ObjectiveTo explore the relationship between the serum levels of proangiotensin （AGT）,angiotensinⅡ（AngⅡ） and angiotensin converting enzyme （ACE） and index of liver fibrosis in patients with chronic hepatitis B（CHB） and HBV-related cirrhosis. Methods One-hundred and eighty patients were divided into normal control group （n=30）,mild hepatitis group （n=30）,moderate hepatitis group（n=30）,and cirrhosis group （n=90）;the patients with cirrhosis were further divided into Child class A,B and C according to individual Child-Pugh score（30 in each）. The levels of AGT,Ang Ⅱ and ACE in serum sample of patients were measured by ELSIA; Serum levels of hyaluronic acid （HA）,laminin （LN）,pro-collagen type Ⅲ（PCⅢ） and collagen type IV（IV-C）were detected by chemiluminescence method. Results Serum levels of HA,LN,PCⅢ,Ⅳ-C,AGT,Ang Ⅱ and ACE in patients with cirrhosis were （350.7±124.9） ng/L,（307.3±139.5） ng/L,（280.3±141.3） ng/L,（256.25±110.42） ng/L,（3.45±0.66） ng/mL,（120.58±26.69） ng/L and （79.70±25.67） U/L,respectively,which were significantly higher than those in normal controls [（68.8±20.7） ng/L,（58.6±20.9） ng/L,（53.0±21.1） ng/L,（47.0±21.1） ng/L,（3.0±0.4） ng/ml,（104.0±13.8） ng/L and （61.6±12.6） U/L,respectively,P<0.05];serum AGT levels in patients with Child-Pugh class A and B were （3.4±0.4） ng/ml and （3.3±0.6） ng/ml,respectively,significantly higher than those in normal controls （P<0.05）;serum Ang Ⅱ and ACE levels in patients with Child class C were （125.4±19.1） ng/L and （83.4±22.5） U/L,respectively,which were significantly higher than those in the normal controls （P<0.05）; No linear correlation could be demonstrated between serum level of AGT,Ang Ⅱor ACE and liver fibrosis indexes. Conclusions Serum levels of AGT,Ang Ⅱ and ACE increase significantly with the progress of liver fibrosis and cirrhosis,but not correlate with indicators of hepatic extracellular matrix metabolism.

Objective To investigate the safety of autologous bone marrow stem cells or umbilical cord blood stem cells transplantation in treatment of patients with decompensated cirrhosis through hepatic artery and the improvement in liver function and prothrombin activity in a short term. Methods Sixty-five patients with decompensated cirrhosis were randomly divided into bone marrow group（33 cases） and umbilicus cord blood group （32 cases）;patients in bone marrow group received autologous bone marrow stem cells transplantation through hepatic artery and the umbilicus cord blood group received umbilical cord blood stem cells through the same way;the changes of serum alanine aminotransferase,total bilirubin,prothrombin activity,albumin and alpha-fetoprotein after 8 weeks were determined,and the improvement in symptoms and postoperative adverse reactions were observed. ResultsThree days after cell transplantation,patients in both groups achieved significantly improvement in symptom such as fatigue and anorexia but had no significantly difference between the two groups. At eight weeks post therapy,in patients of bone marrow group and umbilicus group,serum albumin level increased significantly from the baseline of （31.0±4.6） g/L to （34.6±7.1）g/L and（26.6±8.0）g/L to（37.8±8.3）g/L, prothrombin activity from （48.8±13.4） % to （55.5±11.2）% and（47.5±12.5） to（58.9±14.0）%,but the improvement did not differ between the two groups;alanine aminotransferase,total bilirubin and alpha-fetoprotein were（45.6±12.3） IU/L,（28.1±13.5）μmol/L and（11.3±4.1）μg/L respectively in patients of bone marrow group and （47.2±11.8） IU/L,（30.7±14.8） μmol/L and（9.8±35） μg/L respectively in patients of umbilical group at 8 weeks post therapy,but the improvement did not differ between groups. Conclusions It is safe and effective in treatment of patients with decompensated cirrhosis using autologous bone marrow stem cells and umbilical cord blood stem cells transplantation through hepatic artery and no significant difference was observed between the two group.

ObjectiveTo study the risk factors for acute kidney injury in patients with decompensated liver cirrhosis. Methods Relevant clinical data of 254 patients with decompensated liver cirrhosis and ascites were retrospectively analyzed. The patients were divided into observation group with serum creatinine levels beyond the upper limit of normal（n=135） and control group with normal serum creatinine（n=119）. The risk factors for acute kidney injury were analyzed by univariate and multivariate analysis methods. ResultsThe incidences of hepatic encephalopathy were 50.4% in observation group and 10.1% in control group (P<0.01）;the incidences of spontaneous bacteria peritonitis （SBP） and infection in other sites were 70.4% and 32.6% in observation group,significantly higher than in patients in control group （41.2% and 19.3%,respectively,P<0.01）;the serum sodium,total bilirubin levels and white blood cell counts were 128 mmol/L, 391.8 μmol/L and 9.33×10⁹/L,respectively,in observation group, which were significantly different as compared to those in control group （136.8 mmol/L,51.58 μmol/L and 3.9×10⁹/L,respectively,P<0.01）;the plasma prothrombin time activity（PTA） were （34.2±17.3）% in observation group and （52.1±16.1）% in control group （P<0.01）. logistic regression analysis showed that hepatic encephalopathy,hyponatremia,total bilirubin,PTA,white blood cell counts were all independent risk factors for acute kidney injury in patients with decompensated cirrhosis （P<0.05）. Conclusion Patients with decompensated cirrhosis are under high-risk of acute kidney injury when hepatic encephalopathy,infection,hyponatremia,hyper-bilirubinemia or serious coagulopathy occur.

Objective To investigate the relationship between serum HBV DNA loads and hepatic pathological changes in patients with mild chronic hepatitis B. Methods Three hundred and ten patients with CHB were divided into HBeAg-positive and HBeAg-negative group. Serum HBV DNA loads were determined by fluorescence quantitative polymerase chain reaction, and pathological changes in liver biopsies were examined by HE staining. The relationship between serum HBV DNA load and hepatic histological grades and fibrosis stages was analyzed. Results Inflammatory grade of G₀ and fibrosis stage of S₀ accounted for 42.0% and 58.0% in HBeAg-positive patients,respectively,However,G₀,G₁ and G₂ and S₀ accounted for 29.1%,30.2%,34.9%,and 51.2% in HBeAg-negative patients,respectively;There was no significant correlation between serum HBV DNA load and inflammatory grade（r=-0.098,P>0.05）,while a negative correlation was found between serum HBV DNA load and the fibrosis stage（r=-0.309,P<0.01）in HBeAg-positive group;There was a positive correlation between serum HBV DNA load and inflammatory grade（r=0.306,P<0.01）,while no obvious correlation was found between serum HBV DNA load and the fibrosis stage（r=0.112,P>0.05）in HBeAg-negative group. Conclusions Relationship between HBV DNA loads and hepatic pathological changes differs as serum HBeAg status different in patients with hepatitis B virus infection.

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.

Objective To investigate the therapeutic effect of standard interferon plus adefovir dipivoxil for patients with HBeAg-positive chronic hepatitis B. Methods In this randomized multi-centered controlled clinical trial,87 patients with HBeAg-positive chronic hepatitis B were randomly divided into interferon α-2b monotherapy group（32 cases,with injection of 6 million units of interferon α-2b every other days for 48 weeks）,adefovir dipivoxil monotherapy group（27 cases,with oral 10 mg per day for 72 weeks）and combinational treatment group（28 cases,with interferon α-2b 6 MU every other day for 48 weeks and 10 mg of adefovir dipivoxil per day for 72 weeks）. Serum ALT,serum HBV markers and HBV DNA levels in these patients were tested every 12 weeks. Results The average ages of patients receiving interferon α-2b alone,adefovir dipivoxil alone or the combinational treatment were（31.8±6.6）,（34.2±6.4） and （30.5±7.2） years,respectively,and the baseline serum HBV DNA levels in the three groups were（7.68±1.56）log₁₀ IU/ml,（7.61±2.00）log₁₀IU/ml and（7.80±1.79） log₁₀IU/ml,respectively,and there were no significant difference in average age and baseline HBV DNA level among three groups（P>0.05）,either gender composition or the baseline ALT level（P>0.05）;At the end of week 72,the HBeAg seroconversion rates were 41% and 19%,the rates of HBV DNA loss were 53% and 63%,the ALT normalization rates were 63% and 67%,and HBsAg seroclearance rates were 0% in interferon or adefovir dipivoxil monotherapy patients,all of which were significantly lower than those in patients receiving combinational treatment（57%,89%,93% and 14,respectively,P<0.05）. Conclusion In terms of viral suppression,ALT normalization,and HBeAg or HBsAg seroconversion rates,the therapy of standard interferon α-2b plus adefovir dipivoxil for 48 weeks is significantly better than using them alone.

Objective To study the virologic determinants of spontaneous seroclearance or seroconversion of HBeAg and/or HBsAg in pregnant women who are chronic hepatitis B virus （HBV） carriers. Methods The pregnant women diagnosed as chronic HBV carriers between August,2002 and July,2004 were included and followed up between October,2009 and March,2010. The HBV serologic markers and HBV DNA were detected. Results A total of 419 individuals were recruited in this study,and the average follow-up period was 6.4 years. Although 155 women lost,a total of 264（63.0%） women were successfully followed up,of whom 76 （28.8%） were HBeAg-positive at presentation. 55.3% （42/76） of HBeAg-positive women were seroconverted to anti-HBe spontaneously at the follow-up. Compared with 34 women without seroconversion,42 with HBeAg/anti-HBe seroconversion had lower levels of serum HBV DNA,HBeAg and HBsAg（all P<0.01）. The postpartum HBeAg seroconversion rate in 6 pregnant women with HBV DNA <1×10⁶ IU/ml,17 with HBeAg <700 S/CO,and 13 with HBsAg<1×10⁴ IU/ml were 100.0%,100.0% and 92.3%,respectively. The spontaneous HBsAg seroclearance was found in 38 （14.4%） women at the follow-up. The serum HBsAg levels at presentation were significantly lower in women with HBsAg seroclearance than 226 without HBsAg seroclearance （P<0.001）. The postpartum HBsAg seroclearance rate in 25 pregnant women with HBsAg <100 IU/ml was as high as 56.0%. Conclusions HBeAg-positive women with serum HBV DNA <1×10⁶ IU/ml,HBeAg <700 S/CO and/or HBsAg <1×10⁴ IU/ml are more likely to undergo spontaneous HBeAg seroconversion,and those with serum HBsAg <100 IU/ml have a higher chance of spontaneous HBsAg seroclearance.

Objective To investigate the relapse and its influencing factors in patients with chronic hepatitis B （CHB） after recombinant interferon-alpha （rIFN-α） treatment during 5 years of followed-up. Methods 186 CHB patients with complete response after rIFN-α treatment were followed-up for 5 years,and the relapse rate was observed and the possible factors influencing relapse were analyzed. Results Out of 186 patients,sustained virologic response was obtained in 119 cases （64.0%）,and the relapse occurred in 67 cases （36.0%）;Recurrence of illness occurred from the first 2 months to 47 months after stopping antiviral treatment,and 43 cases（23.1%） got relapse in the first year,while no relapse case in the fifth year;With the followed-up period prolonged,the recurrence rate reduced year by year,and the cumulative recurrence rate increased year by year. The recurrence rates of second, third and fourth year were 9.1%,6.2% and 2.5%,respectively,without statistically significant difference among them（P>0.05）. The relapse rate of patients younger than 40 years was 31.1%,much lower than 48.2% in patients older than 40 years（P<0.05）. The relapse rate in patients receiving IFN-α of 6 month course was 52.5%,much higher than 34.4% in receiving IFN-α of one year course（P<0.05） or 26.0% in receiving IFN-α of 18 month course（P<0.01）. The relapse rates in patients with underlying HBV DNA≤1×10⁶copies/ml was 26.5%,much lower than 41.5% in with HBV DNA>1×10⁶ copies/ml （P<0.05）. The relapse was not related to patient's gender,IFN-α doses and pretreatment serum ALT level（P>0.05）. Conclusion The relapse rate of CHB patients with complete response after IFN-α treatment as higher in the first year after discontinuation of the regimen,and the patient's age,treatment course and pretreatment HBV DNA levels are the influencing factors of relapse,but not the patient's gender,IFN-α doses and ALT level before treatment.

Objective To observe the effects of comprehensive insulation measures on changes of temperature in patients with hepatocellular carcinoma（HCC） underwent hepatectomy and on postoperative recovery. Methods Sixty patients with HCC were randomly divided into control and observation group. 30 cases in control group were given regular insulation measures,while the other 30 cases in observation were treated with comprehensive insulation measures when they underwent hepatectomy. The temperature variation,emergence agitation and shiver,the incidence of postoperative complications such as cough and fever,the leaving bed time and average hospitalization days were compared between the two groups. Results The temperatures of patients in observation group after liver parenchyma transaction and during recovery period were（36.0±0.43）℃ and （36.1±0.37）℃,respectively,while they were（35.7±0.33）℃ and（35.8±0.20）℃ in control group,and the incidence of hypothermia during operation in observation group was significantly lower than that in the control group（P<0.01）. The incidences of shiver and emergence agitation during recovery period were 10.0% and 13.3%,respectively in observation group,while they were 40.0% and 36.7%,respectively in control group. Incidence of postoperative cough and fever were 13.3% and 10.0%, respectively in observation group, while they were 36.7% and 33.3%,respectively in control group （P<0.05）.The first leaving bed time was（26.8±3.57）hours in observation group,while it was （41.2±4.44）hours in control group（P<0.05）. The mean hospital stay was（8.1±1.79）d in observation group,while it was （10.2±1.59）d in control group（P<0.05）. ConclusionsComprehensive insulation measures can effectively maintain relatively normal body temperature in patients with HCC during hepatectomy. It can also reduce the incidence of emergence agitation and shiver,as well as the occurrence of postoperative complications. Furthermore, comprehensive insulation measures play an active role in fast-track surgery （FTS） of patients with HCC.

Objective To evaluate the gallbladder contractility of patients with hepatolenticular degeneration （HLD） by cardiac left ventricular volume calculation method （modified Simpson method）. Methods The modified Simpson method was conducted at the long axis view to measure the gallbladder volume of 104 subjects（54 with HLD and 60 normal persons） under fasting conditions and after the administration of lipoid-food,and the gallbladder emptying rates in two groups were calculated and compared. Results Under the fasting state,there was no statistical difference in the volume of gallbladder between the patients with HLD [（27.31±6.90） ml] and the healthy controls [（25.63±4.72） ml];after the conduction of lipoid-food test,the gallbladder volume in patients with HLD was （10.31±4.61）ml,significantly bigger than in the controls [（3.41±2.78）ml,P<0.05],while the gallbladder emptying rate in patients with HLD [（54.85±12.12）%] was significantly lower than that in the controls [（73.48±7.60）%,P<0.01]. ConclusionsThe modified Simpson method is easy to perform and of good repeatability in measurement of gallbladder volume and is helpful in evaluation of gallbladder contractility in patients with HLD.

Objective To investigate the clinical features of patients with Wilson’s disease（WD） in different clinical classification. Methods Clinical data of 256 inpatients with WD were collected retrospectively. The patients were then divided into liver type,cerebral type and mixed type according to their major clinical presentations and the differences in clinical features of patients in each group were further analyzed. Results Among 256 patients with WD,patients with mixed type （152 cases,59.4%） and liver type（74cases,28.9%）were the common type as compared to cerebral type （27cases,10.5%） or other subtypes（3 cases,1.2%）. The ratio of patients with decompensated cirrhosis and the levels of various liver serum biochemical parameters （ALT,AST,ALP,GGT,BIL and GLB） in patients with liver type （78.4%） were higher than in patient with mixed type （22.0%,P<0.05）. Serum copper in patients with liver type [（1.04±1.50）mg/L] were lower than patients with cerebra type [（2.96±2.88） mg/L] and mixed type [（2.34±2.68）mg/L,P<0.001],but no difference in serum ceruloplasmin level and 24-h urinary copper excretion between the two groups（P>0.05）. The positive ratio of Kayser-Fleischer rings in patients with liver type （64.9%） was lower than in patients with cerebral type （92.6%） and mixed type （90.1%,P<0.05）. A logistic regression analysis showed that age （OR 0.922,P=0.014） and serum ceruloplasmin level （OR=35902.1,P=0.015） were related to the presence of Kayser-Fleischer rings. Only 3（9.7%） out of 31 patients with WD with liver type developed into mixed type during the average follow-up of（8.3±5.8） years. Conclusions Mixed and liver type are more common in patients with WD,and liver dysfunction is more severe in patients with liver type than in mixed type,suggesting that the liver is the most common target in WD.

Objective To study the differences of serum IgG4 levels in various autoimmune liver diseases and to analyze the clinical characterization of patients with high serum IgG4 levels. Methods 65 patients with autoimmune liver diseases were enrolled for this study including 11 patients with autoimmune hepatitis （AIH）,47 patients with primary biliary cirrhosis（PBC） and 7 patients with overlap syndrome of AIH and PBC. The serum IgG4 levels was detected by immuno-scatter turbidmetry. The differences of serum IgG4 levels in the three groups were studied. The clinical features of patients with autoimmune liver disease were analyzed according to their serum IgG4 levels. The significance of inter-group differences of measurement data was assessed by Student’s t-test or Mann-Whitney U test and enumeration data by Fisher’s exact test. Results The serum IgG4 levels in patients with AIH was 642.2 mg/L（97.7 mg/L~1687.0 mg/L）,a little higher than in patients with PBC [153.9 mg/L（78.9 mg/L~400.3 mg/L）,P=0.076] and in with overlap syndrome [229.9 mg/L（154.9 mg/L ~417.9 mg/L）,P=0.388];Three patients with AIH had high serum IgG4 levels （≥1350 mg/L） out of 11 patients with AIH. The ratio of IgG4/IgG was higher in the three patients with higher as compared to 8 with relatively low serum IgG4 levels（P<0.05）;The three patients with elevated IgG4 levels had diabetes mellitus type 2 and one of them was also complicated with rheumatoid arthritis, whereas the other 8 patients with low serum IgG4 levels were not;14 patients with PBC with higher serum IgG4 levels（≥200 mg/L） had higher total serum bilirubin levels as compared to those in 33 patients with relatively low serum IgG4 levels [（45.09±74.85）μmol/L vs.（26.38±23.03） μmol/L,P=0.05）]. Conclusion Compared with patients with PBC or overlap syndrome of AIH and PBC,the patients with AIH have a higher serum IgG4 levels. The patients with AIH with high serum IgG4 levels might be complicated with other autoimmune or metabolic diseases.

Objective To investigate the changes of interleukin-22 （IL-22） and suppressor of cytokine signaling 3（SOCS3） mRNA in murine hepatitis virus 3（MHV-3） induced chronic viral hepatitis in C3H/Hej mice. Methods Chronic viral hepatitis in C3H/Hej mice was induced by intra-peritoneal injection of MHV-3 virus at dose of 100pfu. At day 0,5,10,15 and 20 post-infection,IL-22 and SOCS3 mRNA in the liver tissues were detected by real-time PCR. Results IL-22 and SOCS3 mRNA level in livers of model mice at day 0 were （0.26±0.15）% and（6.35±2.21）%,respectively. At day 10,15 and 20,IL-22 mRNA levels in the liver tissues were （6.28±2.79）%,（2.50±1.24）% and（2.73±0.85）%,respectively,and SOCS3 mRNA levels were（16.92±4.39）%,（14.06±4.09）% and （13.36±1.89）%,respectively, all of which were markedly increased than baseline（P<0.05）. The mRNA levels of IL-22 and SOCS3 both peaked at day 10 post MHV-3 infection. Conclusions IL-22 and SOCS3 may play an important role in the pathogenesis of MHV-3-induced chronic viral hepatitis in mice.

Objective To investigate the effects of astaxanthin on chronic liver injury in rats and to explore the underlying mechanism. Methods Chronic liver injury in rats were induced by carbon tetrachloride injection,and the rats were randomly divided into control,model and astaxanthin group. The content of ALT,AST,ALP,TP in serum and superoxide dismutase （SOD）,glutathione-S-transfcrase （GST）,glutathione （GSH） and malondialdehyd （MDA） in liver tissues were detected. The collagensⅠmRNA were detected by RT-PCR. Results The collagens index in model group were （1.84±0.24）,much higher than in control [（0.42±0.12）,P<0.05],while the collagens index in astaxanthin group （0.89±0.12） decreased significantly（P<0.05） as compared to that in the model; The collagenⅠmRNA in model group（0.48±0.06） was higher than in control group（0.12±0.02）,while it decreased （0.35±0.09） in astaxanthin group （P<0.01） as compared to that in the model;In control group,the MDA,GST,GSH and SOD in liver tissues were （1.93±0.76） nmol/mg, （18.43±5.34） U/mg,（75.45±9.67） mg/g and （678.80±76.56） U/mg,respectively. They were（6.56±1.09） nmol/mg,（54.34±7.65） U/mg,（35.45±9.01） mg/g and （203.89±89.00 U/mg）,respectively. After treatment of astaxanthin,they were（3.34±1.12） nmol/mg,（30.89±4.78） U/mg,（56.78±7.78） mg/g and （432.34±92.56 U/mg）, respectively. ConclusionAstaxanthin could attenuate chronic liver injury in rats by improving the anti-oxidative stress.

The portal vein thrombosis （PVT） is a common complications in patients with liver cirrhosis. The upper gastrointestinal hemorrhage usually occurs in patients with PVT. The main mechanism of PVT formation is the reduction of portal vein blood flow velocity. At present,medicine selection is priority to the management of PVT. Studies have shown that anticoagulant therapy does not increase the risk of gastrointestinal bleeding,and it is recommended that the patients having the indications should be given anticoagulants for PVT. The routine anticoagulation can reduce the incidence of portal thrombosis in patients having partial splenic artery embolization. So far,many problems are still need to be solved in early diagnosis,monitoring indexes for anticoagulation,the dosage of heparin and prevention of recurrence in dealing with patients with PVT.

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.

The infection of hepatitis B virus （HBV） plays an important role in the occurrence of hepatocellular carcinoma （HCC）. Multiple factors may be involved in the hepatocarcinogenesis of HBV-related HCC,such as inflammatory response,HBV X gene and its protein,the mutation of HBV core promoter and pre-S 2 genes,HBV spliced protein and so on. We will discuss some progresses in this field.

Drug-induced liver injury (DILI) refers to varying degrees of liver damage which caused by the drug itself or its metabolites. In recent years, there has been an increasing number of reports about DILI. However, it is often misdiagnosed for the low incidence of DILI symptoms and lack of specificity. There are various diagnostic criteria of DILI in different countries. So it is of great significance to compare the advantages and disadvantages of these criteria and to find the best diagnostic strategy for early treatment and prognosis of DILI.

Hepatic sinusoidal obstruction syndrome is rare clinically,but the incidence is recently increased. The clinical manifestations are mainly refractory ascites,jaundice and hepatomegaly.The main causes is the ingestion of pyrrolizidine alkaloids-containing herbs or plants. The early diagnosis is currently difficult. There is no specific therapy for patients with hepatic sinusoidal obstruction syndrome,except for symptomatic and supportive therapy. This review mainly discuss the mechanism,pathology,early diagnosis,and therapy of this entity.