Objective To retrospectively analyze the safety and efficacy of transarterial chemoembolization （TACE） by using gelatin sponge microparticles（GSMs） in different diameters in patients with spontaneous rupture of hepatocellular carcinoma（HCC）. Methods From August 2010 to December 2013,11 patients with spontaneous rupture of HCC received GSMs-TACE in Zhongshan Hospital Affiliated to Dalian University. CT scanning and determination of serum AFP levels were performed 1,3 and 6 months after initial GSMs-TACE,and tumor response was evaluated according to mRECIST 1.1 criteria and AFP levels. Results The 11 patients after GSMs-TACE were Followed-up for 1 to 6 months with a mean range of 5 months. 11 patients receiving GSMs-TACE achieved successful rapid hemostasis without technique-related complications;the survival rates at 1,3 and 6 month（s） were 90.9% （10/11）,72.7% （8/11） and 63.6% （7/11）,respectively,and the Objective effective rates were 70.0%,75.0%,71.4%,respectively;the postoperative complications mainly included local pain（100%）,nausea and vomiting （73.0%）,fever（54.5%）;two patient received hepatectomy 10 days and 30 days after GSMs-TACE,respectively. Conclusion TACE using GSMs of different diameters is safe and effective for patients with spontaneous rupture of HCC in the purpose of achieving hemostasis,improving survival rates and even getting the subsequent surgical operation.

Objective To evaluate the feasibility and safety of laparoscopic hepatectomy. Methods The clinical data of 14 patients who underwent laparoscopic hepatectomy in our hospital from December 2009 to December 2011 were retrospectively analyzed. There were eight primary liver cancer,one case of hepatic metastases from rectal cancer,one case of liver focal nodular hyperplasia,one case with fatty degeneration of liver combined with cholecystolithiasis,and three cases of liver cavernous hemangioma. Results All the 14 patients underwent laparoscopic hepatectomy successfully,without conversion to open surgery. Out of them,eight underwent the assisted laparoscopic hepatectomy and 6 cases underwent total laparoscopic hepatectomy. Three cases were performed hepatic left lateral lobectomy,one cases underwent left hemihepatectomy,and ten cases underwent partial resection. The average operation time was 124.2 min （62~276 min）,the intraoperative average hemorrhage was 155.7 ml （40~550 ml）, and the mean hospital stay was 10.8 d（8~15 d）. No serious complications were found in all 14 patients. Eight patients who had primary liver cancer were followed-up for 5 to 25 months. Of the four patients with primary liver cancer who were followed-up for more than one year,one patient died of cancer recurrence and the other three patients remained survival. The 1 a survival rates was 3/4. Conclusions Laparoscopic hepatectomy is feasible and safe for benign and malignant tumors of liver under the premise of meeting operation indications.

Objective To investigate the difference of recurrence-free survival and overall survival in patients with hepatitis B-related hepatocellular carcinoma receiving and not receiving antiviral therapy. Methods 156 patients with serum HBV DNA positive liver cancer underwent radical resection were randomly selected in our hospital from January 2004 to December 2006. All of them had complete clinical and follow-up data. They were divided into two groups,80 had operation and 76 had postoperative nucleoside analogue antiviral treatment. The antiviral strategies including oral lamivudine and adefovir or entecavir. Kaplan Meier method was applied to compare postoperative recurrence-free survival and overall survival between the two groups. Results The serum HBV DNA loads were（1.63±1.15）×10⁴ copies/ml and less than 1×10²copies/ml in 76 patients receiving antiviral therapy one month and three months after operation,much lower than at presentation（P<0.05）,while serum HBV DNA loads did not change in 80 patients without antiviral therapy;the recurrence-free survival in 80 patients without antiviral therapy was （10.25±2.56） m,while it was [（21.43±3.35） m,P<0.01] in 76 patients with antiviral therapy;the 1 a,3 a and 5 a recurrence-free survival rates in 80 patients without antiviral treatment were 54.6%,22.3% and 0.0%,while they were 73.1%,36.2% and 23.4% in 76 patients with antiviral therapy（P<0.05）;the overall survival in 80 patients without antiviral therapy was（18.42±3.21）m,while it was [（30.28±2.62）m,P<0.01] in 76 patients with antiviral therapy;the overall survival rates at 1 a,3 a and 5 a in 80 patients without antiviral therapy were 81.2%,42.0% and 16.3%,while they were 92.2%,73.4% and 31.6% in 76 patients with antiviral therapy（P<0.05）. Conclusion Standard antiviral treatment can improve prognosis and prolong the total survival in patients with serum HBV DNA positive liver cancer.

Objective To investigate the changes of glucose regulated protein 78（GRP78）,a endoplasmic reticulum stress （ERS） related gene,C/ enhancer-binding protein homologous protein （CHOP） and X-box binding protein（XBP） 1 mRNA in peripheral leukocytes in patients with chronic hepatitis B viral infections. Methods The mRNA levels in peripheral leukocytes were measured by real time PCR in 43 individuals with asymptomatic hepatitis B virus carriers,47 patients with chronic hepatitis B,41 with hepatitis B related liver cirrhosis,35 with hepatitis B related hepatocellular carcinoma（HCC） and 40 normal healthy persons. Results The GRP78 mRNA levels in hepatitis B virus carriers,in patients with chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma were higher than that in healthy controls[（0.58±0.53）,（0.76±0.57）,（0.59±0.67） and （0.50±0.64） vs. （0.01±0.61）,P<0.01 for all];the XBP 1 mRNA in hepatitis B virus carriers,in patients with chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma were also higher than that in health controls [（1.07±1.09）,（1.44±1.00）,（1.17±1.69） and （0.90±1.33） vs. （0.01±0.97）,P<0.05 for all];The GRP78 mRNA （0.48±0.59） in patients with serum HBsAg levels of <1500 IU/ml were much lower than in with serum 1500~20000 IU/ml[（0.76±0.56）,P<0.05] or >20000 IU/ml[（0.74±0.56）,P<0.05];The XBP 1 mRNA levels in patients with serum HBV DNA levels of 1×10³ to 10⁵copies/ml was lower than in patients with higher serum HBV DNA load（>1×10⁵copies/ml）[（0.86±1.13） vs. （1.44±1.31）,P<0.05];However,there existed no statistical differences as respect to the three mRNA levels among patients with different serum alanine aminotransferase,nor between patients with normal or abnormal serum bilirubin,nor between HBeAg-positive and HBeAg-negative patients. Conclusion Endoplasmic reticulum stress may beassociated with the disease progression in patients with chronic HBV infection.

Objective To assess the liver fibrosis by serum gama-glutamyltransferase（γ-GT） and HBsAg quantification（qHBsAg） ratio（GqHBsR） in patients with chronic hepatitis B. Methods A total of 232 patients with chronic hepatitis B were enrolled and all had liver biopsied. Serum γ-GT and HBsAg were detected. Liver fibrosis was believed to be significant as ≥S2 and to be mild or without fibrosis as less than S2 existed. Diagnostic efficacy of GqHBsR was assessed at different cut-off values for significant liver fibrosis by using receiver operating characteristic （ROC） curves. Results The area under ROC （AUC） of GqHBsR for significant liver fibrosis was 0.704. When the GqHBsR was greater than 9.570 for significant liver fibrosis,the sensitivity,specificity,positive predictive value（PPV） and negative predictive value（NPV） were 49.2%,88.2%,84.2% and 57.7%;When the GqHBsR was >10 for significant liver fibrosis,the specificity and PPV were 88.2% and 83.3%,respectively;When the GqHBsR was>20 for significant liver fibrosis,specificity and PPV were both 100%;When the GqHBsR was <2.4 for significant liver fibrosis,the sensitive and NPV were 98.4% and 81.8%,respectively;When the GqHBsR was <2 for significant liver fibrosis,the sensitive and NPV were both 100%;The area under ROC（AUC） of fibrosis index based on the 4 factor（FIB-4）,aspartate aminotransferase to platelet ratioindex（APRI）,γ-GT and HBsAg for significant liver fibrosis were 0.638,0.631,0.606 and 0.588,respectively,all were less efficient as compared to that of GqHBsR. Conclusion GqHBsR yields a higher AUC than aspartate aminotransferase to platelet ratio index,FIB-4,γ-GT or HBsAg. This noninvasive diagnostic models for determination of liver fibrosis might be useful in clinical practice.

Objective To elucidate the changes of gut microbiota projects in patients with non-alcoholic fatty liver diseases（NAFLD）. Methods Fresh faecal samples from 47 NAFLD patients underwent liver biopsies and 34 health individuals were examined using bar coded 454 pyrosequencing technology. 16S DNA V3~V5 variable regions were sequenced and the operational taxonomy unit （OUT） was analyzed to evaluate the differences of microbiota projects. Results The OUT of patients with NAFLD were（88.32±28.27）,significantly lower than those in the controls[（109.65±30.65）,P<0.01）];In Phylum level,the abundance of Firmicutes had significantly increased in NAFLD patients than in the controls[（51.2±17.8）% vs.（46.4±12.8）%,P=0.048],while the abundance of Bacteroidetes had significantly reduced[（31.0±18.8）% vs.（43.3±14.4）%,P<0.01];In Class level,the abundance of Erysipelotrichi had significantly increased in NAFLD patients than in the controls [（3.2±5.1）% vs. （1.0±1.2）%,P=0.009],while the abundance of Bacteroidia had significantly decreased [（31.0±18.8）% vs.（42.3±14.0）%,P=0.004]; In Genus level, the Lactococcus[（0.0038±0.0001）%] had significantly reduced in NAFLD patients compared with controls [（0.0145±0.001）%,P=0.003];The same results were found in Prevotella Genus. However,Streptococcus had significantly increased in NAFLD patients [（1.50±0.03）%] than in controls （0.21±0.24）%,P=0.004]. Conclusions Patients with NAFLD had a lower diversity of gut microbiota projects.

Objective To explore the relationship between non-alcoholic fatty liver diseases （NAFLD） and acute ischemic stroke and their risk factors. Methods A total of 481 in-hospital patients without alcohol abuse at the Xinhua Hospital affiliated to Shanghai Jiaotong University from January 2013 to November 2013,who had gone through both cranial magnetic resonance image （MRI） plus diffusion weighted imaging （DWI） and abdominal ultrasonography,were enrolled. Among them,225 patients had NAFLD and 218 were diagnosed with acute ischemic stroke. Correlation analysis of the association between NAFLD and acute ischemic stroke was carried out by studying fasting plasma biochemical indexes,results of carotid vascular ultrasonography and American National Institutes of Health Stroke Scale （NIHSS） scores. Results In our study,the mean age of NAFLD patients with or without acute ischemic stroke were（68.49±10.88） yr and （62.83±11.68） yr,respectively. There existed statistic difference between the two groups in 24-hour average systolic pressure[（152.11±14.69） mmHg vs.（139.76±20.19） mmHg],ALT[（23.69±14.8） U/L vs. （29.34±17.89） U/L],HbA1c[（7.03±1.86） vs.（6.33±1.35）%],fasting blood glucose levels[（7.14±2.61） vs. （6.15±1.89） mmol/L] and 2 h postprandial blood glucose [（11.33±4.45） vs. （9.66±4.23） mmol/L],P<0.05 for all. Binomial Logistic multivariate regression analysis identified 24-hour average systolic pressure （OR 1.028,95%CI 1.005-1.052）,age（OR 1.054,95%CI 1.013-1.097）,and fasting blood glucose（OR 1.338,95%CI 1.039-1.723） were independently associated with the occurrence of acute ischemic stroke in NAFLD patients. Differences existed between acute ischemic stroke patients with or without NAFLD in serum levels of GGT [（34.75±30.98） U/L vs. （26.21±16.62）U/L],total cholesterol [（12.26±7.72） mmol/L vs.（4.43±1.03） mmol/L],triglycerides[（1.82±0.92） mmol/L vs. （1.26±0.6）mmol/L],LDL-C[（2.97±0.79） mmol/L vs.（2.73±0.71） mmol/L],HbA1c[（7.03±1.86） vs.（6.32±1.34）%],fasting blood glucose[（7.14±2.61） mmol/L vs.（6.38±2.13） mmol/L] and 2 h postprandial blood glucose[（11.33±4.45） mmol/L vs.（9.66±4.23） mmol/L],P<0.05 for all. Binomial Logistic multivariate regression analysis revealed HbA1c（OR 1.468,95%CI 1.057-2.04） and triglycerides（OR 2.479,95%CI 1.375-4.468） were independent risk factors for the occurrence of NAFLD in acute ischemic stroke patients. Conclusion This study suggests that advanced age,elevated systolic pressure and fasting blood glucose are risk factors for NAFLD patients developing acute ischemic stroke,and hypertriglyceridemia and hyperglycemia are risk factors for acute ischemic stroke patients with underlying NAFLD.

Objective To explore the changes of serum IL-33 levels in patients with alcoholic liver diseases. Methods Serum levels of IL-33 and its soluble receptor sST2 in patients with alcoholic hepatitis（n=40）, severe alcoholic hepatitis（n=17）,alcoholic liver cirrhosis（n=75）,and healthy individuals （n=20） were measured by ELISA. IL-33 and sST2 levels in different groups were compared and the correlation between serum IL-33 levels and the regular biochemical indexes was analyzed. Results Patients with alcoholic hepatitis,severe alcoholic hepatitis and cirrhosis had elevated serum IL-33 levels than that in the controls[（85.20±9.44） pg/ml,（68.70±8.14） pg/ml,（64.45±3.78） pg/ml vs. （42.17±2.41） pg/ml,P<0.001 for all],while IL-33 in patients with alcoholic hepatitis were significantly higher than that in cirrhotic patients（P<0.05）;however,there was no statistical difference between patients with severe hepatitis and cirrhosis with different Child-Pugh class;Serum sST2 in alcoholic hepatitis,severe alcoholic hepatitis and cirrhosis group significantly elevated compared to that in the controls [（96.75±11.30） pg/ml,（51.92±11.78） pg/ml,（75.82±6.81） pg/ml vs. （43.97±3.01） pg/ml,P<0.001 for all],while serum sST2 levels in patients with alcoholic hepatitis was higher than that in patients with severe hepatitis or cirrhosis（P<0.001 and P<0.05,respectively）;in addition,serum sST2 in patients with alcoholic cirrhosis with Child-Pugh A class was significantly higher than those in cirrhotic patients with Child-Pugh B class or C class（P<0.001 for both）;there was no correlation between serum IL-33 and sST2（R=0.100,P=0.180）;Serum IL-33 levels in patients with alcoholic liver disease showed positive correlation with lymphocyte counts（R=0.273,P<0.01）,ALB（R=0.237,P<0.01）,ALT（R=0.462,P<0.001）,AST（R=0.387,P<0.001）and CHE（R=0.225,P<0.01）,while no significant correlation with neutrophils,TBIL,ALP,GGT,TC and PTA. Conclusion Elevated serum IL-33 levels might contribute to the development of alcoholic liver disease by aggravating immunological reaction.

Objective To investigate the prognostic factors of drug-induced liver injury（DILI）. Methods Sixty-nine patients with DILI were included in this study from July 2008 to July 2014. The factors were assessed by Logistic regression analysis. Results The ages of patients with DILI were mainly among 50 to 59 year old. The number of female patients was more than male ones. The most common clinical manifestation in this series was hepatocyte type（78.3%）,the second was cholestasis type and the third was mixed type. The patients at different ages had no significant difference in clinical types（P>0.05）. The recovered patients accounted for 76.1%,and the unrecovered one was 23.9%. TCM-induced DILI accounted for 43.5% of patients and their prognosis was relatively poor.The prognosis of DILI was not associated with age,gender,and underlying chronic diseases（P>0.05）,but significantly associated with the clinical type,history of allergies and immune characteristic clinical manifestation（P<0.05）. The total bilirubin,total bile acid and alkaline phosphatase were the independent predictors for prognosis of DILI patients（P<0.05）. Conclusion The prognosis of patients with DILI mainly depends on the drug category and the individual physical features.

Objective To investigate the causative relationship between smoking and the occurrence of primary biliary cirrhosis（PBC）. Methods A questionnaire survey-based,and gender-and age-matched case-control study,was carried out. 109 patients with PBC and 218 healthy volunteers were consecutively recruited at Xijing Digestive Disease Hospital from 2009 to 2014. ResultsThe total consumption of cigarettes in patients with PBC was remarkably higher than that in controls[（P25 32393.8,P75 134137.5） vs.（P25 22356.3,P75 104025.0）,P<0.01];the median consumption of cigarettes in patients with PBC was also higher than that in controls （93075.0 vs. 76650.0,P<0.01）;The age of first exposure to smoking and total lasting time of smoking in patients with PBC were（19.5±2.7） years and （24.3±8.1） years,respectively,much younger or longer than（23.7±6.4） years and （23.1±9.3） years in controls;the average daily consumption of cigarettes in patients with PBC were（5.0,15.0）,while they were （2.5,11.3） in controls （P>0.05）;There existed no differences between the two groups as respect to the history of smoking or passive smoking,age of first exposure to passive smoking,total lasing time of passive smoking,the daily consumption of passive smoking and the total consumption of passive smoking,neither in the sum consumption of smoking and passive smoking. Conclusion Smoking may serve as a vital risk factor for the development of PBC.

Objective To investigate the effects of lentivirus-mediated prolyl oligopeptidase overexpression on thioacetamide （TAA）-induced liver fibrosis in rats. Methods 40 male Sprague-Dawley （SD） rats were randomly divided into four groups. Thioacetamide（TAA,5%） was injected intraperitoneally to induce liver fibrosis in rats. After 1-week TAA/saline treatment,rats were given normal saline（normal control group and TAA model group）,empty virus（TAA plus empty vector group）,or lentivirus containing POP gene（lentivirus-POP） （TAA plus lentivirus-POP group）;Rats were sacrificed 4 weeks after initial TAA/saline treatment; Pathological changes of the liver were examed by HE staining and Masson staining;Hydroxyproline content in liver tissues were detected by chemical colorimetric;Real-time PCR and Western blot were used to determinate POP mRNA expression and POP protein content in liver,respectively. Results Relative level of POP protein in model group was（0.123±0.04）,significantly decreased compared with normal control[（0.189±0.052）,P<0.05];POP protein level in rats received lentivirus-POP was（0.304±0.044）,significantly higher than that of other groups（P<0.01）;the changes in POP mRNA expression was similar with POP protein content. The fibrosis grade in TAA model group and empty virus group were mostly of S2,and the semi-quantitative analysis of the fibrotic tissue by Masson staining were （15.2±1.69） and （15.3±4.62）,respectively,which were significantly higher than those of the normal controls and TAA plus lentivirus-POP group[（1.75土0.63） and（7.75±2.71）,P<0.05];Hydroxyproline content in model group and empty virus group were[（504.47±111.15） μg/g wet liver weight] and[（498.32±90.87） μg/g wet liver weight],respectively, significantly higher than that of the normal controls[（298.20±47.47） μg/g wet liver weight,P<0.05],while hydroxyproline content in TAA plus lentivirus-POP group was[（383.52±43.49） μg/g TAA wet liver weight],significantly lower than those of model group and empty virus group（P<0.05）. Conclusions POP expression decreases in fibrotic liver induced by TAA;POP can be successfully overexpressed in rat liver by lentivirus containing POP genes,attenuates TAA-induced liver fibrosis and decreases hydroxyproline content in the rat liver.

Objective To investigate the effects of iron deposition on the liver fibrosis and its potential mechanisms in rats. Methods 39 SD rats were randomly divided into fibrosis group（n=27） and control group （n=12）. Rats with hepatic fibrosis（n=27） were established by intraperitoneal injection of dimethylnitrosamine （DMN,10 μL.kg^-1）. After one-week DMN injection,the 27 rats were randomly divided into model group （n=15） and desferrioxamine group（n=12）. At the beginning of the third week,rats in model and desferrioxamine group were respectively injected intraperitoneally with normal saline or desferrioxamine at the dose of 100 mg·kg^-1·d^-1,3 times per week for 2 weeks before they were sacrificed. Liver tissues were stained with HE,Masson and Prussian blue,respectively;Immunohistochemistry was applied for the detection of α-smooth muscle actin （α-SMA） expression;Hepatic iron concentration （HIC） in liver tissues were evaluated by flame atomic absorption spectrophotometry（FAAS）;ELISA was adopted to examine the concentrations of serum ferritin and transferrin. Automatic biochemical analyzer was used to detect the liver function and the serum level of iron. The mRNA levels of transforming growth factor-β1（TGF-β1） was detected by quantitative PCR. Results Our histopathological findings showed that iron loads in liver tissues in model group increased obviously,accompanied with excessive collagen deposition,hepatocyte denaturation and necrosis and activation of a great number of hepatic stellate cells （HSCs） and the iron distributed in fibrous septa with main deposition in Kupffer cells（KCs） and HSCs;The hepatic iron concentration in model group [（0.778±0.098） mg/g] was higher than that in control group[（0.436±0.043） mg/g,LSD-t=5.15,P<0.01] and than in desferrioxamine group[（0.595±0.146） mg/g,LSD-t=-2.76,P<0.05];Compared with in control,the level of serum ferritin in model group significantly increased,and the level of serum transferrin obviously decreased [ferritin,（47.657±27.851） ng/mL vs.（24.166±27.626） ng/mL,LSD-t=2.21,P<0.05;transferrin,（0.322±0.099） mg/mL vs.（0.653±0.170） mg/mL,LSD-t=-4.78,P<0.01];Compared with in the model group,the serum level of ferritin had reduced and the serum level of transferrin increased in desferrioxamine group [ferritin,（10.261±12.466） ng/mL vs. （47.657±27.851） ng/mL,LSD-t=-3.52,P<0.01;transferrin,（0.584±0.180） mg/mL vs.（0.322±0.099） mg/mL,LSD-t=3.77,P=0.01];Compared with in control,TGF-β1 mRNA in model group was significantly up-regulated [（11.896±0.639） vs. （2.292±0.222）,LSD-t=25.95,P<0.01],which decreased as compared with in desferrioxamine group[（7.481±0.745）,LSD-t=-11.95,P<0.01]. Conclusion Iron deposition in the liver may play an important role in the onset and development of hepatic fibrosis. The potential mechanism might be related to iron deposition in KCs and HSCs,facilitating the activation of HSCs.

Objective To investigate the efficacy of Shengmai,a herbal medicine,alprostadil and reduced glutathione in treatment of patients with systemic inflammatory response syndrome（SIRS）. Methods Sixty-two patients with SIRS were randomly divided into two groups. Patients in control group（n=28） received basic treatment,and patients in treatment group（n=34） were given Shengmai,alprostadil and reduced glutathione injections intravenously for 7 days at the basic treatment. The serum levels of serum interleukin 6（IL-6）,IL-10,tumor necrosis factor alpha （TNF-α） and C reactive protein （CRP）,and incidences of multiple organ dysfunction syndrome（MODS） as well as mortality rates in the two groups were recorded and compared. Results After 7 day treatment,the levels of serum IL-6,TNF-α,IL-10 and CRP in patients in treatment group were（98.5±18.5） pg/ml,（31.8±9.5） ng/ml,（25.6±7.8） mg/ml and （92.5±24.5） μg/L,significantly lower than those in the controls [（180.6±34.5） pg/ml,（58.6±15.8） ng/ml,（40.5±10.2） mg/ml and 72.8±18.0） μg/L,respectively,P<0.01];The incidence of MODS in control patients was 35.6%,significantly higher than that in treatment group （11.8%,P<0.05）; The mortality rates of patients in treatment and in control group were 5.9% and 21.4%,respectively,which had no significant statistical difference（P>0.05）. Conclusions Shenmai,alprostadil and reduced glutathione injection were effective in blocking SIRS process,which might be related to the inhibition of inflammatory response.

Occult hepatitis B virus （HBV） infection （OBI） is defined as the status with persistent serum HBsAg negative, but with serum/intrahepatic HBV DNA positive. Due to the differences in prevalence of HBV infection,prevalent viral strains, study samples,as well as sensitivity and specificity of methodology,the available data of OBI prevalence quite varied. The pathogenesis of OBI has not been fully elucidated. It is a complex process involving multiple virological and host factors. OBI can be transmitted through blood transfusion,parturition and liver transplantation to cause de novo infection. Immune dysfunction andapplication of immunosuppressive agents can lead to OBI reactivation and recurrence of typical serological evidence. The slight but persistent necro-inflammation can promote the progression of liver disease and increase the risk of tumorigenesis. In clinic,more sensitive detection methods are needed for diagnosis of OBI to reduce OBI-related potential threat and help clinicians to take reasonable managements to slow the progression of the disease.

Chronic liver diseases,having high morbidity and mortality,are important public-health problems worldwide. Chronic hepatitis may progress into advanced liver fibrosis,cirrhosis or even liver cancer. The correct evaluation of the severity of liver diseases is therefore necessary. However,the liver biopsy is invasive, and the measurement of hepatic venous pressure gradient is complicated. Recently,many studies suggest that non-invasive diagnostic techniques to measure the changes of liver and spleen stiffness are correlated with the severity and progression of liver diseases. This review mainly discuss the application of spleen stiffness measurement in non-invasive diagnosis of patients with chronic liver diseases.

Primary biliary cirrhosis（PBC） is a kind of autoimmune diseases with unknown etiology. Th17 cells and Treg cells are two subpopulations of CD4⁺T cells,plays suppression of,or promotion of inflammatory reactions respectively. They inhibit each other in the differentiation and function. Many studies suggest that Th17 and Treg cells,and related cytokines differ in PBC patients from in healthy persons,but the exact mechanism remains unclear. In recent years,their changes in the pathogenesis of PBC has become a hot topic. This review focuses on the research about Treg cells and Th17 cells and their roles in the pathogenesis of PBC.

Bone marrow mesenchymal stem cells （BMSCs） can be differentiated into functional and mature hepatocytes in the proper conditions. The application of BMSCs may provides a new approach for end-stage liver disease. In this review,we summarized the progress in the application of BMSCs for treating patients with liver diseases such as cirrhosis,hepatocellular carcinoma （HCC） and liver failure. We’ll also discuss the transplantation and the existing problems in the practice.

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.