Objective To establish an experimental model of alcoholic fatty liver accompanied with intestinal endotoxemia in rats. Methods A rat model of alcoholic fatty liver was established by gradient ethanol gavage method;The liver steatosis,intrahepatic inflammation,liver function tests and serum lipopolysaccharide were determined at 3 and 6 weeks of experiment. Result Significant liver steatosis was observed after 6 weeks of ethanol administration in the model rats;The liver index,liver steatosis scores,inflammation scores in model rats were（3.6±0.2）,（3.0±0.9）and（1.0±0.6）,respectively, significantly higher than those in normal controls[（3.1±0.1）,（0.0±0.0） and（0.0±0.0）,respectively,P<0.05）];Similarly,serum lipopolysaccharide,D-lactate,diamine oxidase and aspertate aminotransferase levels in model rats at 6 months were（1435.6±52.9） pg/ml,（20.7±5.4） mmol/L,（25.5±2.0）U/L and （124.5±13.2） U/L,which were also significantly higher than those in normal controls[（89.9±10.5） pg/ml,（5.0±1.1）mmol/L,（7.4±1.7） U/L and（40.4±15.2） U/L,respectively,P<0.05]. Conclusion A rat model of alcoholic fatty liver accompanied with intestinal endotoxemia can be successfully establish by using gradient ethanol gavage for 6 weeks.

Objective To evaluate plasma IL-21 levels in patients with alcoholic liver diseases and the effects of recombinant IL-21 on proliferation and activation of LX-2 hepatic stellate cells in vitro. Methods The plasma levels of IL-21 in patients with alcoholic hepatitis（n=17）,patients with alcoholic liver cirrhosis（n=51）,and healthy controls（n=20） were measured by ELISA;the LX-2 hepatic stellate cells were subjected to recombinant IL-21 at the concentration of 1 ng/ml or 10 ng/ml for 24 or 48 hours,then the cell proliferation and expression of α-smooth muscle actin were determined by CCK-8 and by FACs,respectively. Results Plasma levels of IL-21 were significantly elevated in patients with alcoholic hepatitis and cirrhosis as compared to that in healthy controls（P<0.05）,however,no significant difference was observed between patients with alcoholic hepatitis and patients with alcoholic cirrhosis,and no significant difference was found among cirrhotic patients with different Child class either;Incubation of LX-2 hepatic stellate cells with IL-21 at 1 ng/ml or 10 ng/ml for 24 or 48 hours did not affect cell proliferation,but significantly increased the expression of α-smooth muscle actin in the cells（P<0.05）. Conclusion IL-21 might contribute to the fibrogenesis in alcoholic liver diseases though induction of activation of hepatic stellate cells.

Objective To evaluate the efficacy and safety of sylibin in the treatment of patients with alcoholic liver disease（ALD）. Methods A systematic search of literatures in Cochrane Library,Pubmed,OVID,CNKI,VIP and Wanfang Database was performed,and randomized controlled trial（RCT） of silybin for ALD treatment were retrieved;RevMan 5.0 software was used for Meta-analysis. Results A total of 8 RCT trails involving 849 patients with ALD were included;The overall efficacy of silybin for ALD was better than that in the control group,with a OR-value of 5.49（95%CI=3.51-8.58,P<0.00001）;Between the silybin and the control group,the weighted mean differences（WMDs）for ALT,AST,and GGT were -6.20（95%CI -9.06 - -3.35）,-14.17（95% CI -17.08 - -11.25） and -32.32（95% CI -36.83 - -27.81）,respectively,and the WMDs for PT and ALB were 2.11（95%CI 0.64-3.57） and 1.42（95% CI 0.08 - 2.75）,respectively,while WMDs for TC and TG were -1.40（95% CI -1.61 - -1.19）and -0.35（95% CI -0.56 - -0.13）,respectively;The adverse effect rate in silybin group was 0.8%,while that in control group was 1.7%. Conclusion Silybin might be effective in improving liver function without clinically significant adverse effects in patients with ALD.

Objective To analyze the clinical features of inpatients with alcoholic liver diseases（ALD）. Methods Clinical data of inpatients with alcoholic liver diseases in our hospital from 2002 to 2011 were analyzed. Results The ratio of patients with ALD to total inpatients with liver diseases was 1.74% in 2002 and 2.89% in 2006,and it reached to 4.18% in 2011,a 2.4-fold increase in ten years;The percentage of male patients was 97.69%（4278/4379）;Patients diagnosed as alcoholic cirrhosis,ALD（without classification） and mild alcoholic hepatitis accounted for about 70.66%,10.44% and 9.96% of all ALD patients,and only about 4% of patients were diagnosed as severe alcoholic hepatitis or alcoholic liver failure or alcoholic steatosis（P<0.01）;The average age of patients with alcoholic cirrhosis was 49.6 year-old,significantly greater than that in patients with ALD complicated by non-alcoholic fatty liver disease（36.9 year-old,P<0.01）;The recovery rates in patients with mild alcoholic hepatitis and alcoholic steatosis were 80.28% and 91.58%,respectively,significantly higher than that in patients with severe alcoholic hepatitis（47.78%,P<0.01）. Conclusions The ratio of ALD inpatients to total inpatients with liver diseases is increasing gradually and more attention should be pay to male patients and patients with mild ALD to prevent disease progress.

Objective To investigate the effect of tamoxifen（TAM） on steatosis in HepG2 cells in vitro and on the expression of key regulators involved in lipid metabolism in the cells. Methods A cell model of steatosis was induced in HepG2 cells in vitro with oleic acid（OA） at 50 μmol/L;HepG2 cells were then subjected to different concentrations of TAM（5 to 20 μmol/L） at the presence of OA for 72 h;Intracellular lipid accumulation was assessed by oil red O staining and measurement of triglyceride;The expression of sterol regulatory element-binding protein-1c（SREBP-1c）,fatty acid synthase（FAS）,steroyl-CoA desaturase（SCD）,carnitine palmitoyltransferase 1（CPT1）and mitochondrial trifunctional protein（MTP）was determined by Western blot;Cell viability was detected by cell counting Kit-8 assay. Results After incubation for 72 h,the intracellular triglyceride in control group was（16.53±0.17） mg/100 mg protein,similar to that of cells treated with 5μmol/L TAM,however,the intracellular triglyceride was increased by 31%[（21.57±0.16） mg/100 mg protein] and 44%[（23.82±0.44） mg/100 mg protein] in cells treated with 10 μmol/L and 20 μmol/L of TAM,respectively（P<0.05）;TAM treatment（5 to 10 μmol/L）significantly increased the expression of SREBP-1c,FAS,SCD and MTP without affecting the expression of carnitine palmitoyltransferase 1（CPT1） in HepG2 cells;TAM did not affect HepG2 viability. Conclusions TAM promotes OA-induced cell steatosis,probably by up-regulation of SREBP-1c,FAS and SCD,thus increases fatty acid synthesis in the cells.

Objective To investigate the efficacy and safety of combination therapy of pegylated interferon α-2a（PEG-IFNα-2a）and hepatitis B vaccine in treatment of patients with chronic hepatitis B（CHB）. Methods One hundred and seventy-two patients with CHB in our hospital from October,2008 to October,2012 were recruited and randomly divided into observation group（PEG-IFNα-2a plus hepatitis B vaccine） and control group（PEG-IFNα-2a alone,86 cases in each group）;The negative conversion rates of serum HBV DNA and HBeAg,normalization rates of ALT and adverse events at 6 and 12 months after treatment and at the end of 6-month followed-up between the two groups were compared. Results The negative conversion rates of HBV DNA and HBeAg,and the ALT normalization rates in observation group at 6 and 12 months after treatment and 6 months followed-up were 81.4%,53.5%,82.6% and 93.0%,64.0%,95.3%,respectively,all of which were significantly higher than those of corresponding parameters in control group（67.4%,38.7%,68.6% and 75.6%,46.5%,77.9%,respectively,P<0.05）;The serum ALT and AST levels at 6 and 12 months after treatment and at 6-month followed-up in observation group were （93.5±43.1） U/L and （86.0±50.6） U/L,（40.8±25.1） U/L and （50.7±28.6） U/L,（36.5±11.3） U/L and（43.2±15.7） U/L,respectively,all of which were significantly lower than those in control group （116.4±58.6） U/L and （105.3±52.8） U/L,（50.6±26.2） U/L and （59.5±25.4） U/L,（46.0±24.4） U/L and （52.6±23.9） U/L,respectively,P<0.05）. Conclusion Combination therapy of PEG-IFNα-2a with hepatitis B vaccine significantly improved the efficacy of PEG-IFNα-2a in treatment of patients with CHB.

Objective To compare the clinical features between patients infected with hepatitis B virus （HBV）presenting A181T/V mutation or A181T/V+N236T mutation in HBV reverse transcriptase region after nucleoside treatment. Methods Fifty-five patients with rtA181T/V mutation and 34 patients with rtA181T/V+rtN236T mutation were enrolled in this study. Their administration of nucleoside analogues was reviewed;Serum ALT, AST,HBV M and HBV DNA were detected;HBV genotypes were determined by DNA sequencing. Results In adefovir treatment group,the A181T/V+N236T mutation was more common than rtA181T/V mutation（57.6% vs. 42.4%,P<0.05）,while the occurrence of rtA181T/V mutation was higher than A181T/V+N236T mutation in patients receiving lamivudine treatment（75.5% vs. 24.5%,P<0.05）;In the total 89 patients in our series,there were 14 cases with genotypes B and 75 cases with genotype C of HBV infection,and there was no significant difference in the distribution of mutations between patients with either of the two genotype infection; There were no statistical differences as respect to age,gender,ALT,AST,HBV DNA, HBsAg titers and HBeAg status between the two groups of patients with different mutations. Conclusions A given nucleoside analogue treatment leads to specific pattern of HBV reverse transcriptase region mutation;However,there is no special clinical significance between different mutations.

Objective To investigate the effect of combined therapy of compound embryonic bovine liver extract and entecavir in patients with chronic hepatitis B. Methods Forty-eight patients with chronic hepatitis B were randomly divided into treatment group（n=24） and control group（n=24）. Patients in treatment group were treated with compound embryonic bovine liver extract plus entecavir,and those in control group were treated with entecavir alone. The treatment lasted for 48 weeks and the liver function tests,serum hepatic fibrosis indexes and the histological activity index and fibrosis before and after treatment in the two groups were examined. Results At the end of 48 weeks of the treatment,serum albumin levels in patients in treatment group（41.0±2.9 g/L）were significantly higher than that in the controls（36.2±2.2 ） g/L,P<0.01;Serum hyaluronic acids （158.0±70.3）ng/ml,laminin（83.6±29.9） ng/mland collagen type IV（90.3±41.2） ng/mlin the treatment group were significantly lower than those in the controls（170.6±71.1） ng/ml,（107.5±33.7） ng/ml and（113.5±52.4） ng/ml,respectively,P<0.05）;Histopathological examinations of the liver biopsies showed that the grades and stages of the liver injuries in treatment group were decreased significantly as compared with in control group（P<0.05）. Conclusions Combined therapy of compound embryonic bovine liver extract and entecavir are better than entecavir alone in inhibiting liver inflammation and fibrosis in patients with chronic hepatitis B.

Objective To observe the efficacy of compound embryonic bovine liver extract tablets in treatment of patients with chronic hepatitis B（CHB）. Methods One hundred and twenty patients with CHB were recruited, and divided randomly into control group（n=56）or treatment group （n=64）;Patients in control group were treated with basic liver-protecting treatment and patients in treatment group were treated with combinational therapy of compound embryonic bovine liver extract tablets and basic treatment. Changes in liver function tests and fibrotic parameters were examed after 3 months of treatment. Results At the end of 3 months of treatment,the fatigue and poor appetite were improved in 92.00% and 91.84%,respectively,in treatment group,significantly higher than those in controls（56.41% and 58.33%,respectively,P<0.05）;the serum ALT, AST, GGT and total bilirubin levels in treatment group were （35.6±17.2） U/L,（38.5±18.6） U/L,（40.6±19.7） U/L and （16.1±13.9） μmol/L,respectively,significantly decreased than those before treatment [（110.8±61.4） U/L for ALT,（97.2±62.4） U/L for AST,（106.3±60.1） U/L for GGT and（47.8±19.3） μmol/L for total bilirubin,P<0.05];serum PIIIP（36.7±11.3 μg/L）, HA （276.4±79.5 μg/L）,LN（169.8±73.4 μg/L） and IV-C （155.8±61.5 μg/L） in treatment group decreased significantly than those before treatment[（16.4±6.1） μg/L for PIIIP,（110.8±51.4） μg/L for HA,（70.8±34.9） μg/L for LN and（97.8±41.4） μg/L for IV-C,P<0.05],which lowered more obviously than in control. Conclusion Compound embryonic bovine liver extract may be a promising therapeutic remedy for patients with CHB.

Objective To investigate serum thyroid hormones,anti-thyroid autoantibodies and interleukin （IL）-6 levels and its clinical significance in patients with chronic hepatitis B virus（HBV） infection. Methods Eighteen healthy persons,65 patients with chronic hepatitis B（CHB）and 34 patients with hepatitis B liver cirrhosis were included in this study,and serum levels of thyroid hormones,anti-thyroid autoantibodies and IL-6 were determined by electrochemiluminescence. Results The serum levels of anti-thyroid peroxidase antibody（TPOAb）,anti-thyroglobulin antibody（TGAb）,anti-thyroid stimulating hormone receptor antibody（TRAb）and IL-6 in patients with CHB were（9.5±5.6） KIU/L,（42.5±218.7） KIU/L,（1.5±0.7） IU/L,and（6.6±12.6） pg/mL,respectively,and in cirrhotic patients were（9.5±8.6） KIU/L,（47.6±101.5） KIU/L,（2.2±1.7） IU/L and（15.8±25.5） pg/mL,respectively,all of which were significantly higher than those in normal controls[（4.4±5.6） KIU/L,（7.7±18.3） KIU/L,（0.8±0.8） IU/L and （2.8±2.0）pg/mL,respectively,P<0.05],while FT3 in patients with CHB and cirrhotics were （2.4±0.5） ng/L and（2.4±0.6）ng/L,respectively,significantly lower than that in normal controls[（2.9±0.2） ng/L,P<0.05];Serum TRAb and IL-6 levels in cirrhotic group were（2.2±1.7）IU/L and（15.8±25.5） pg/mL,respectively,significantly higher than that in patients with CHB[（1.5±0.7） IU/L and（6.6±12.6） pg/mL,respectively,P<0.05],while serum TT3 and TT4 levels in cirrhotic group were（0.8±0.3）nmol/L and（5.4±1.9） nmol/L,respectively,significantly lower than those in CHB group [（1.3±0.3） nmol/L and（8.0±2.2） nmol/L,respectively,P<0.05]. Conclusion Detection of serum thyroid hormones,anti-thyroid autoantibodies and IL-6 in patients with chronic HBV infection is of clinical significance in evaluation of the disease progress and prognosis.

Objective To investigate the expression of Fas antigen and Fas ligand（FasL） in liver tissues from chronic asymptomatic hepatitis B virus （HBV） carrier （ASC）. Methods Liver biopsy specimen and sera from 120 individuals with ASC were obtained;The expression of Fas and FasL in liver tissues were detected by immunohistostaining. Serum levels of soluble Fas （sFas） and sFasL were measured by ELISA. Results Only 11% had a normal appearance of liver tissues in the 120 chronic HBV carriers,and 59% had mild and other 30% had moderate to severe hepatitis;Fas and FasL were negative in normal liver tissues,almost absent or only slightly positive in hepatocytes and lymphocytes in inflammatory zone of the interface in liver tissues with mild hepatitis,and strongly positive in those with moderate or severe hepatitis,showing a pattern of diffused staining in the interface area of hepatic lobules;The strongly positive rate for Fas and FasL in moderate（34.8% and 30.4%,respectively） and severe hepatitis（69.2% and 53.8%,respectively） was significantly higher than that in mild hepatitis or normal liver tissues（P<0.05）;Serum sFas from persons with normal liver tissues was（1.68±0.33） ng/L,and they increased significantly to（2.58±0.31） ng/L,（3.94±0.21） ng/L and（5.94±0.26） ng/L,respectively,from individuals with mild,moderate and severe hepatitis（P<0.01）. Conclusion The Fas-FasL mediated apoptosis might play an important role in the disease progress of ASC.

Objective To compare the efficacy and safety of pegylated interferon-α2a（PEG-INF α-2a） or INF α-2a combined with ribavirin in treatment of patients with chronic hepatitis C（CHC）. Methods 30 patients with CHC were treated with PEG-INF α-2a and 30 with INF α-2a,and all were combined with ribavirin;The efficacy of each treatment was observed at 4,12 and 48 weeks. The rate of sustained virologic response （SVR） and the adverse reactions were evaluated 24 weeks after treatment termination. Results The SVR in PEG-INF α-2a group was 90.0%,significantly higher than that in INF α-2a group（56.7%,P<0.01）;Adverse reaction such as fever,muscular soreness,hair loss and decline in neutrophils and platelet counts were observed in both groups, but the incidences of fever and muscular soreness in PEG-INF α-2a treated patients were 36.7% and 33.3%, respectively,which were significantly lower than that in INF α-2a treated patients（P<0.05）;The rate of decline of neutrophils in PEG-INFα-2a treated patients,from 4 to 24 weeks,was more obvious than that in INF α-2a group. Conclusion PEG-INFα-2a plus ribavirin shows better efficacy for CHC without a significant increase in adverse reactions.

Objective To observe the therapeutic effects of co-transplanted umbilical cord blood stem cells and bone marrow stem cells for rats with acute liver failure induced by D-galactose. Methods Mononuclear cells isolated from umbilical cord blood and bone marrow of rats were cultured in medium containing hepatocyte growth factor（HGF） and stem cell factor（SCF） for 3 weeks,and the expression of hepatocyte markers,such as AFP and ALB,were detected by immunocytochemistry;A rat model of acute liver failure was established by D-galactose injection（1.4 g.kg^-1,intraperitoneally） for 24 h. Rats with acute liver failure were subjected to transplantation of bone marrow stem cells,umbilical cord blood stem cells,and umbilical cord blood stem cell mixed with bone marrow stem cell,or an equal amount of saline per day for seven days. The survival rates,liver function and pathological changes in liver were studied. Results Bone marrow stem cells and umbilical cord blood stem cells were successfully proliferated and differentiated into hepatocytes in vitro by stimulation of HGF and SCF. The 9-day survival rates of rats with acute liver failure in umbilical cord blood stem cell,bone marrow stem cell and mixed stem cell transplantation group were 55.6%,50.0% and 77.8%,respectively,all of which were markedly higher than that in rats treated with saline（16.7%,P<0.01）;The 9-day survival rate of rats in mixed cell transplantation group was significantly higher than that of rats in umbilical cord blood stem cell or bone marrow stem cell alone （P<0.01）. Conclusions Bone marrow stem cell and umbilical cord blood stem cell transplantation improve liver function of rats with acute liver failure,and combinational transplantation of these two cells is efficient.

Objective To study the changes in serum inflammatory cytokines in patients with acute liver failure （ALF）. Methods Fifteen patients with ALF in our hospital from June 2011 to June 2013 were included in this study,and 15 healthy subjects were served as normal controls. Serum levels of interleukin（IL）-2,IL-4, IL-5,IL-6,IL-10,IL-17,IL12p70,tumor necrosis factor（TNF）-α and TNF-β were measured by cytometric bead array. Results No statistical differences were observed between ALF patients and healthy controls in serum IL-2,IL-4,IL-5,IL-12p70 and TNF-βlevels;The serum level of TNF-α,IL-6,IL-10 and IL-17 in patients with ALF were 13.49 pg/mL,480.96 pg/mL,330.28 pg/mL and 6.36 pg/mL,respectively,significantly higher than those in healthy controls（7.32pg/mL for TNF-α,P=0.03;4.64 pg/mL for IL-6,P<0.01;5.47 pg/mL for IL-10,P<0.01;and 2.03 pg/mL for IL-17,P=0.04）. Conclusion Inflammatory cytokines play a significant role in the pathophysiology of ALF.

Objective To evaluate serum levels and clinical significance of secreted frizzled-related proteins （sFRP）-1 and β-catenin in patients with hepatocellular carcinoma（HCC）and chronic hepatitis B （CHB）. MethodsSerum levels of sFRP-1 and β-catenin in 36 patients with HCC,36 patients with CHB and 36 healthy persons were detected by ELISA;Spearman correlation analysis was used to estimate the relevance between sFRP-1, β-catenin and age,ALT,albumin,total bilirubin. Results The serum levels of sFRP-1 in patients with HCC and CHB were（1136.28±332.43） pg/ml and（1194.53±156.84） pg/ml,respectively,both significantly higher than that in healthy persons[（1477.26±563.12） pg/ml,P<0.05];The serum level of β-catenin in patients with HCC was （527.2±20.9） pg/ml,significantly higher than those in patients with CHB（374.0±8.3） pg/ml and normal persons （369.8±21.5） pg/ml,P<0.05）;No correlation was found between serum sFRP-1 or β-catenin levels with age,ALT,albumin,total bilirubin either in CHB or in HCC group. Conclusion The serum sFRP-1 levels in patients with HCC and CHB decrease,while the serum β-catenin levels in patients with HCC increase.

Objective To evaluate serum level of microRNA-21（miR-21） in normal persons and patients with different liver diseases,and to investigate its effect in the diagnosis of hepatocellular carcinoma（HCC）. Methods The serum level of miR-21 in healthy controls （n=25）,patients with chronic hepatitis B（CHB,n=25）, cirrhosis（n=25）,and HCC（n=25） were measured by real-time quantitative RT-PCR. The relationships between serum miR-21 levels and clinical pathological features of HCC were also investigated. Results The relative serum levels of miR-21 in normal controls,CHB and cirrhotic patients were（1.1±1.7）,（2.3±2.6） and （2.8±2.5）,respectively,all of which were significantly lower than that in HCC patients（22.6±4.4）,P<0.001;The relative serum levels of miR-21 in HCC patients one week and one month after surgery were（18.4±3.5） and （3.1±2.7）,respectively,significantly lower than that before operation（22.6±4.4）,P<0.001;Serum levels of miR-21 were correlated with tumor size,tumor thrombosis and HBV infection,but not with tumor numbers,tumor differentiation and serum AFP levels. Conclusions Serum levels of miR-21 is elevated in HCC patients and might be used as a potential biomarker for the early diagnosis of HCC.

Objective To investigate the changes of peripheral T lymphocyte subsets in patients with primary liver cancer（PLC）underwent microwave ablation. Method 152 patients with PLC were recruited and received microwave ablation treatment. One day before,and 1 week and 4 weeks after the treatment,the distributions of peripheral T lymphocyte subsets were determined by flow cytometry,and serum levels of alpha fetoprotein were measured by a automatic biochemical immune analyzer. Contrast-enhanced CT scans were performed in all patients one month after the treatment. Results The percentages of CD4⁺ or CD8⁺T lymphocytes and the ratio of CD4⁺/CD8⁺in this series one day before the treatment were （21.4±4.1）%,（58.6±7.8）% and（0.98±0.45）,respectively,while the percentages of CD4⁺T lymphocytes increased to （26.5±3.8）% and（32.3±5.1）%,and the CD4⁺/CD8⁺ratio increased to（1.12±0.43）and（1.51±0.40）,but CD8⁺T lymphocytes decreased to（47.2±7.7）% and （28.1±7.3）%,respectively（P<0.05）one week and 4 weeks after microwave ablation; serum alpha fetoprotein levels were significantly decreased from the baseline [（1109±727） ng/ml] to （890±681） ng/ml 1 week or （215±18） ng/ml 4 weeks after ablation（P<0.01）;contrast-enhanced CT scans revealed a complete ablation rate of 97.37%（148/152） for tumors one month after therapy. Conclusions Microwave ablation for PLC shifts the distribution of peripheral blood T lymphocyte subsets toward a CD4⁺ cells-favorite status,which might play a role in improving the efficacy of the therapy.

Objective To explore the liver histopathological characteristics of recurrent hepatitis C in patients with liver transplantation. Methods 54 liver biopsies were obtained from 28 patients who were diagnosed as recurrent hepatitis C after liver transplantation. Results The main liver pathological features of recurrent hepatitis C in patients with liver transplantation included liver cell degeneration and necrosis,lymphocyte and other inflammatory cell aggregation in the portal area,and early occurrence of fibrosis;Besides,liver histopathological features of rejection reaction and drug-induced liver injury were also present in some cases;Liver fibrosis of recurrent hepatitis C in late periods（>12 months） after liver transplantation was significant severe than in patients with recurrent hepatitis C at early periods（the liver staging score were （1.82±1.12） and （1.13±1.08）,respectively,P<0.05）;No significant differences in pathological manifestations among different viral genotypes of HCV infection were found;Histological activity index in patients with rejection reaction and drug-induced liver injuries were（2.32±0.64）and（2.33±0.88）,respectively,much higher than that in cases without rejection reaction or drug-induced liver injuries（1.64±0.59）,（P<0.05）. Conclusion Hepatitis C recurrence after liver transplantation has characteristic changes in liver pathology,and liver pathological examination in time might help evaluating the liver injuries of hepatitis C recurrence after liver transplantation.

Alcoholic liver disease（ALD） is one of the most common liver diseases. The treatment of severe alcoholic hepatitis（SAH）and the control of alcohol abuse are the hot spots in this field. Child-Pugh class,Maddrey discriminate function,the model of end-stage liver disease（MELD）,Glasgow alcoholic hepatitis score,age/bilirubin/INR/creatinine（ABIC）score,and Lille score systems can be used to predict the prognosis of patients with SAH. Liver transplantation is still the major treatment for patients with ALD at end-stage illness.

Alcoholic liver disease is caused by long-term heavy alcohol drinking. Alcoholism may lead to the multiple systems injury of human body,including neuropsychiatric injury. The manifestations of neuropsychiatric injury caused by alcoholism are complex and varied,which often make clinical diagnosis difficult. In this paper,we will review the mechanisms of alcohol-induced mental disorders,the clinical features and treatment of five kinds of common alcoholic mental disorders. Effective multi-disciplinary collaboration and the help of society and family members are great significance for diagnosis,treatment and prevention of these diseases.

Non-alcoholic fatty liver disease（NAFLD）is the most common chronic liver disease worldwild. Insulin resistance is among the major causes of NAFLD,but its specific pathogenesis is still unclear. Recent findings show that bile acid nuclear receptors improve insulin resistance and liver fibrosis. Furthernore,a variety of adipokines secreted by fat cells play an important roles in the onset and progression of NAFLD. In addition,studies also show that bile acid nuclear receptors can affect the secretion of adipokines.

Quantification of serum HBsAg and HBeAg in patients with CHB is useful in the prediction of response to antiviral treatment, and they can be used to guide the treatment strategy. Here we reviewed the changes in serum HBsAg and HBeAg levels in patients with CHB and their relations to HBV replication, which include serum HBV DNA, and intrahepatic HBV cccDNA. This review will help to understand the clinical value of serum HBsAg and HBeAg levels in the prediction of antiviral efficacy in patients with CHB.

The morbidity of abnormal glucose metabolism in patients with hepatitis C infection increases gradually. In addition to the common pathogenesis similar to hepatogenous diabetes,malfunciton in pancreatic β-cell and insulin resistance （IR） play important roles in the pathogenesis of abnormal glucose metabolism in patients with hepatitis C virus infection. IR may be more important,and hepatic steatosis, tumor necrosis factor-α overexpression,decreased adiponectin, abnormality in synthesis of cytokine signaling inhibitory factors and in iron metabolism may all be involved in IR.

Intestinal flora is an important part of the intestinal barrier. Under healthy condition,a normal balance of intestinal flora is maintained, however, under pathological circumstances a number of factors can change the balance and result in dysbacteriosis. In turn dysbacteriosis promotes the progress and exacerbation of chronic liver diseases. Administration of probiotics can improve the balance of intestinal flora and help the recovery of chronic liver disease.

Primary biliary cirrhosis（PBC） is considered as an idiopathic autoimmune liver disease,mainly found in middle-aged women. Out of many related risk factors,the demographic factors,environmental factors and genetic factors as well as family history,smoking history and urinary tract infections,have always been thought to be important. In recent years,with the progress in basic and clinical research,especially the application of genome-wide association study technology,scholars found some genes,such as human leukocyte antigen genes,interleukin（IL）-12 and the X chromosome monomer,etc,may lead to this disease. In the future,more samples and GWAS data are needed to verify those new findings to elaborate the pathogenesis of the disease in genetic level.