Objective To investigate the complications and death causes，and their relationship，in patients with liver failure. Methods The age，gender，etiology，complication，and prognosis of the 1892 patients with liver failure were retro-prospectively analyzed. Results There were 1206（63.74%） cases of male and 686 cases（36.26%） of female included in this study，with an average age of（48.9±11.3） years；The major causes of liver failure included hepatitis B virus infection（1319，69.7%），hepatitis E virus infection（102，5.4%），drug-induced liver injury（102，5.4%），alcohol （89，4.7%）and unknown etiology（107，5.7%）；A total of 1543 patients with liver failure suffered from complications including infection，hemorrhage，hepatic encephalopathy，hepatorenal syndrome，and encephaledema，and their incidence were 69.82%，30.97%，23.04%，16.97%，and 2.59%，respectively；The incidences of hepatic encephalopathy（77.14%），hepatorenal syndrome（45.71%），and encephaledema（20.0%） were significantly higher in patients with acute liver failure than all other kinds of liver failure（P<0.05）；The mortality of patients with encephaledema was 100%，while the mortality of patients with hepatorenal syndrome was 90.65%；The mortality of 1092 patients with one complication was 62.09%，and 288 patients with two complications was 78.47%；Furthermore，the mortality of 163 patients with three or more complications was up to 98.16%. Conclusion Patients with liver failure was prone to suffering from complications，and the most common complication was infection，while the worst complications were encephaledema and hepatorenal syndrome；The mortality of patients with liver failure increases with the numbers of complications.

Objective To investigate the changes and clinical significance of plasma adiponectin（ADPN） in patients with hepatitis B virus-related acute-on chronic liver failure（HBV-ACLF）. Methods Eighty-two patients with HBV-ACLF admitted to our department from Jan，2009 to Dec，2012 were included in this study. Clinical data were collected，and plasma ADPN was determined with ELISA. Patients were further divided into survival and dead group according to the clinical outcome at the end of 30 day hospitalization. The differences in plasma ADPN and model for end-stage liver disease （MELD） score between these two group were determined，and multivariate logistic regression analysis was used to evaluate the significance of ADPN and MELD score in prognosis of short-term survival. Results The plasma levels of ADPN at early-stage （n=24），middle-stage（n=30） and end-stage （n=28） of patients with HBV-ACLF were （0.68±0.15）ng/ml，（0.76±0.17） ng/ml and （0.89±0.18） ng/ml，respectively，which significantly increased with the progress of liver failure（F=12.30，P<0.01）；No significant differences as respect to gender，age，AST，ALT，white blood cells and HBV DNA load were observed between 30 survival and 52 dead patients，however，the plasma ADPN and MELD scores in survival patients were （0.7±0.2）ng/ml and （26.3±6.4），respectively，both significantly lower than those in dead patients[（0.82±0.18）ng/ml and（37.9±8.1），respectively，P<0.01]；Multivariate logistic regression analysis showed that MELD score（OR=1.43，95%CI:1.22-1.65，P<0.01），plasma level of ADPN （OR=1.23，95%CI:1.12-1.34，P<0.01），serum albumin （OR=1.18，95%CI:1.11-1.26，P<0.01） and AST/ALT ratio（OR=1.06，95%CI:1.01-1.11，P<0.01） were independent risk factors for short-term prognosis in patients with HBV-ACLF. Conclusions Plasma level of ADPN is associated with the progress of liver dysfunction，and an increase in plasma level of ADPN indicates a poor short-term prognosis in patients with HBV-ACLF.

Objective To investigate the clinical features and prognosis of patients with alcoholic liver failure. Methods The clinical features and prognosis in 130 patients with alcoholic liver failure who had admitted to Beijing 302nd Hospital of PLA from January 2004 to May 2013 were retrospectively analyzed. Results The precipitating factors of patients with alcoholic liver failure were concurrent infection（52.3%），short-term excessive drinking （8.5%），fatigue （3.8%），emotional change （0.8%） and unknown cause （34.6%）; The curative or improvement rate of patients with alcoholic liver failure was 41.5%，the nonresponsive to treatment was 42.3%，and the mortality rate was 16.2%；Hepatic encephalopathy and cerebral edema or cerebral hernia（33.3%），septic shock （28.6%），hemorrhagic shock （23.8%） and hepatorenal syndrome （9.5%） were the top four causes of death；The incidence of cerebral edema，cerebral hernia，hepatorenal syndrome in nonresponsive or death patients were 14%，7% and 36% respectively，significantly higher than those in improved patients （1%，1% and 6%，respectively，P<0.01）；The blood hemoglobin levels in nonresponsive or death patients[（85.0± 28.3）g/L]was significantly lower than that in improved patients[（95.2±27.6） g/L，P<0.05]；The Maddrey's discriminant function，MELD score and Glasgow score in nonresponsive or death patients were （94.56±63.17），（25.52±8.29）and（9.76±1.04），respectively，significantly higher than those in improved patients [（68.24±24.61），（19.03±10.13）and（9.30±1.11），P<0.01]；Prothrombin time （r=-0.19，P=0.03），international normalized ratio （r=-0.21，P=0.02），blood urea nitrogen （r=-0.28，P=0.01） and creatinine （r=-0.28，P=0.01） were negatively correlated with the prognosis of patients（P<0.05 or P<0.01）；Patients with cerebral edema （r=-0.26，P=0.01），cerebral hernia （r=-0.26，P=0.01） and hepatorenal syndrome （r=-0.38，P=0.01）were negatively correlated with the prognosis（P<0.01）. Conclusions The common precipitating factors of patients with alcoholic liver failure are concurrent infection and short-term excessive drinking. Coagulation， kidney and brain dysfunction are important predictors for poor prognosis.

Objective To investigate the efficacy and safety of adefovir dipivoxil （ADV）alone or in combination with lamivudine （LAM） in the treatment of patients with LAM-resistant hepatitis B e antigen（HBeAg）-positive chronic hepatitis B （CHB）. Methods One hundred patients with LAM-resistant HBeAg-positive CHB were randomly divided into ADV treatment group （n=50） and combinational therapy group （LAM plus ADV，n=50）; The treatment was carried on for 12 m；At the end of 3，6，9 and 12 m，the normalization rate of ALT，serum HBV DNA viral load， seroconversion rate of HBeAg，and adverse events were observed. Results At the end of 3，6，9 and 12 m of treatment，serum HBV DNA load in patients receiving ADV alone or in combinational therapy decreased significantly as compared to their baselines levels（P＜0.05）；Furthermore，at the end of 6，9 and 12 m，serum HBV DNA load in combinational therapy patients were lower than those in patients receiving ADV alone [（3.94±1.16），（3.37±1.19） and（3.14±1.18） lg copies/ml vs.（4.51±1.37），（4.07±1.14） and （3.85±1.16）lg copies/ml，respectively，P<0.05]；At the end of 6，9 and 12 m of treatment，the negative conversion rates of serum HBV DNA in combinational group were 56.0%，64.0% and 76.0%，respectively，significantly higher than those in patients receiving ADV alone （32.0%，44.0%，and 56.0%，respectively，P<0.05），while the normalization rates of ALT in combinational group were 72.0%，80.0%，and 92.0%，respectively，significantly higher than those in patients with ADV treatment alone（52.0%，60.0%，and 76.0%，respectively，P<0.05）；There was no significant difference in negative conversion rates of HBeAg or seroconversion rate of HBeAg to anti-HBe between the two groups；Serious adverse events did not occur in both groups. Conclusions ADV in combination with LAM in treatment of patients with LAM-resistant HBeAg-positive CHB is effective and safe and is promising in dealing with nucleos（t）ide-resistant patients with CHB.

Objective To analyze the difference in clinical features between male chronic hepatitis B（CHB） patients with or without hepatic steatosis and to search for the risk factors for hepatic steatosis. Methods Two hundred and nine male patients with CHB who were hospitalized for the first time and underwent liver biopsy from March 2010 to March 2013 were included in this study，and the patients were divided into two groups according to the presence or absence of hepatic steatosis；Serum lipids，uric acid，glucose，alcohol consumption， obesity，overweight and hepatitis B virus DNA load between the two groups were compared，and risk factors for hepatic steatosis were analyzed using binary logistic regression. Results Among the 209 patients，there were 121 cases（57.9%） with and 88（42.1%） without hepatic steatosis；Uric acid，low density lipoprotein and triglyceride were （352.5±87.1） mmol/L，（2.8±0.8） mmol/L and （1.8±0.1） μmol/L，respectively，in CHB patients with hepatic steatosis， all of which were remarkably higher than those in CHB patients without steatosis [（310.3±69.1）mmol/L，（2.2±0.6） mmol/L and（1.2±0.7）μmol/L， respectively，P<0.01）]；Obesity，overweight and low density lipoprotein were the risk factors for hepatic steatosis（P<0.01）. Conclusions Obesity and hyperlipidemia， but not viral load and alcohol consumption，are the risk factors for hepatic steatosis in male patients with CHB.

Objective To evaluate the efficacy and influence factors of pegylated interferon alpha-2a （Peg IFN alpha-2a） plus ribavirin （RBV） for treatment of patients with chronic hepatitis C. Methods Three hundred and thirty-one patients with chronic hepatitis C were treated with Peg IFN alpha-2a（180 μg/week or 135 μg/week） plus RBV（900 to 1200 mg/d） for 48 to 72 weeks， and all patients were followed up for 24 weeks after treatment. HCV genotypes，HCV RNA by PCR and liver function index were tested before and after therapy，respectively. Results Rapid virologic response（RVR），early virologic response （EVR） and sustained virologic response （SVR） were 65%（215/331），94.9% （314/331） and 84.9%（281/331），respectively in this series of patients with CHC；HCV genotypes were obtained in 176 patients， and the SVR was 88.0% and 79.4% in 108 patients with HCV genotype-1 infection and 68 with non-genotype 1 infection，respectively，which did not differ statistically between the two groups；Higher SVR of 93.3% was obtained in 75 patients with baseline HCV RNA ≤4×105 IU/ml than 82.4% （P<0.05） in 256 patients with >4×105 IU/ml；SVR in 215 patients having RVR was significantly higher than that in 116 patients having not （92.6% vs. 70.7%，x2=28.099，P=0.000）；Similarly，SVR in 314 patients having EVR was significantly higher than that in 17 patients having not （88.5% vs. 17.6%，x2=63.194，P=0.000）；The age of 50 patients with CHC who did not achieve SVR [（46±15） years] was older than that of 281 patients who did [（38±13） years，P<0.05]，and the duration of infection in patients who did not achieved SVR [（14.8±8.0） years] was longer than that in patients who did [（11.5±7.7） years，P<0.05）. Conclusion Peginterferon alpha-2a plus ribavirin is effective in treatment of patients with CHC， and the efficacy is related to serum HCV RNA load at baseline， age of patients， disease course， and RVR or EVR at early stage of the regimen.

Objective To analyze the changes in cirrhotic etiologies of inpatients from 2002 to 2011 in North China. Methods Cirrhotic etiologies and its changes were analyzed in 53092 patients with liver cirrhosis for the first time in our hospital from 2002 to 2011. Results Hepatitis B related cirrhosis（74.2%），hepatitis C related cirrhosis （10.8%），alcoholic cirrhosis （5.8%） and auto-immune liver diseases related cirrhosis （3.9%） were the top four etiologies；The percentage of hepatitis B related cirrhosis was decreased from 81.5% in 2002 to 66.8% in 2011，while the percentage of alcoholic cirrhosis was increased from 3.3% to 7.7%，a 2.3-time increase in 10 years；Patients with auto-immune liver diseases related cirrhosis were mainly female（84.3%） and patients with hepatitis B related cirrhosis and alcoholic cirrhosis were mainly male（80.0% and 98.0%，respectively，P<0.01）；The average age was less than 50 years in patients with alcoholic cirrhosis and hepatitis B related cirrhosis， while the average age was greater than 50 years old in patients with hepatitis C related cirrhosis and auto-immune liver diseases related cirrhosis （P<0.01）；For all patients，North China ranked first in patient’s family register，but for patients with alcoholic cirrhosis and auto-immune liver diseases related cirrhosis，Beijing and East China ranked the second and third place，respectively，in patient’s family register；The top three places accounted for 79.7% of patients with alcoholic cirrhosis；The improvement rate were greater than 70% in patients with the top four etiologies related cirrhosis，and the improvement rate were even higher （80%） in patients with alcoholic cirrhosis and auto-immune liver diseases related cirrhosis （P<0.01）. Conclusions Hepatitis B，hepatitis C，alcoho and auto-immune liver diseases are the top four etiologies of liver cirrhosis. The percentage of hepatitis B related cirrhosis is gradually decreasing，while the percentage of alcoholic cirrhosis is increasing from 2002 to 2011 in North China.

Objective To investigate the radioimmunoimaging of 99mTc labelled humanized single-chain Fv dimmers （BDM3） and immunonanoparticles for hepatocellular carcinoma in nude mice bearing human hepatocellular carcinoma，and to study their application in diagnosis and therapy of hepatocellular carcinoma. Methods The label rate of 99mTc-BDM3 and 99mTc-BDM3 nanoparticles was determined by isotopic analyzer. The labelled BDM3 and BDM3 nanoparticles were injected intraperitoneally into the nude mice bearing human hepatocellular carcinoma. At intervals of 1 h，4 h and 8 h，the mice in each group were imaged on a SPECT，and then were sacrificed immediately to get various organs and tumors. Radioactivity ratio of tumor to non-tumor （T/NT） was measured. Results The label rates of 99mTc-BDM3 and 99mTc-BDM3 nanoparticle were 91% and 92%，respectively；The positive display rates by the antibody and its nanoparticle were both 100%；The ratio of T/NT were （1.63±0.17） and （3.63±0.21） 1 h，（3.82±0.24） and （5.63±0.26） 4 h，（0.48±0.21） and （1.41±0.32） 8 h after injection of 99mTc-BDM3 and 99mTc-BDM3 nanoparticle，respectively. The differences between two groups were statistical significance；Favorable images were obtained after 4 h. The labelled BDM3 and BDM3 nanoparticles concentrated in carcinoma and did not in nontumor，that showed an evident targeting effect in tumor. As a result of a double targeting effect，the BDM3 nanoparticles group had more concentration in tumor，and increased the imaging effect. Conclusions The humanized single-chain Fv dimmers （BDM3） and immunonanoparticles for hepatocellular carcinoma has high affinity to nude mice bearing human hepatocellular carcinoma xenografts. They could be target carrier for diagnosis and therapy of hepatocellular carcinoma.

Objective To investigate the effect of pentoxifylline （PTX） on ethanol metabolic enzymes and peroxisome proliferator-activated receptor alpha （PPAR-α） in C57BL/6 mice with alcoholic liver disease. Methods Sixty-four mice were randomly divided into alcoholic liver disease model， PTX intervention and control group; Acute alcoholic liver injury was induced in mice by intragastric administration with 50% alcohol，and chronic alcoholic liver injury was induced by intragastric administration with 20% alcohol daily for six weeks；Serum alcohol dehydrogenase（ADH） and cytochrome P4502E1 （CYP2E1） activity was measured by colorimetric method；The mRNA levels of ADH，CYP2E1 and PPAR-α were measured by PT-PCR；The protein expression of CYP2E1 and PPAR-α was determined by immunohistochemistry. Results The serum activity of ADH did not differ among mice with acute[（11.2±1.6）U/ml] or chronic[（5.8±1.4） U/ml] alcoholic liver injury and controls[（12.5±1.2）U/ml and（4.3±0.6）U/ml，respectively]；In mice with acute and chronic liver injury，the CYP2E1 activity was（12.2±1.8）U/ml and （11.8±1.7） U/ml，respectively，significantly higher than those in normal controls[（7.9±1.4）U/ml and （6.5±1.2） U/ml，P<0.01）] and those in PTX-intervented mice [（8.1±1.5） U/ml and （7.8±1.5）U/ml，P<0.01]；The relative CYP2E1 positive cells in liver tissues in mice with acute and chronic alcoholic liver injury were （765±21） and （682±25），respectively，significantly higher than those in normal controls [（308±12） and （305±18），P<0.01）] and in mice with high-dosage of PTX intervention [（521±18） and （418±12），respectively，P<0.01]；The mRNA levels of ADH in liver tissues of mice with acute and chronic alcoholic liver injury were similar to that in the controls， however， the relative CYP2E1 mRNA levels[（1.47±0.32） and （1.13±0.52）] were significantly higher than those in normal controls [（0.89±0.23） and （0.45±0.28），respectively，P<0.01）] and in mice with high-dose of PTX[（0.92±0.27） and （0.48±0.32），respectively，P<0.01）];PPAR-α mRNA levels in liver tissues did not differ among mice with acute liver injury and normal controls，however，it was significantly lower than that in normal controls（0.85±0.21） in liver of mice with chronic alcoholic liver injury[（0.45±0.31），P<0.05]；The PPAR-α positive cells in mice of acute and chronic alcohol injury were （322±15） and（262±23），respectively，significantly higher than those in normal controls[（721±18）and （689±14），P<0.01] and in mice with high-dose of PTX intervention[（548±20） and （725±19），P<0.01]. Conclusion PTX attenuates acute or chronic alcoholic liver injury，probably by through up-regulation of CYP2E1 and down-regulation of PPAR-α.

Objective To compare the differences in serum liver enzymes， mortality and liver histological changes in three different strains of mice with concanavalin A（ConA） -induced acute hepatic injury （AHI）. Methods C57BL/6J mice，BABL/c mice and KM mice were subjected to ConA at four different dosages （i.e.6， 12，20 and 30 mg·kg-1） for 8 hours，and then mice were sacrificed and serum liver enzymes and liver histological changes were examined. Results ConA at dose of 6 mg·kg-1 successfully induced acute liver injury in all three strains of mice；ConA at dose of 12 mg·kg-1 caused remarkable increases in serum ALT （1006.8 ± 12.1） U/L and AST （1391.8 ± 13.4）U/L levels in KM mice，significantly higher than those in BABL/c mice [（75.7 ± 0.5） U/L and （284.7 ± 23.4） U/L，respectively and in C57BL/6J mice （104. ±32.2） U/L and （492.2 ± 12.3） U/L，respectively，P<0.05]；Similarly，liver index （5.4±0.3） and spleen index（0.7±0.5） in KM mice were significantly higher than that in BABL/c mice [（5.2±0.4） and （0.6±0.3），respectively and in C57BL/6J mice（5.0±0.6） and （0.6±0.2），respectively，P<0.05]；Serum ALT and AST levels did not differ among three strains of mice when Con A at dose of 20 mg·kg-1 was used，however，the mortality in BABL/c （4/10） and C57BL/6J（5/10） was significantly higher than that in KM mice（1/10）；30 mg·kg-1 of ConA resulted in a remarkably high mortality in all three strains of mice （30% in KM mice，100% in BABL/c and 100% in C57BL/6J mice）. Conclusion Mouse strains play a significant role in liver response to Con A，and the tolerance of KM mice to ConA is better than BABL/c and C57BL/6J mice and the liver damage is in a dose-dependent manner.

Objective To investigate the changes of intestinal barrier function and protective effects of Huazhirougan granule in rats with alcoholic fatty liver disease. Methods Sixty Sprague-Dawley （SD） rats were randomly divided into control，model，low （1.1 g·kg-1·d-1），middle （2.2 g·kg-1·d-1） and high dose（4.4 g·kg-1·d-1） of Huazhirougan granule treatment groups；Rats in model and treatment group were fed with 56% alcohol once a day for five weeks to establish alcoholic fatty liver model，and the changes in bacterial translocation （BT），intestinal mucosal permeability （represented by lactulose （L）/ mannitol （M），e.g. L/M%），blood biochemistry，intestinal mucosa and liver pathohistoloy were determined. Results At the end of fifth week，the changes of liver steatosis and inflammation were moderate in model rats，and the BT，L/M %，liver index and serum ALP were 70.0%，（0.38±0.18）%，（427.1±126.6）IU/L and （4.3±0.6）%，respectively，significantly higher than those in the control group[10.0%，（0.23±0.07）%，（306.4±67.1）IU/L and （3.6±0.4%），respectively，P<0.05）]；Huazhirougan treatment in the three doses significantly eased liver steatosis and inflammation; The L/M % and liver index in low dose treatment group were （0.27±0.06）% and （3.8±0.3）%，significantly lower than those in model group（P<0.05）；The BT and liver biochemistry were also improved in the treatment group as compared to those in the control；In middle and high dose treatment group，the L/M % were （0.22±0.16）% and（0.18±0.07）%，and the liver index were （3.7±0.3）% and （3.6±0.2）%，significantly lower than those in model group（P<0.01）；Similarly，in middle and high dose treatment group，the BT were 10.0% and 22.2%，ALT were（39.8±5.0）U/L and（40.8±5.6）U/L，AST were（113.4±38.3） U/L and（111.2±28.9） U/L，and ALP were （334.4±47.6） IU/L and （350.2±112.2） IU/L，respectively，significantly lower than those in model group[70.0%，（54.1±17.2）U/L，（163.2±67.5） U/L，（427.1±126.1）IU/L，respectively，P<0.05）]. Conclusions The rats with alcoholic fatty liver disease have intestinal barrier dysfunction， and the herbal Huazhirougan granule has a protective effect on intestinal barrier and liver function.

Objective To evaluate pulmonary intravascular macrophage accumulation and changes of plasma level of endotoxin in rats with hepatopulmonary syndrome （HPS）. Methods Thirty Wistar rats receiving sham surgery or common bile duct ligation （CBDL） were sacrificed 5 weeks after surgery；Arterial blood were obtained for arterial blood gas analysis，and plasma were obtained for measurement of endotoxin（by Limulus test），nitric oxide （by Nitrale reduetase） and tumor necrosis factor alpha （by ELISA）；The lung and liver tissues were collected for histological evaluation. Results As compared to sham group，rats in CBDL group at fifth week had lower PaO2 [（64.2±7.3） mmHg vs. （97.7±4.5） mmHg，P<0.05]， higher plasma levels of endotoxin，nitric oxide and tumor necrosis factor-ɑ [（0.2297±0.0362） Eu/ml vs. （0.0938±0.0309） Eu/ml，（56.2±9.5） μmol/L vs.（32.9±4.3） μmol/L，and（1.5±0.2） ng/ml vs.（0.4±0.1） ng/ml，respectively，P<0.05]；The histological examination revealed that fibrosis in the liver and the expansion and congestion of the pulmonary capillaries together with pulmonary intravascular macrophage accumulation in the lung，were observed in CBDL-treated rats. Conclusions In rats with experimental model of hepatic cirrhosis，the elevated level of plasma endotoxin，accumulation of pulmonary intravascular macrophages and increased secretion of inflammatory cytokines may contribute to intrapulmonary vasodilation and hyoxemia as a result of hepatopulmonary syndrome.

Objective To investigate the inhibitory effect and related mechanisms of Brucea oil on proliferation of H22 hepatoma cell line. Methods H22 cells cultured in vitro were incubated with different concentration of Breucea oil （10~160 μg/ml） and cell proliferation was determined by MTT assay；Mice bearing H22 tumors were treated with Breacea oil for 10 days，and then the mice were scarified and tumor inhibitory rate， spleen index and thymus index were calculated；MTT was performed to detect the proliferation of spleen cells from tumor-bearing mice；The serum TNF-α was measured by enzyme-linked immunosorbent assay and serum transforming growth factor-α （TGF-α） levels by radioimmunoassay. Result The cell proliferation was inhibited by Brucea oil to 34.1%~52.31% of that of in the control at concentrations of 10 to 160 μg/ml；At concentration of 25 and 50 mg·kg-1，the tumor mass in tumor-bearing mice were reduced to （1.095±0.301） g and （0.920±0.250） g，respectively，and serum TGF-α levels decreased to（11.172±0.639） pg/ml and （14.438±0.587） pg/ml，respectively，significantly lower than those in non-treated tumor-bearing mice[（1.867±0.554） g and （16.354±0.762） pg/ml，respectively]；In contrast，serum TNF-α levels increased to（28.132±2.456） pg/ml and（26.521±3.267）pg/ml，respectively，significantly higher than that in non-treated tumor-bearing mice[（20.231±2.614） pg/ml，P<0.05]；Brucea oil also promoted the proliferation of spleen cells，but had no significant effect on the spleen index and thymus index as compared to those in tumor-bearing mice. Conclusion Brucea oil inhibits the proliferation of H22 cells in vitro and in vivo，and the anti-tumor effect might be related to the regulation of spleen cells in tumor-bearing mice.

Hepatorenal syndrome（HRS） is one of serious complications of severe liver diseases including liver failure， decompensated cirrhosis and liver cancer. Although the diagnostic criteria for HRS has been defined clearly， the specific diagnostic indicators are lack in clinical practice. HRS is just a clinical exclusion diagnosis. Once the symptom of significant reduction in the amount of urine with increased serum creatinine levels suddenly appears，it might be the early signs of HRS. As respect to the treatment of HRS，combination of vasoconstrictors and albumin，TIPS，CRRT and MARS could improve renal function， mainly serving as a bridge for liver transplantation. So far，liver transplantation is the most effective treatment for HRS.

Liver failure related gastrointestinal bleeding includes diffuse hemorrhage of the gastrointestinal mucosa caused by serious coagulation dysfunction,esophageal gastric varices, portal hypertension gastropathy and digestive tract ectopic varices. This review provides an overview of clinical differential characteristics between liver failure related gastrointestinal bleeding and simple gastrointestinal bleeding，disease spectrum，diagnosis and treatment.

Transforming growth factor-β1 （TGF-β1） is a kind of cytokine with broad biological functions. It induces abnormality in cell number and function of immune cells and results in chronic infection of hepatitis B virus （HBV）；At the same time，TGF-β1 inhibits HBV replication through different ways；TGF-β1 also promotes liver fibrosis，affects hepatocellular carcinoma in a dual manner，and plays a significant role in the development of liver failure.

Hepatitis B virus infection may result in acute or chronic hepatitis B. The outcomes of chronic hepatitis B virus infection include chronic hepatitis，cirrhosis，hepatocellular carcinoma and liver failure. Host，virus factors and their interactions affect disease progression. The change in biological characteristics caused by HBV gene mutations is one of the pivotal factors determining the outcomes of HBV infection.

Portopulmonary hypertension （PPHTN） is defined as the development of pulmonary arterial hypertension associated with increased pulmonary vascular resistance complicating portal hypertension, with or without advanced liver disease. The presence of PPHTN markedly increases mortality. No effective medical therapies are currently available and liver transplantation is the only accepted treatment at the time. This review stresses on the epidemiology, pathophysiology, clinical presentation, diagnosis, treatment and the prognosis of PPHTN.

Primary biliary cirrhosis is a chronic, slowly progressive cholestatic liver disease of unknown etiology. The antimitochondrial antibody detected in the blood is specific and wih high sensitivity for the diagnosis of PBC. Recent years,with the increased acknowledge of clinic phsicians and the popular of the detection of autoantibodies, the incidence and prevalence has increasing trend year by year,early diagnosis and treatment have great significance on the prognosis of the disease. This researth is focused on the significance of the antimitochondrial antibody and its subtypes in diagnosing of primary biliary cirrhosis.

MicroRNAs（miRNAs） are a class of 21 to 25 nucleotides non-coding small RNAs that regulate post-transcriptionally gene expression. Recent findings show that the abnormal expression of miRNAs is closely related to a number of diseases，especially the development of malignant tumor. miRNAs are expressed at different levels in various cancers.Studies shows that miRNAs can be used as biological markers for histological classification，prognosis and early diagnosis of hepatocellular carcinoma，and are expected to become a new therapeutic target in vivo. In this paper，a number of known small miRNAs are reviewed for their effect in carcinogenesis in liver cancer.