Objective To investigate the levels of IFN-γ and TNF-α in MHV-3-induced fulminant hepatic failure. Method MHV-3-induced fulminant hepatic failure was adopted in mice and the serum and hepatic levels of IFN-γ and TNF-α was assayed by ELISA. Results As MHV-3 infection passed by，the serum and hepatic levels of IFN-γand TNF-αwas elevated significantly，and they reached the highest before the mice were dead. Conclusion IFN-γand TNF-αmight take part in the pathogenesis of MHV-3-induced fulminant hepatic failure in mice.

Objective To observe the hepatic expression of histone deacetylase 2（HDAC2）with the treatment of ethyl pyruvate（EP）in rats with acute live failure induced by D-galactosamine hydrochlorate. Methods 78 male Wistar rats were divided randomly as normal，model，intervention of EP and EP treatment groups. The expressions and levels of HDAC2 in liver tissues were detected by immunohistochemistry and ELISA，respectively. Results Compared with normal group，the expression of HDAC2 in model group decreased（P<0.05）；Of which the IOD/Area values at 12h and 24h were 0.0817±0.0118 and 0.0726±0.0111，much lower than that in normal group（0.1125±0.0047，P＜0.01）. Conclusion The expressions of HDAC2 in rats with acute live failure were remarkably reduced. Although EP could protect the liver，it has no effect on the expression of HDAC2.

Objective To construct an expression vector with small interfering RNAs of Smad3 in vitro. Methods Three possible small interfering RNAs to Smad3 gene were designed and synthesized，subsequently transfected into rat hepatic stellate cells using Liposome 2000. RT-PCR was used to detect the expression of the Smad3 gene. Then the strands were cloned into pRNAT-U6.1/Neo vector to construct the recombinant plasmids and confirmed by sequencing. Results Both RT-PCR and sequencing assays showed that the recombinant vector pRNAT-SiSmad3 was successfully constructed. Conclusion The successful construction of the recombinant plasmid pRNAT-SiSmad3 will be beneficial to further study in the experiment of Smad3 down-regulation.

Objective To investigate the effect of three hepatic vascular occlusion maneuvers on the apoptosis of liver cells during ischemia-reperfusion injury in rats. Methods One hundred and twenty-eight Wistar rats were randomly divided into the sham operation group（SO，n=8），Pringle group（PR，n=40），hemihepatic vascular occlusion group（HH，n=40）and hepatic blood inflow occlusion without hemihepatic artery control group（WH，n=40）. Each group except for the SO group was further devided into 5 subgroups（n=8），which were 1h，2h，6h，24h and 72h group，respectively. After 30min of hepatic vascular occlusion with three methods，the liver blood flow was reperfused. The liver cell apoptosis rate，hepatic histopathology and the survival rate at 72 hours after reperfusion were measured. Results After each period of reperfusion，ALT，AST and apoptosis rates were significantly higher in PR group than in HH and WH group，and the pathological and ultrastructural changes of hepatic tissues at 6 hours after reperfusion were significantly worse in PR group than in HH and WH group；Survival rates at 72 hours after reperfusion were 87.5%（7/8），100%（8/8）and 100%（8/8），respectively，in PR，HH and WH group. Conclusion Hepatic blood inflow occlusion without hemihepatic artery control can reduce hepatic ischemia-reperfusion injury.

Objective To study the effects of polyene phosphatidylcholine on iron homeostaisis in rats with alcoholic liver disease. Methods Thirty wistar rats were randomly divided into control，model and intervention group. The animals were feeded with or without Lieber Decarli liquid in twenty and polyene phosphatidylcholine was given in ten rats. The serum alanine aminotransferase（ALT），aspartate aminotransferase（AST），malonyldialdehyde（MDA），iron，total iron binding capacity（TIBC），ferritin and hepcidin were examined after 6 weeks. Hepatic tissue was assessed by hematoxylin and eosin staining，prussian blue iron staining and immunohistochemisty staining. Results There were no significant differences in serum concentration of iron and TIBC among the three groups（P>0.05）；the levels of serum ALT，AST and ferritin in the model group were respectively 37.9±14.3 U/L，55.0±18.6 U/L and 337.8±132.8 ng/ml，much higher than that in control group（P<0.05，respectively）；the level of serum hepcidin was 124.1±32.0 ng/ml，much lower than in control（P=0.034）；the level of serum MDA in the intervention group was 3.6±2.4 nmol/ml，much lower than that in the model group（P=0.01）；there was no difference in liver iron content among the three groups. Conclusion Alcohol can lead to liver injury and iron overload，and decrease hepcidin expression in liver. Polyene phosphatidylcholine can protect alcohol liver damage by lipid hydroperoxides.

Objective To study the effect of Qi Ji preparation on mRNA expression of peroxisome proliferator activated receptor α（PPARα）in hepatic tissue of rats with nonalcoholic steatohepatitis. Methods The NASH model of rat was made by high fat diet. The rats were randomly divided into normal control，model，Qi Ji preparation and methionine/choline compound treated group. The mRNA expression of PPARα in hepatic tissues of rats was detected by useing in situ hybridization. Results By means of image analysis，the PPARα mRNA expression in model animals decreased（P<0.05）as compared with that in normal control group；QiJi preparation and methionine/choline compound increased the PPARα mRNA levels obviously. Conclution QiJi preparation could increase the PPARα mRNA expression in hepatic tissues.

Objective To evaluate the efficacy between entecavir and adefovir dipivoxil in hepatitis B e antigen-positive nucleos（t）ide-naive patients with chronic hepatitis B. Methods Chinese and English papers（randomized controlled clinical trials） about comparison of efficacy between entecavir and adefovir dipivoxil in hepatitis B e antigen-positive nucleos（t）ide-naive patients with chronic hepatitis B were searched from January 2003 to May 2010 online. Heterogeneity was examined by Chi-square test，the relative risk was calculated and forest-graph was drawn. The evaluated index contained undetectable serum HBV DNA，serum ALT normalization and HBeAg loss. Results 212 articles were totally found，and only one English and three Chinese articles fit well for the study were included. Meta analysis showed that the rates of undetectable serum HBV DNA（P=0.0002，RR=1.74）and serum ALT normalization（P=0.04，RR=1.34）in entecavir-treated patients at week 12 were higher than those in adefovir dipivoxil-treated，but there was no statistic significances as respect to the rates of undetectable serum HBV DNA （P=0.20） and HBeAg loss（P=0.27）between the two groups at week 24. Conclusion Entecavir has a quicker effect in decreasing serum HBV DNA and normalizing serum ALT at early stage than adefovir dipivoxil，however，the efficacies are the same at week 24.

Objective To investigate the histological changes in liver biopsy tissues in patients with CHB after therapy of adefovir dipivoxil（ADV）for 48 weeks. Methods 35 patients with CHB were enrolled into this study，each case was given ADV orally at dose of 10mg per day for 48 weeks and liver biopsy was performed at the beginning and the end of the treatment. The liver tissues were evaluated and scored according to Knodell’s HAI by two histopathologists. At the same time，routine biochemical liver function tests and serum HBV DNA level were assayed. Results 68.5%（24/35）patients had a reduction of their total hepatic HAI scores（8.3±3.9 to 4.8±3.6，t＝3.901，P<0.05）；the reduction of HAI had no differences between patients with HBeAg/anti-HBe seroconversion and those without；serum ALT，AST，HBV DNA levels decreased respectively（t=5.520，t=3.663 and t=4.848，P<0.01）；Conclusion Significant improvement in liver histology，ALT normalization，suppression of HBV DNA replication can be obtained in the majority of patients treated with adefovir for 48 weeks.

Objective This study assessed the safety and efficacy of adefovir dipivoxil（ADV）in treatment of patients with chronic hepatitis B and lamivudine-resistant hepatitis B virus（HBV）. Methods One hundred and one hepatitis B e-antigen（HBeAg）-positive na■ve patients（69 cases）and lamivudine-resistant HBV patients（32 cases）were treated with adefovir dipivoxil 10mg daily. The efficacy was evaluated until at 144th month（the administrated end point）and then continuously at 240th month. Results At the 144th month，the rates of ALT normalization were 91.3% and 90.6% in na■ve group and lamivudine-resistant group，respectively；the negative rates of HBV-DNA were 88.4% and 84.3%，respectively；the negative rates HBeAg were 34.7% and 28.1%，respectively；the seroconversion rates of HBeAg/HBeAb were 55.5% and 53.1%，respectively，and the seroconversion rates of HBsAg/HBsAb were 7.2% and 6.3%，respectively. There was no significant difference between the two groups（P>0.05）. The blood routine，urine routine and renal functions whether in the administered period or during the follow-up had no abnormal findings related to ADV. Conclusions Adefovir dipivoxil could effectively inhibit HBV replication，normalize ALT and enhance transformation from HBeAg to HBeAb for cases with naive patients and lamivudine-resistant patients． It is safe and has a good tolerance．

Objective To investigate the implication of the model of end-stage liver disease（MELD）in assessment of short and middle term prognosis in patients with decompensated liver cirrhosis. Method 167 patients with decompensated liver cirrhosis admitted to our hospital were studied and followed up at least for one year. MELD and Child-Turcotte-Pugh（CTP）score were calculated at presentation. The receiver operation characteristic curves（ROC）and the area under ROC were used to determine the ability of predicting three，six and twelve month mortality. Result There were 23，42 and 66 dead cases at month 3，6 and 12，respectively；the MELD and CTP scores in dead were much higher than in survivals（P＜0.001）；the higher the MELD score，the higher risk the dead. Conclusion Both MELD and CTP scores can accurately predict the short and middle term prognosis of patients with decompensated liver cirrhosis.

Objective To investigate plasma exchange（PE）and hemodiafiltration（HDF）treatment in patients with fulminant hepatitis. Methods 119 patients with severe hepatitis were randomly divided into three groups. The basic medical treatment was the same. 47 cases in group A received PE，32 in group B received with PE+HDF. Results In group A，16 patients recovered，22 improved and 9 died，in group B，9 recovered，17 improved，and 6 died，and in group C，7 recovered，22 improved and 11 died；NO，LPS，TNF alpha dropped significantly after the treatment of liver supporting. Conclusion PE and HDF treatment in patients with fulminant hepatitis can significantly decrease TBIL，NH3，NO LPS，TNF alpha，and improve the survival rate of the patients.

Objective To investigate the therapeutic effects and safety of liver assist device with human hepatoma cell line on patients with severe hepatitis. Method Five patients with liver failure were treated with continuous hematoplasma dialysis filtration and were supported by liver assist device with C3A cell line for 72 hours. Result Three patients recovered from the liver failure，1 improved and 1 died；After treatment，level of AFP were significant increased（P<0.05），while the TBIL decreased in the patients（P<0.05），But the level of ammonia and albumin had no significant change. During the treatment，there was no severe complication such as hemorrhage and allergic reaction. Conclusions Liver assist device with human hepatoma cell line may be an alternative method to treat patients with liver failure.

Objective This study was designed to compare fast track surgery with conventional perioperative management in primary hepatic cancer patients undergoing lobular resection. Methods 53 primary hepatic cancer patients undergoing lobular resection were recruited for this comparative study. 23 patients received perioperative fast track rehabilitation，and 30 received conventional perioperative care. Outcomes were assessed by postoperative hospital stay，liver function tests and medical costs. Results Fast track rehabilitation group was associated with a significantly shorter postoperative hospital stay，less medical costs，earlier first passage of flatus in the postoperative period compared with conventional care group. Conclusion Fast track rehabilitation is feasible and effective in primary liver cancer patients undergoing resection.

Objective To evaluate the clinical applications with 64-slice spiral computed tomography portography（MSCTP）and reconstruction techniques. Methods Fifty-six patients with portal-systemic diseases were examined by the 64-slices spiral CT and arterial,portal venous and balance phase scans were performed. Portal vein and their branches were constructed by maximum intensity projection（MIP），volume rendering（VR）and multiple planar reformation（MPR）techniques. The scope and extend of the portal vein diseases were evaluated. Results MSCTP could display normal and abnormal portal veins satisfactorily，and portal vein branches over four grades could be revealed by VR and MIP technique，which could detect the invasion and tumor thrombosis of portal vein，and show the range of colateral circulation and estimate its degree in portal venous hypertension. MPR could directly show the whole shape and the extent of the diseases. Conclusion MSCTP is a noninvasive method to evaluate portal venous system. MSCTP has high clinical application values.

Objective To analyze faults in performing indocyanine green excretion test and their potential causes. Methods Indocyanine green excretion test was carried out by indocyanine green pulse spectrophotometry （DDG-3300K）in 226 patients with liver diseases. Common faults in the test were analyzed. Results By analyzing the graphics produed by DDG-3300K，we summarized 4 kinds of common operative faults that appeared in 15 patients，including delayed injection，over-slow injection，interruption during injection，and spilling of drugs. Conclusions The right manipulation and correct nursing are guarantees of a successful test and its accurate result.

Objective To explore the endoscopic features of portal hypertensive gastropathy（PHG）in patients with hepatitis B-induced liver cirrhosis. Methods Endoscopy was performed routinely in 108 patients with hepatocirrhosis of chronic hepatitis B and the incidence of PHG was analyzed retrospectively. Results PHG was found in 42（38.9%），and esophageal varices in 91（84.3%）patients；the Child-Pugh class was markedly related to the severity of PHG（P<0.05）；there was a significantly positive correlation between the esophageal varices and PHG（P<0.05）. Conclusion The incidence and severity of PHG are positively related to the liver function and esophageal varices.