients with liver lesions.

Hepatic fibrosis （HF） is a pathological process in a variety of chronic liver diseases, which may eventually progressed to cirrhosis or even liver cancer. Therefore,how to delay,cease or reverse HF is particularly important. HF is a complicated process that is involved by various cytokines and cell signaling pathways. Elucidation of these signaling pathways might provide some approaches to intervene the development of HF.

Objective To explore the efficacy of the gelatin sponge particle and embosphere microsphere embolization for the treatment of patients with hepatocellular carcinoma and tumor rupture. Methods 49 patients with rupture of hepatocellular carcinoma underwent transcatheter arterial embolization by gelatin sponge particle （n=23） or embosphere microsphere（n=26） embolization in recent 5 years,and instant hemostatic and rehaemorrhagia rates were compared. Results There was no difference between gelatin sponge particle and embosphere microsphere embolization on the effects of instant hemostatic（both were 100%）;Seven days after intervention,the rehaemorrhagia rate in gelatin sponge particles was 13.0%（3/23）,one patient was transferred to surgery,one patient was re-intervened and one patient dead because of haemorrhagic shock,respectively;The rehaemorrhagia rate in embosphere microspheres group was 3.8%（1/26,P<0.01）,and the patient received re-intervention and the bleeding was stopped successfully. Conclusion The instant hemostatic effect is the same between the gelatin sponge particle and embosphere microspheres embolization in patients with rupture of hepatocellular carcinoma,however,the embosphere group has much less chance to rebleeding within 7 days.

Portopulmonary hypertension （PPHTN） is defined as the development of pulmonary arterial hypertension associated with increased pulmonary vascular resistance complicating portal hypertension, with or without advanced liver disease. The presence of PPHTN markedly increases mortality. No effective medical therapies are currently available and liver transplantation is the only accepted treatment at the time. This review stresses on the epidemiology, pathophysiology, clinical presentation, diagnosis, treatment and the prognosis of PPHTN.

Liver fibrosis is a pathological process characterized by intrahepatic diffuse excess deposition of extracellular matrix （ECM）,which is also a common response occurred in the progression of varied chronic liver disease to cirrhosis. As ECM is mainly secreted by hepatic stellate cells（HSC） and its activation process is the central part of liver fibrosis development. In this review,we will summarize the mechanism of HSC activation in combination with the roles of hepatocytes,other non-parenchymal cells and various profibrogenic cytokines. This paper will also describe the significance of intestinal flora alteration and aberrant expression of microRNAs in the development of liver fibrosis.

Vascular inteventional therapy has played an important role in patients with unresectable primary liver cancer（PLC）,while the effect of vascular interventional therapy is closely related to the choice of embolic materials. We reviewed the characteristics and the clinical application of common embolic materials used in vascular inteventional therapy.

Objective To evaluate the efficacy of two domestic kits using different nucleic acid extraction methods for quantitative detection of serum hepatitis B virus（HBV） nucleic acids. Methods Thirty-six serum samples from hepatitis B patients with HBV DNA levels <1x10⁴ IU/ml after antiviral treatment were collected and HBV DNA was detected by kits from two pharmaceutical Co..The quantitative linear range,accuracy,sensitivity and specificity of each kits were evaluated and compared. Results Out of 36 serum samples,the HBV DNA levels in 14 were <500 IU/ml by KELONG reagent,while they were>1.00× 10³ IU/ml by San Xiang reagent;There was a good correlation in 31 samples by the two reagents（r=0.817,P<0.05 ）;The positive rates of serum HBV DNA were 55.6% and 94.4%,respectively,by the two kit detection（x²=12.07,P=0.000）;We detected serum HBV DNA in some strong positive samples after serial dilution and the results showed a good linear correlation （San Xiang: r=0.999,KELONG:r=0.992）;The relative deviations by San Xiang kit repetition was within ±0.3logIU/ml,while it was beyond ±0.3logIU/ml in two detections by KELONG. Conclusions The findings in this study suggests that the San Xiang reagent is more stable as it use nanometer magnetic extraction, which might be superior to boiling method for DNA extraction because the magnetic nanoparticle has wider liner ranger and significantly improves the sensitivity and accuracy of HBV DNA detection.

Hepatocyte apoptosis can be divided into physiological and pathologicalapoptosis. Both of them are relevant to the progression of liver disease. Reactive oxygen species（ROS） play an important role in the induction of hepatocyteapoptosis. Recently， some reports show thatnuclear factor E2-related fator 2（Nrf-2） represents one of the mostimportant cellular defense mechanisms against oxidative stress，inflammatory and tumorigenesis. Here，we reviewed the mechanisms of signal transduction involved in Nrf-2 related pathway and its possible roles in the process of hepatic apoptosis under oxidative stress.

Objective To investigate the clinical features of patients with primary liver cancer （PLC），and the current states of clinical diagnosis and multi-disciplinary team（MDT） management in clinical practice. Methods The clinical data of 5390 patients with PLC enrolled in our general hospital in south China from 1st Jan， 2010 to 30th Dec，2013 were retrieved，and we reviewed the patient's gender，age，etiology，qualitative detection of serum HBeAg，HBV DNA and alpha fetoprotein（AFP） levels，Child-Pugh class，Barcelona clinic liver cancer （BCLC） stages and the strategy of treatment for them. Results The median age of 5390 patients was 53-year-old，while male persons accounted for 87.4% and the prevalence of hepatitis B virus （HBV） infection was 84.15%；serum AFP positive（≥20 μg/L） accounted for 65.63%，and in HBeAg positive patients was 76.95% （671/872），much higher than that in HBeAg negative patients [54.11%（685/1266），P<0.01]；serum HBV DNA positive （≥1.0×103IU/ml） was 70.73 %（1022/1445）；as for pathological classification，the hepatocellular carcinoma （HCC） ranked first （84.7%）；the patients with BCLC stage C was 41.0% and B 31.0%；only 10% of PLC patients received comprehensive treatment；There were 56（5.3%） out of 1051 patients at initial admission，and 28 （2.7%） at repeated admission receiving MDT therapy；the hospitalization fee for conventional management was 28 thousand RMB，which was reduced by 6.83% to 26 thousand for MDT treatment. Conclusion The patients with PLC are often with underlying chronic HBV infection and are likely to be in advanced stage when hospitalized. The MDT should be recommended for their diagnosis and treatment.

Primary biliary cirrhosis （PBC） is one of the autoimmune liver diseases. Ursodeoxycholic acid（UDCA） is the only therapeutic drug approved by FDA. Most patients have a good response to UDCA. Many research on treatment of PBC for the use of fibrates，6- ethyl chenodeoxycholic acid，and budesonide，shows promising results.

Objective To investigate the complications and death causes，and their relationship，in patients with liver failure. Methods The age，gender，etiology，complication，and prognosis of the 1892 patients with liver failure were retro-prospectively analyzed. Results There were 1206（63.74%） cases of male and 686 cases（36.26%） of female included in this study，with an average age of（48.9±11.3） years；The major causes of liver failure included hepatitis B virus infection（1319，69.7%），hepatitis E virus infection（102，5.4%），drug-induced liver injury（102，5.4%），alcohol （89，4.7%）and unknown etiology（107，5.7%）；A total of 1543 patients with liver failure suffered from complications including infection，hemorrhage，hepatic encephalopathy，hepatorenal syndrome，and encephaledema，and their incidence were 69.82%，30.97%，23.04%，16.97%，and 2.59%，respectively；The incidences of hepatic encephalopathy（77.14%），hepatorenal syndrome（45.71%），and encephaledema（20.0%） were significantly higher in patients with acute liver failure than all other kinds of liver failure（P<0.05）；The mortality of patients with encephaledema was 100%，while the mortality of patients with hepatorenal syndrome was 90.65%；The mortality of 1092 patients with one complication was 62.09%，and 288 patients with two complications was 78.47%；Furthermore，the mortality of 163 patients with three or more complications was up to 98.16%. Conclusion Patients with liver failure was prone to suffering from complications，and the most common complication was infection，while the worst complications were encephaledema and hepatorenal syndrome；The mortality of patients with liver failure increases with the numbers of complications.

Objective Non-alcoholic fatty liver diseases (NAFLD) is the most prevalent chronic liver disease worldwide at present, and the main mechanisms involved in the pathogenesis include insulin resistance, oxidative stress and so on. Different serum markers are closely related to the pathogenesis of NAFLD, but there is no clear conclusion yet. This article reviewed the important role of different serum markers in patients with NAFLD.