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.

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.

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.

The Chinese Society of Hepatology of the Chinese Medical Association invited relevantexperts to revise and update the Guideline of Prevention and Treatment of Nonalcoholic Fatty Liver Disease(2018Version) and renamed it as (Version 2024) Guideline for the Prevention and Treatment of MetabolicDysfunction-associated (non-alcoholic) Fatty Liver Disease. Herein, the guiding recommendations on clinicalissues such as screening and monitoring, diagnosis and evaluation, treatment and follow-up of metabolicdysfunction-associated fatty liver disease are put forward.

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.

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.

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.

Objective This study was designed to evaluate of reliability and validity of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） in patients with liver cirrhosis. Methods A total of 138 patients with liver cirrhosis were enrolled in this study. The reliability and validity of the two scales was evaluated by Cronbach’s α co-efficient,intraclass correlation co-efficient （ICC）,Kaiser-Meyer-Olkin （KMO） score and Bartlett’s test of sphericity（BTS）. Results The prevalence of anxiety and depression in this series were 38.2% and 63.1%,respectively;SAS scale’ Cronbach's α coefficient was 0.777 and SDS scale’ was 0.782, indicating better homogeneity reliability; Twenty items of SAS and SDS scales were analyzed by exploratory factors to construct validity and four main factors were extracted from the SAS scale that showed the variances ratio were 15.4%,14.9%,10.6% and 10.2%,respectively,and four factors accounted for 51.1% of the total variance of accumulated explanation;Five main factors were extracted from SDS scales that showed the variance ratio were 14.0%,12.6%,11.9%,10.3% and 8.4%,respectively,with 57.4% of the total variance;The re-measurement analysis of SAS and SDS scale’s items found that the two measurements were highly correlated with each other （P<0.001）. Conclusion SAS and SDS scales have a better reliability and validity in the investigation of psychological and mental impairment in patients with liver cirrhosis.

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.

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.

Recently,transient elastography is widely used in diagnosis of patients with chronic liver diseases. Scholars worldwide have found that the technology would be helpful for noninvasive diagnosis of liver fibrosis, monitoring effect of treatment and predicting prognosis of liver disease. This review will focus on the principle,application and impact factors in this technology.

Analgesia in postoperation may be accompanied by a series of complications,which prolong postoperative recovery and decrease the quality of patient’s life. Research on effective approachesfor management of postoperative pain has been the topic studies in clinical practice. This paper puts focus on the mechanism of postoperative analgesia and reviews the choice of medicine for preemptive analgesia. We also discuss the controversies about the efficacy of preemptive analgesiain the treatment of postoperative pain and explore its clinical applications in the future.

Objective To study the clinical characteristics of patients with Madelung syndrome （MS） in China. Methods We searched China National Knowledge Internet（CNKI）database （1994-2013）,Wanfang database （2000-2013） and VIP Citation database （2002-2013） for articles about MS; Finally,61 articles with 282 cases of MS were included in this study;SPSS17.0 and Excel software were used to analyze the retrieved data. Results In all 282 cases,there were 264 male （93.62%） and 18 female （6.38%） patients,and the male to female ratio was 14.6:1;Among these patients,62 cases from 41 articles had complete case history and clinical data （60 male and 2 female） and the age of patients ranged from 34 to 79 year-old with a average age of （50.04±8.15） year old;In this 62 cases,the course of disease lasted for 3 months and 20 years and the average disease course was （5.62±4.02） years;Forty-one cases （66.13%） had chronic alcoholism; Eighteen cases showed the symptoms of compression of the upper mediastinum,including oppression of the neck, dyspnea,snoring or sleep apnea syndrome;Symmetry or neck-rounded ring-shaped lumps were found in the parotid area,cervical region,and back at physical examination;Fifty-eight （out of 62） cases underwent surgical excision （include plastic surgery）. Conclusion MS is a kind of concealed and slowly progressing benign tumor,mostly affecting middle-aged men with long-term heavy alcohol intake.