Objective To investigate the relationship between platelet-derived growth factor（PDGF）expression and sinusoidal lesions in patients with chronic hepatitis B.Methods Immunohistochemical staining were performed for PDGF expression in hepatic tissues of 120 cases of CHB. The hepatic sinusoidal and Diss’s space lesions were observed by electron microscope. Results There were constriction,emphraxis,dilation,Disse’s space congestion and sinusoidal capillirization in the liver of patients with CHB;The PDGF expression was parallel to the grading and staging of hepatitis B,and to the sinusoidal and Diss’s space lesions;There was a significant difference（P<0.01） among different grades,and the PDGF was strongly positively expressed in severe CHB than in the mild.Conclusion The expression of PDGF is possibly related with histology grading and staging and with sinusoidal lesions in patients with chronic hepatitis B.

Objective To analyse the application value of acoustic radiation force impulse in diagnozing liver fibrosis.Method The right lobes of the liver in 52 patients with chronic hepatitis B and 31 healthy subjects were checked by acoustic radiation force impulse imaging technology in order to measure quantitative value of liver tissue elasticity in regions of interest. Result The virtual touch quantification（VTQ）values in patients with chronic hepatitis B were higher than that in healthy control（P=0.012）；The VTQ value was positively correlated to the degrees of liver fibrosis（Spearman r=0.737，P<0.01）；The liver biopsy results of ≥G3S3 were considered as middle/high-staging liver fibrosis；The VTQ value of 1.6m/s was used as cut-off value and its sensitivity was 93.8%， the specificity was 73.7%and the accuracy was 85.1% to diagnose middle/high-staging liver fibrosis.Conclusion Acoustic radiation force impulse imaging technology might reflect quantitative information of the liver tissue elasticity，which can be used to assess the degree of liver fibrosis.

Objective To explore the pathologic changes in 40 adult patients with chronic HBV infection who were with normal or mildly elevated serum ALT levels.Method To analyze the relation of hepatic pathologic grades indexes and fiberized stages indexes,detected by liver biopsy,serum markers of liver fibrosis（HA,LN,PCⅢ,CⅣ）,detected by chemiluminescence method,main Liver function ,detected by automatic biochemistry analyzer,of 40 patients with chronic hepatitis B infection.ResultsIn 40 patients with chronic hepatitis B infection,the liver pathologic manifestations were G1S0 in three,G1S1 in nine,G1S2 in one,G1S3 in three,G1S4 in four,G2S1 in ten,G2S2 in three,G2S4 in four,G3S4 in two,and G4S4 in one;The serum ALT,ALB and CHE levels in patients with liver inflammation grade and fibrosis stage<G2S2 were higher than that in with≥G2S2,the serum AST and TBIL levels in patients with liver inflammation grade and fibrosis stage<G2S2 were lower than that in with≥G2S2,showing a significant differences in serum AST levels（P<0.05） in two groups.The serum HA,PCⅢ and CⅣ levels in patients with liver fibrosis stage≥S2 were higher than that in with<S2 （P<0.05）,but no significant differences in the serum LN levels was shown（P>0.05）.Conclusion The liver biopsies in HBV infected patients with normal or mild abnormal ALT should be performed in time to guide antiviral treatment and prevent the progression of the disease to liver cirrhosis and liver cancer.

Objective To observe the changes of mitochondrial DNA levels in peripheral blood monouclear cells in patients with chronic hepatitis B receiving long-term adefovir treatment.Methods Patients with CHB were divided into three groups:（1） 2 years group（n=18）:receiving adefovir for 2 years;（2）3 years group（n=25）:adefovir for 3 years;and （3） control group（n=22）:naive patients without antiviral treatment.The mtDNA of PBMCs were detected by quantitative real-time PCR. Plasma MDA and F2-isoprostanes were measured by ELISA and TAOC were detected by spectrophotometry.Results The mtDNA in PBMCs in the 2-year treatment group was 0.6±0.4 copies/cell and in the 3-year treatment group was 0.8±0.5 copies/cell,both significantly lower than in the control group（1.4±1.2copies/cell,P<0.05）;the F2-isoprostanes in 2-year treatment group was 1.5±0.8 ng/ml and in 3-year treatment group was 2.2±1.3ng/ml,much lower than that in the control group（3.7±2.7 ng/ml,P<0.05）;the TAOC in 2-year treatment group was 3.0±1.1 IU/ml,and in 3-year treatment group was 2.3±1.4IU/ml, significantly lower than in the control group（4.3±1.8 IU/ml,P<0.05）.Conclusion The long-term administration of adefovir might injure mitochondrial DNA.

Objective The aim of this study is to explore the effect of lipopolysaccharides on hepatic vascular pathologic changes in chronic hepatitis B.Methods 120 cases of patients with chronic hepatitis B were classified by hepatic vascular pathologic changes.Normal liver tissue of 10 healthy persons were chosen as the control group.The serum LPS levels in cases were quantitatively determinated with enzyme linked immunosorbent assay（ELISA）.The expression of TLR4 was determined by immunohistochemical staining.The results were evaluated by integrative index.Result ①The serum LPS levels in healthy controls were very low（0.30±0.13ng/ml）.The serum LPS levels of patients with hepatic vascular lesions grade 1 were 0.32±0.14ng/ml.There was no signifiant difference in the serum levels between patients of hepatic vascular lesions grade 1 and normal controls（P>0.05）.The serum LPS levels of patients with hepatic vascular lesions grade 2 and grade 3 were 0.71±0.14ng/ml and 1.10±0.15ng/ml respectivity,which were significantly higher than those of normal controls（P<0.01）.There was a positive correlation between serum LPS level and the grade of hepatic vascular lesions （r=0.892,P<0.01）.②The intensity of TLR4 expression in liver tissue of chronic hepatitis B was significantly higher than that of health control（P<0.05）.The positive staining was mainly located on cell membrane and some in cytoplasm.In chronic hepatitis B,the intensities of TLR4 were positively correlated with the grade of hepatic vascular lesions（r=0.728,P<0.01）．Conclusions LPS and its receptor TLR4 might play an important role in hepatic vascular pathologic changes.The serum LPS level can be used as one of indexes to predict the severity of hepatic vascular lesions.

Objective To investigate the changes and clinical significance of E3 ubiquitin ligase Cbl-b and the related signaling molecules CD28 and CTLA-4 in patients with chronic hepatitis C. Methods 25 patients with chronic hepatitis C and 19 healthy persons were enrolled in this study. Peripheral blood monouclear cells （PBMC）were isolated.The related mRNA expressions of Cbl-b,CD28,and CTLA-4 were measured by RT-PCR; HCV RNA was detected by real-time RT-PCR;Genotyping of HCV was performed using a second generation INNO-LiPA line probe assay. Results The mRNA levels of Cbl-b,CD28,and CTLA-4 were increased in chronic hepatitis C, with 1.38-, 1.90-, and 2.68-time higher than those in healthy controls,respectively;The expressions of Cbl-b and CTLA-4 mRNA were significantly increased in HCV genotype 1b （n=11） than those in HCV genotype 2a （n=14）,with 1.74-and 2.81-time higher,respectively（P<0.05）;There were no correlations between the levels of three molecules and HCV RNA,so as to the associations of those and ALT levels.Conclusion Cbl-b and CTLA-4 may take part in the immune tolerance induced by the HCV infection and play an important role in chronic HCV infection.

Objective To investigate the hepatitis B virus replication status in patients with liver cirrhosis and primary liver cancer.Methods In 1982 patients with liver cancer and in 1995 with liver cirrhosis,serum HBV DNA and HBVcccDNA in liver tissues were detected.Results The serum anti-HBe positive rates in patients with liver cirrhosis and liver cancer were 61.7% and 74%,respectively（P<0.01）;in patients with serum anti-Hbe positive no matter with cirrhosis or cancer,the serum HBV DNA≤103copies/ml was 69.1%,much higher than 21.6% in patients with serum HbeAg positive（P<0.01）;in patients with anti-Hbe positive,serum HBV DNA≥107copies /ml was 6.4%,much lower than 42.0% in HbeAg positive（P<0.01）;in anti-HBe positive patients,serum HBV DNA levels was 3.8 lg copies/ml,much lower than in in HbeAg positive（6.1lgcopies/ml）;in 12 patients,all were hepatic HBV DNA positive,and 8 were hepatic HBV cccDNA positive.Conclution Patients with liver cirrhosis and liver cancer have a high percentage of serum anti-HBe positive,and HBV DNA or HBVcccDNA can be detected in liver tissues.

Objective To observe the change of Gankang No.Ⅱon the hydrogen sulfide（H2S）and nitric oxide（NO）levels in patients with hepatitis B liver cirrhosis.Methods 64 patients with hepatitis B liver cirrhosis were randomly assigned to treatment group and control group.The treatment group was treated with Gankang No.Ⅱ in addition to routine treatment.Results After treatment,H2S and NO levels in treatment group were 22.12±3.12μmmol/L and 44.78±5.12μmmol/L,significantly different from those in control group（19.01±2.98μmmol/L and 49.23±3.97μmmol/L,respectively）;After treatment,the TBIL,ALT,ALB and PTA in treatment group were improved（P<0.01）.Conclusion Gankang No.Ⅱ can modulate the H2S and NO level in patients with liver cirrhosis.

Objective To study the effect of blood serum supplemented with Ganfukang compound,a traditional Chinese herb medicine,on the mTOR/P70S6K signal pathway in hepatic stellate cells（HSCs）.Methods HSC-T6 stimulated by acetaldehyde were incubated with blood serum of Ganfukang compound.The expressions of collagen-Ⅰ,Ⅲ,mTOR and P70S6K in each group were analyzed by RT-PCR. Results HSCs exhibited a low mRNA level of collagen-Ⅰ,Ⅲ,mTOR and P70S6K in the control group,whereas they were remarkably increased in the model group（P<0.01 or P<0.05）,and the expression of them were downregulated after treated with blood serum of Ganfukang compound（P<0.01）.Conclusions mTOR/P70S6K signal pathway play an important roles in HSCs activation,and the anti-fibrosis effects of Ganfukang are related to the inhibition of mTOR/P70S6K signal pathway.

Objective To investigate the plasma D-dimer levels and their clinical significance in liver cirrhosis（LC） patients with portal vein thrombosis（PVT）.Methods 77 patients with LC were selected and 31 had PVT,and 46 had not.The PVT was diagnosed by CT scan and the D-dimer levels were detected.Results The plasma D-dimer levels in patients with PVT were significantly higher than that in without PVT（1.2±0.5 mg/l vs. 0.6±0.4mg/l,P<0.01）;The plasma D-dimer level in PVT patients with severe esophageal varices group（1.3±0.5mg/l） was higher significantly than that in patients with mild esophageal varices group（0.9±0.5mg/l,P<0.05）;The plasma D-dimer level in patients with gastrointestinal bleeding （1.5±0.5mg/l） was higher significantly than that in patients without gastrointestinal bleeding（0.8±0.4mg/l,P<0.01）;The plasma D-dimer level in death group（1.318±0.512mg/l）was higher significantly than in survived group（1.0±0.4mg/l,P<0.01）.Conclusion Plasma D-dimer level increases in patients with LC and might prompt the PVT formation.

ObjectiveTo study the prophylactic antibiotics in the treatment of patients with gastroesophageal variceal bleeding.Method 168 liver cirrhosis patients with gastroesophageal variceal bleeding were randomly assigned to the antibiotic prophylaxis group（n=87）and control group（n=81）without antibiotics.Results There were statistical differences between the data in the antibiotic prophylaxis group and the control as respect to bleeding period（16.7±13.6h vs.22.1±17.4h）,the incidence of rebleeding（8.1%/22.2%）,the average amount of blood transfusion（564±437ml/941±482ml）,the incidence of the nosocomial infection（13.8%/65.4%）,the average hospitalization days（11.5±4.3d/13.0±5.4d）and the average hospitalization costs（13807.0±3293.4 yuan/15910.9±4632.2 yuan）;There was no statistical difference between the mortality（4.6% vs.8.6%）in the two groups. Conclusion Using antibiotic prophylaxis in gastroesophageal variceal bleeding patients can draw a better outcomes.

Objective To explore the prevalence of Helicobacter pylori in patients with portal hypertensive gastropathy. Methods Helicobacter pylori was detected by RUT. Results In 264 patients with liver cirrhosis,69.4% was Hp positive,and in 262 with chronic gastritis （CG）,66.4% was positive（P>0.05）;In 79 liver cirrhosis with PHG,75.9% was Hp positive;In 56 liver cirrhosis with duodenal ulcer（DU）,85.7% was Hp positive,and in 109 with peptic ulcer（PU）,61.4% was Hp positive;In 28 liver cirrhosis with gastric ulcer（GU）,71.4% was Hp positive,and in 47 patient with GU,91.5% was Hp positive.Conclusion The prevalence of Hp infection is high in liver cirrohsis patients with DU.

Objective To study the expression of Nodal in hepatocellular carcinoma and its significance.Methods The Nodal protein expression in 95 hepatocellular carcinoma,20 adjacent liver cirrhosis and 12 liver cirrhosis was detected by immunohistochemical staining.Results There was 59 cases（62.1%）with positive expression of Nodal in 95 patients with hepatocellular carcinoma,while 4（20.0%）in 20 adjacent liver tissues,and 2（16.7%）in 12 cirrhosis tissues;Meanwhile,patients with Nodal expression had large tumors,higher rate of vascular invasion,higher Edmondson grades and later TNM stages（P<0.05）.Conclusion Nodal may be related to the development of hepatocellular carcinoma,and might be an important predictor of malignant progression.