Objective To investigate the effect of compound protein nutrition agent on nutritional status and liver function of hepatitis B virus（HBV）-related cirrhotic patients with protein-energy malnutrition（PEM）. Methods Forty HBV-related cirrhotic patients with PEM were enrolled and no other complications existed at the baseline. Patients were then divided into protein nutrition agent group （intervention group,25 cases） and control group （15 cases）. Patients in the intervention group were given evening snack（200g yoghourt and 15g compound protein nutrition agent） with general comprehensive treatment,while patients in the control group only received general treatment. Serum albumin,prealbumin and lymphocyte count were tested and complications were recorded as well. Results Baseline characteristics of the two groups were comparable,and the serum albumin,prealbumin and lymphocyte count in patients of intervention group were significantly increased than that of the controls. At 6 weeks,the albumin,prealbumin and lymphocytes counts in patients of the control group were（30.2±3.2） g/L,（122.10±24） g/L and（1.08.10±0.31）×10⁹/L,significantly lower than the intervention group[（33.6±3.7）g/L,（159.0.6±30.4）g/L and（1.36±0.26）×10⁹/L,P<0.05]. Complications in intervention group were less than the control group（P<0.05）.Conclusions Compound protein nutrition agent nutrients can improve the nutrition status and liver function of HBV-related cirrhotic patients with protein-energy malnutrition and may reduce their complications.

Objective To explore the research hotspots and subject structure of non-alcoholic fatty liver diseases （NAFLD） in China in the past decade. Methods The key words of articles in NAFLD field were retrieved in Chinese science citation database（CSCD） from January 2004 to December 2013. Word-frequency analysis, factor analysis and co-words clustered analysis were applied and statistic analysis was performed using excel 2010 and SPSS17.0. Results Eight hundred and fifty-two articles in presence of keywords about NAFLD were included and 40 high-frequency words were selected,which accounted for 70.2% of all relevant papers. The co-word clustered analysis showed that there were 9 hot subjects about NAFLD during last 10 years including insulin-sensitizing drugs,ultrasonography,epidemiology and risk factors,animal models,pathogenesis and traditional Chinese medicine,insulin resistance,Chinese medicine research,as well as gene and clinical treatment studies. Conclusions The co-word clustered analysis of research hotspots helps to understand the developmental of NAFLD in China.

Objective To analyze the clinical features of inpatients with top four kinds of non-infectious liver diseases（NILD） and changing trend of the disease spectrums over the past decade. Methods The clinical data of 12508 of inpatients with NILD in our hospital in the past decade were collected and analyzed with SPSS18.0. The clinical features and changing trend in disease spectrum were explored. Results Patients with alcoholic liver diseases and autoimmune liver diseases accounted for 35.0% and 32.1%,respectively;the ratio of inpatients with alcoholic liver diseases,drug-induced liver injury and autoimmune liver diseases to total inpatients with liver diseases increased 2.4,2.3 and 2.1-fold,respectively over the past decade;the percentage of male patients with alcoholic liver diseases and non-alcoholic fatty liver diseases accounted for 97.7% and 77.7%, respectively,while the percentage of female patients accounted for 84.3% and 57.9%,respectively（P<0.01）in patients with autoimmune liver diseases and drug-induced liver injury;the average age of patients with autoimmune liver diseases was（47.6±10.6） years, while it was [（35.9±14.1） years,P<0.01） in patients with non-alcoholic fatty liver diseases;the patients in the age range of 40 to 49 years accounted for 37.1% and 25.0%,respectively,in patients with alcoholic liver diseases and drug-induced liver disease,while the patients in the age range of 50 to 59 years and 30 to 39 years accounted for 33.7% and 25.3%,respectively（P<0.01）in patients with autoimmune liver diseases and non-alcoholic fatty liver diseases. Conclusions The ratio of patients with NILD to total patients with liver diseases is increasing gradually over the past decade and more attention should be paid for the management of those patients.

Objective To explore the serum and hepatic level of pancreatic derived factor （PANDER） in patients with non-alcoholic fatty liver diseases （NAFLD）. Methods Forty-one patients with NAFLD confirmed by liver biopsy and 20 healthy persons were included in this study and the patients with NAFLD were further divided into NAFL group （n=10） and NASH group （n=31 cases） according to the NAFLD activity score （NAS）. Serum and hepatic level of PANDER were detected by ELISA method and hepatic level of PANDER mRNA was determined by real-time PCR. Anthropometry data,biochemical and metabolic parameters of all subjects were collected and compared between different groups. Results The serum level and hepatic level of PANDER in patients with NAFLD were（3.38±1.99） ng/ml and（3.27±2.49） ng/ml,respectively,significantly higher than those in healthy controls[（0.94±0.60） ng/ml,（0.98±0.73） ng/ml）,respectively,P<0.05];No significant difference in serum level [（3.42±2.39） ng/ml vs. （3.36±1.91） ng/ml] and hepatic level [（2.33±1.52） ng/ml vs. （3.58±2.68） ng/ml] of PANDER between patients with NAFL and NASH;Serum level of PANDER were positively correlated with hepatic level of PANDER （r=0.425）,BMI（r=0.643）,waist circumference（r=0.637）,hip circumference（r=0.375,triglyceride （r=0.411）,fasting blood glucose（r=0.487）,fasting insulin（r=0.512） and homeostasis model assessment index （HOMA-IR,r=0.547,P<0.05）,and negatively correlated with insulin action index（r=-0.544） and high-density lipoprotein cholesterol（r=-0.396,P<0.05）. Hepatic level of PANDER were positively correlated with serum PANDER level（r=0.425）,body mass index（r=0.379） and waist circumference（r=0.427,P<0.05）. Conclusion PANDER plays an important role in the pathogenesis of NAFLD by affecting body insulin resistance and glucose and lipid metabolisms.

Objective To explore the correlation between liver stiffness measurement （LSM） and controlled attenuation parameter （CAP） in the general population. Methods A correlation of LSM to CAP was conducted in a total of 207 participants who were successfully examined by FibroScan in a general health examination,and the data including gender,age,body mass index（BMI） and waist height radio （WHtR） were recorded. Results The LSM and CAP in overweight and obese participants （BMI≥24 kg/m²） were higher than those in lean participants （BMI<24 kg/m²） [（4.60±1.15）kPa vs. （4.25±1.23）kPa,P<0.001 and （245.24±55.37） dB/m vs.（215.82±55.47） dB/m,P<0.001];participants with WHtR≥0.50 had higher LSM and CAP as compared to those with WHtR<0.50 [（4.52±1.22） kPa vs.（4.19±1.15） kPa,P<0.05 and（247.04±57.78） dB/m vs.（204.65±52.25） dB/m,P<0.05];male participants had higher LSM and CAP than in female [（4.53±1.23）kPa vs.（4.11±1.08） kPa,P<0.05 and （4.11±1.08） dB/m vs.（220.08±57.88） dB/m,P<0.05]; the CAP was higher in participants older than 50 years as compared to participants under 50 years[（246.56±59.06）dB/m vs.（222.88±56.60） dB/m,P<0.01],while the LSM in the two groups showed no difference（P>0.05）;The LSM was significantly correlated with CAP in this cohort（r=0.26,P=0.0002）;Further analysis demonstrated that CAP was correlated with LSM in male,older than or equal to 50 years,

Objective To explore the liver histological changes and HBsAg and HBcAg expression in patients with chronic hepatitis B and low serum alanine aminotransferase（ALT） levels （<2×upper limit of normal,ULN）. Methods Eighty patients with chronic hepatitis B virus infection received liver biopsies from July 2010 to November 2013 in this study. The liver histopathologic changes were analyzed and HBsAg and HBcAg expression in liver tissues were detected by immunostaining. Results The average age in 50 HBeAg-positive patients was （28.52±9.10） years,significantly younger than 30 HBeAg-negative patients [（39.37±10.14）years,P<0.01];The serum HBV DNA load in HBeAg-positive patients was （7.79±0.73） lg copies/ml,significantly higher than that in HBeAg-negative patients[（4.52±1.67） lg copies/ml,P<0.01];The liver inflammation grades and fibrosis staging in HBeAg-positive patients were（1.00±0.57） and （0.38±0.57）,significantly lower than those in HBeAg-negative patients [（1.27±0.45） and （1.07±1.11）,repectively,P<0.01];There were no significant differences in immunostaining scores （ISS） of HBsAg [（0.93±0.92）and （0.77±0.93）,P>0.05] or HBcAg [（1.58±0.88） and （1.63±0.92）,P>0.05] between the two groups;The liver histological inflammation grades and fibrosis staging in 22 patients over 40 years of age were （1.32±0.48） and （1.00±1.27）,respectively,significantly higher than those in 35 patients younger than 30 years of age [（0.69±0.58） and （0.40±0.50）,respectively,P<0.01];No significant differences were observed between both genders in either liver inflammation grades [（1.12±0.55） and（1.07±0.54）] or fibrosis staging [（0.71±0.82） and （0.50±0.96）];There were no significant differences in ISS of HBsAg [（0.89±0.89） and （0.82±1.00）] or HBcAg [（1.44±0.94） and （1.24±1.09）] between males and females. Conclusions Patients over 40 years of age with hepatitis B virus infection are recommended for liver biopsies in time in order to elucidate the histopathological changes.

Objective To investigate the effectiveness and impact on liver function of two different chemotherapy regimens in treatment of patients with pulmonary tuberculosis complicated by chronic hepatitis B. Methods One hundred and sixteen patients with pulmonary tuberculosis and chronic hepatitis B were recruited in our hospital from October 2010 to December 2012. The patients were then randomly divided into two groups. Patients in control group （n=58） were treated with 2HRZE/4HR for half a year,and patients in observation group（n=58） were treated with 3HESG/9HEG for one year. The effectiveness,impact on liver function and adverse reactions were recorded and compared between the two groups. Results Total efficiency,rate of bacteriologic conversion of sputum,rate of focus absorption,rate of cavity shrinking and rate of cavity closure in patients in observation group were 98.3%,87.9%,94.8%,93.1%and 79.3%,respectively,significantly higher than in the controls（87.9%,65.5%,75.9%,72.4%and 54.3%,respectively）;AST,ALT,TBIL,ALB and INR and restoration time of abnormal liver function in observation group were （51.7±6.8） U/L,（52.3±7.2） U/L,（26.4±5.7） μ mol/L,（37.8±7.6） g/L,（1.1±0.4）and （16.7±5.8） d,significantly lower or less than in the controls[（69.3±12.1） U/L,（70.5±11.3） U/L,（36.5±4.3） μmol/L,（48.5±9.2） g/L,（1.5±0.6）and（28.9±10.3） d,respectively];incidence of abnormal liver function and adverse reaction rates in patients in observation group were 29.3% and 3.4%,significantly lower than in the controls（62.1% and 15.5%,respectively）;time for appearance of abnormal liver function in observation group was（35.7±9.6） d,significantly longer than in the controls[（17.4±8.2）d,P<0.05]. Conclusions Chemotherapy with 3HESG/9HEG for one year is safe and effective in treatment of patients with pulmonary tuberculosis complicated by chronic hepatitis B,with low incidence and later occurrence of liver injury.

ObjectiveTo evaluate hepatitis B virus （HBV） mutations and its impact on antiviral effects in chronic hepatitis B（CHB） patients with mutants resistant to lamivudine or adefovir.Methods142 nucleos（t）ide-naive CHB patients treated with lamivudine were switched to lamivudine plus adefovir（n=72） or entecavir plus adefovir （n=70） because of lamivudine resistance and 72 nucleos（t）ide-naive CHB patients treated with adefovir were switched to adefovir plus lamivudine （n=36） or adefovir plus entecavir （n=36） after resistance occurred. HBV DNA polymerase reverse transcriptase mutations were analyzed before and after 48 weeks of rescue therapy.ResultsAmong CHB patients with lamivudine resistance,mutation patterns were mainly M204V and IL180M, with a frequency of 98.6%（140/142） and 56.3%（80/142）,respectively;Undetectable serum HBV DNA were noted in 86.1% of patients in lamivudine and adefovir treatment group,and 97.1% of patients in entecavir and adefovir treatment group（P>0.05）;Among CHB patients with adefovir resistance,A181V and N236T mutation rates were 63.9%（46/72） and 52.8%（38/72）,respectively;Undetectable serum HBV DNA were found in 52.8%（19/36） of patients in adefovir and lamivudine treatment group,significantly lower than that [77.8% （28/36）,x²=4.963,P<0.05] of patients in adefovir and entecavir treatment group.ConclusionsAddition of adefovir dipivoxil to lamivudine is effective rescue therapy in patients with rtM204 mutation resistance to lamivudine,but in patients with rtA181 mutation resistance to adefovir dipivoxil,the addition of entecavir is superior to lamivudine.

Objective To investigate the dynamic changes of quantitative hepatitis B surface antigen concentration in predicting virologic response to entecavir（ETV） therapy in patients with HBeAg-positive chronic hepatitis B（CHB）. Methods Seventy-eight treatment-naive patients with HBeAg-positive CHB receiving ETV （0.5 mg/daily） were recruited and followed up for 1 year from January 2011 to January 2012. Serum samples were collected at baseline and every 3 months after ETV treatment. Serum HBsAg and HBeAg concentrations were quantitatively determined by chemiluminescence assay and serum HBV DNA levels were determined by real-time polymerase chain reaction. The correlation of HBsAg and HBV DNA level was analyzed by Pearson correlation analysis. The receiver operating characteristic curve（ROC） was used to predicted HBV virologic response and determine the optimal threshold. Results Sixty-nine（88.5%）patients achieved virologic response（VR）,while 9 did not;there was no significant difference for baseline levels of serum ALT in patients with VR [（141.8±27.2）IU/ml] and without [（136.2±29.7） IU/ml,t=0.27,P=0.793];serum HBV DNA levels in patients with VR[（6.7±1.0）lg IU/ml] was significantly lower than that in patients without[（7.6±0.8）lg IU/ml,t=-2.27,P=0.033];there was no significant difference in HBsAg concentration between patients with VR and without[（3.8±0.6） lg IU/ml vs.（4.0±0.4）lg IU/ml,t=-1.75,P=0.094]. HBsAg and HBV DNA levels were positively correlated（r=0.45,P=0.02）. there was a rapid decline in HBsAg concentration during the first 3 months of therapy,followed by a much slower decline in the subsequent periods;from the baseline to month 3,the reduction of HBsAg concentration in patients with VR was faster than in patients without[（0.3±0.2） lg IU/ml vs.（0.2±0.1） lg IU/ml,t=2.245,P=0.035]. The lg HBsAg concentration at month 3 showed the biggest area under the curve （AUC）（AUC=0.840,P=0.005）,and the max Youden index（0.602） was appeared at the cut-off value of 3.85 lg IU/ml,with a diagnostic sensitivity and specificity of 84.2% and 78.7%,respectively. Conclusions lg HBsAg≤3.85 lg IU/ml after 3 months of ETV treatment can be used as an indicator to predict the virologic response of patients with CHB 1-year after ETV treatment.

Objective To observe the extremely rapid virologic response（ERVR） in naive patient with chronic hepatitis C with genotype 1 virus infection receiving pegylated interferon and ribavirin treatment. Methods Forty naive hepatitis C patients with genotype 1 infection had baseline serum HCV RNA≥400000 IU/ml and they were treated with peginterferon-alpha-2a at dose of 180 μg per week and ribavirin at dose of 1000-1200 mg/d. After 2 week treatment,they all got so-called extremely rapid virologic response and then,they were randomly divided into two groups,e.g. 20 patients continued the regimen for 36 weeks（group 1） and another 20 patients received the therapy for 48 weeks（group 2）. All patients were followed-up for 24 weeks after discontinuation. Results The end-of-treatment virologic response （ETVR）,sustained virologic response（SVR） and recurrence rate of patients in group one were 100%,90% and 10%,respectively,while they were 95%,90% and 5.3% in group 2. There was no statistical differences between the two groups;There was a negative correlation between baseline serum HCV RNA levels and SVR （OR=0.422,95%CI 0.05-0.29,P=0.007） in the 40 patients;The SVR in patients with baseline serum HCV RNA<6×10⁷IU/ml was higher than that in patients with baseline serum HCV RNA≥6×10⁷IU/ml in group 1（P=0.005）,but not in group 2（P=0.063）. Conclusions The ERVR in naive patients with chronic hepatitis C receiving peginterferon-alpha-2a plus ribavirin treatment suggests relatively less anti-viral regimen and the same efficacy.

Objective To study the clinical characteristics of hospitalized patients with autoimmune liver diseases （AILD）. Methods The clinical data including age and gender,laboratory tests,liver biopsy results and treatment plans in 102 hospitalized patients with AILD were collected and analyzed. Results The mean age of 102 patients was（50.32±12.87） years old and the female/male ratio was 5.8/1. The mean age of 51 hospitalized patients with autoimmune hepatitis（AIH） was（48.38±13.88）years old and the female/male ratio was 9.4/1;the mean age of 25 hospitalized patients with primary biliary cirrhosis（PBC） was（54.95±14.33） years old and the female/male ratio was 4/1. The differences in average age and gender ratio between the AIH and PBC patients were not statistically significant;Among the newly diagnosed patients who had underwent liver biopsies,the mean level of serum alanine aminotransferase（ALT） in 22 patients with AIH was （565.3 ± 482.9） U/L,significantly higher than in 5 patients with PBC [（75.5±25.0） U/L,P<0.05）];the mean level of serum IgM in patients with AIH was （1.63±0.8） g/L,significantly lower than in patients with PBC[（4.49±1.2） g/L,P<0.05];The early diagnosis of AILD patients was difficult,and liver biopsy was the common cause of hospitalization in the newly diagnosed patients. There were a variety of reasons for hospitalization,among which cirrhosis complications accounted for the majority. The treatment programs were more individualized. Conclusions The conditions of the hospitalized patients with AILD are often complex,criticall and difficult in diagnosis and therapy. Liver biopsies is important and valuable for the diagnosis of AILD.

Objective To explore the dynamic changes of cytochrome P4502El（CYP2E1）in liver tissues of rats with hepatic stress injury（HSI） secondary to traumatic brain injury（TBI）. Methods Forty healthy male Wistar rats were randomly divided into sham-operated and TBI group. The animal model was established by an improved Feeney method. Serum levels of ALT and AST were measured by enzymatic assay at 6,12 and 24 h after TBI;MDA contents in liver tissues were also measured. Pathological changes of liver tissues were observed under light microscopy. The CYP2E1 mRNA levels and its protein expression were detected by RT-PCR and Western blot,respectively. Results At 6 h and 24 h after TBI,serum ALT elevated significantly [（83.0±10.3） U/L and（1204.5±146.6） U/L,respectively,P<0.01）] as compared with baseline [（42.2±8.1） U/L];at 12 h after TBI,serum AST elevated significantly[（280.4±53.3） U/L,P<0.01）] compared with baseline[（44.0±7.2）） U/L],and it peaked at 24 h[（790.3±114.5） U/L];at 6 h after TBI,serum MDA elevated significantly [（14.2±0.2） nmol/mg,P<0.05] compared with baseline[（5.2±0.2） nmol/mg],and it peaked at 24 h after TBI [（56.3±0.5）nmol/mg];at 24 h after TBI,the injuries in liver tissues were serious,with expanded sinus,scattered spotty necrosis and inflammatory cell infiltration;at 6 h after TBI,both mRNA and protein levels of CYP2E1 were significantly elevated[（0.89±0.05）and（120.24±1.22）,P<0.05] compared with baseline[（0.28±0.02） and（61.68±0.60）,respectively],and they peaked at 24 h after TBI[（1.50±0.02）and（200.40±2.61）,respectively,P<0.01]. ConclusionsCYP2E1 may be involved in oxidative stress in hepatic stress injury after TBI.

Objective To investigate the effect of boschniakia rossica ethanol extract（BREE） on hydroxyproline（Hyp） and inflammatory cytokines in rats with non-alcoholic fatty liver diseases （NAFLD）. Methods The model of NAFLD in rats was established by hight-fat diet administration. Rats were randomly divided into control,model and BREE treatment group （500 mg·kg^-1·d^-1）. All rats were sacrificed to harvest serum and liver tissues at the end of eighth week. Serum levels of AST,ALT and reduced glutathione （GSH） were measured,and the levels of interleukin （IL）-1β,tumor necrosis factor（TNF）-α and IL-6 in liver tissues were detected by ELSIA. HE staining and immunohistochemistry were performed for evaluation of liver pathological changes and the expression of NF-kB/p65 in liver tissues,respectively. Results Serum levels of ALT [（39.47±20.26） U/L] and AST[（46.48 ± 18.52） U/L] in rats subjected to BREE treatment significantly decreased as compared to in the model group [（79.32±19.05）U/L and （88.35±17.46） U/L,respectively,P<0.01];Serum GSH levels in BREE-treated rats [（349.43±45.52） mg/L] significantly increased than in the model [（265.38±28.57） mg/L,P<0.01];The positive rates of NF-kB/p65 [（15.49±4.78）%] and Hyp contents [（14.28±3.08） mg/g] in liver tissues in BREE-treated rats significantly decreased than in the model [（87.54±6.59）% and （35.47±4.53）mg/g,respectively,P<0.01];the IL-1β,TNF-α and IL-6 levels[（34.51±5.61） pg/mL,（45.37±7.03） pg/mL,（18.98±5.04） pg/mL,respectively] in liver tissues in BREE-treated rats were significantly lower than in the model [（78.25±6.51） pg/mL,（85.64±6.25） pg/mL,（29.19±4.82） pg/mL,respectively,P<0.01];BREE also significantly alleviated pathological changes in the liver. Conclusions BREE significantly improves liver function and collagen deposition in rats with NAFLD by down regulation of NF-κB/p65 and inflammatory cytokines in the liver.

Objective To investigate the effects of Rac1 on epithelial mesenchymal transition（EMT） induced by transforming growth factor β1（TGF-β1）,and on cell proliferation and apoptosis of L02 cells in vitro. Methods Rac1 plasmids with different activity including pExRed-NLS Flag（vector）,pExRed-NLS Flag Rac1（wild type）,pExRed-NLS Flag Rac1T17N（dominant negative mutant） and pExRed-NLS Flag Rac1G12V（constitutively active mutant） were transiently transfected into L02 cells,followed by stimulation of exogenous TGF-β1 at dose of 5ng/ml;Exogenous Flag-Rac1 fusion protein was determined by Western blot analysis;Immunofluorescence and Western blot were used to evaluate epithelial markers of Ck8 and mesenchymal markers of vimentin;Cell motility was assessed by transwell assay and wound healing assay;L02 cells were treated with different concentrations of Rac1 inhibitor （NSC23766）,and the influence of Rac1 on cell proliferation and apoptosis were detected by CCK-8 assay or Annexin V-FITC/PI double staining,respectively. Result All kinds of plasmids were successfully transiently transfected into L02 cells;Compared with the vector group and the wild type group,constitutively active mutant pExRed-NLS Flag Rac1G12V significantly increased the expression of vimentin,decreased the expression of CK8 and enhanced cell motility,whereas the effects of dominant negative mutant pExRed-NLS Flag Rac1T17N were just the opposite of above results（P<0.05）;Disruption of Rac1 activity with NSC23766 inhibited cell proliferation（P<0.05） without increasing cell apoptosis. Conclusions Rac1 promotes the EMT process and cell proliferation induced by TGF-β1 in L02 cells without affecting cell apoptosis in vitro.

The inflammasome is a sort of multiprotein complexes in the cytoplasm,acting as an important component of the body’s innate immune. The nucleotide-binding oligomerization domain（NOD）-like receptors（NLRs）,for example the NLRP3,mainly consists of NLRP3,apoptosis-associated speck-like protein（ASC）and cysteinyl aspartate specific proteinase （Caspase-1）,which plays a vital roles in the immune regulation and antimicrobial activities. In recent years,there has been a growing number of evidence indicating that NLRP3,the inflammasome,may be closely associated with all kinds of liver diseases. The activation pathway,regulatory mechanism of NLRP3 and its relationship with liver diseases were reviewed .

This review aims to discuss the necessity and feasibility of preventing and controlling hepatitis C virus （HCV） infection in hospitals,and how to take effective strategies of intervention,establish a relatively standard and complete management system,and improve the effectiveness of management continually. The Third Affiliated Hospital of Sun Yat-Sen University enhanced the publicity and training of staffs,introduced the liaison system,and ensured patients’ informed consent. With these efforts,the medical personnel and the patients have increased awareness of HCV infection and paid more attention to it,and the relevant divisions have achieved cross-sectional cooperation and worked well. The percentage of anti-HCV screening to surgical cases and the percentage of HCV RNA screening in cases with anti-HCV positive in 2012 raised by 5.87% and 28.4%,respectively,as compared to in 2011. It is obvious that hospitals are able and necessary to strengthen management of preventing and controlling the HCV infection with effective measures to protect the safety and rights of patients’ and medical personnel’.

It is well established that variceal hemorrhage is one of the most common and severe complications in patients with liver cirrhosis and portal hypertension. Despite the advances in the last three decades in its treatment, mortality from variceal bleeding is still around 15%~20%. Moreover,variceal bleeding often leads to deterioration of liver functions. Furthermore,it is a common trigger for other complications of liver cirrhosis. Therefore, primary and secondary preventions of variceal hemorrhageare important strategy for improving the survival in patients with decompensated liver cirrhosis and esophageal varices. Nonselective beta-blockers（NSBB） have been shown to reduce the hepatic venous portal pressure gradient and are recommended for the prevention of the first variceal hemorrhage and rebleeding. The advantages of NSBB therapy are good tolerance,oral administrationand lowcost.However,the indication of NSBB should be limited to patientswith a high risk of variceal bleeding because of the potential side effects of the therapy.