Objective To investigate the influence of whey proteins （WP） on serum lipid metabolism and hepatic fatty infiltration changes in rats with nonalcoholic fatty liver disease（NAFLD）. Methods 35 SD rats were randomly divided into control （n=12）,model （n=11） and the therapeutic groups （n=12）. The control group were fed with normal diet,and the other two groups were fed with high-fat diet.Meanwhile,the therapeutic group were treated with WP（100mg/ml,0.5ml/d）. All rats were sacrificed at the end of six weeks.The pathological changes in livers in all rats were pathologically evaluated with HE stain,and the serum biochemistry index was also measured. Results Compared with the control group,the degree of fatty and inflammation were more serious in the model group,while oral administration of WP reduced the final body and liver weights of rats;the alanine transaminase was 34.8±5.6U/l,and serum triglyceride level was 0.2±0.1mmol/l in WP group,obviously reduced as compared to those in model group;liver histology showed an improvement of fatty infiltration in therapeutic group;the NAFLD activity score was significantly improved from 6.2±0.9 to 2.9±1.4（P<0.01） in WP group. Conclusions The obtained Results indicate that WP play a possible role in the regulation of liver biochemistries in the rat with NAFLD.The regulatory effect of WP is accompanied by an improvement in fatty infiltration and hepatic inflammation.

Objective To investigate the effect of motivational interviewing on patients with non-alcoholic fatty liver disease. Methods 76 patients with non-alcoholic fatty liver disease were randomly divided into intervention and control groups. 38 patients were intervened by motivational interviewing with inquiry, information and listenning and another 38 patients in control group were informed by using traditional health education. Results Before intervention, the body weights, serum triglycerides （TG）,cholesterol （TC） and body mass index in the two groups were not significantly different（Ρ>0.05）,while after 3-mon intervention,diet and exercise behaviors in motivational interviewing group were significantly improved with weight loss,decreased serum TG and TC and body mass index significant（Ρ<0.05）. Conclusion Motivational interviewing can effectively change the diet and exercise behaviors in patients with non-alcoholic fatty liver disease and improve their hyperlipidemia.

Objective To observe the clinical efficacy of Dangfei Liganning combined with lecithin for treating patients with non-alcoholic steatohepatitis（NASH）. Methods 116 patients with NASH were randomly divided into three groups. The combination therapy group（n=45）was treated with Dangfei Liganning and lecithin tablets,and the Dangfei Liganning group （n=38）and lecithin group （n=33）were treated with Dangfei Liganning and lecithin tablets orally,respectively. The regimen lasted for three months.Before and after treatment,clinical data including main symptoms,hepatic function parameters,blood cholesterol and fatty liver image under B ultrasound in the three groups were monitored respectively. Results The rates of symptoms alleviation such as fatigue,anorexia,abdominal discomfort in the combination therapy group were higher than in the lecithin group（x²=3.94,x²=10.63,x²=8.54,P<0.05 or P<0.01）. Fatigue improvement was better in the Dangfei Liganning group than in the lecithin group（x²=3.97 or P<0.05）;The levels of AST and ALT were declined obviously in the combination therapy group and Dangfei Liganning group than in the lecithin group after treatment（P<0.05 or P<0.01）. AST,ALT,TG,TC were also lower in the combination therapy group than in the Dangfei Liganning group （P<0.05 or P<0.01）;Fatty liver under B ultrasound in the combination therapy group and lecithin group were obviously improved after treatment（P<0.05 or P<0.01）; Some patients had abdominal distension,nausea,anorexia and other gastrointestinal reactions after taking Dangfei Liganning. Conclusion Dangfei Liganning combined with lecithin has good clinical efficacy and security for the treatment of patients with NASH.

Objective To investigate the effect of microecological products capsule containing bacillus subtilis and enterococcus（Medilac-S） on the alteration of intestinal permeability and levels of serum endotoxin in patients with nonalcoholic steatohepatitis（NASH）. Methods Thirty healthy adults and sixty patients with NASH were included in this study.Their serum endotoxin,diamine oxidase, D-lactate and ALT levels were measured respectively.The patients with NASH were treated with Medilac-S for 4 weeks. Results Compared with control,the serum endotoxin,diamine oxidase,and D-lactate levels in patients with NASH increased [143.60±21.41EU/l vs 109.78±17.81EU/l（t=7.71,P<0.01）;2.6±0.47U/ml vs 2.3±0.48U/ml（t=2.24,P<0.05）; and 6.1±1.05mg/l vs 5.3±0.97mg/l（t=4.89,P<0.01）,respectively];after four week treatment with Medilac-S,the serum endotoxin,diamine oxidase,D-lactate and ALT levels decreased remarkably. Conclusions Medilac-S could effectively decrease intestinal permeability and levels of serum endotoxin and ALT in patients with NASH.

Objective To study the effect of traditional Chinese medicine Gan-fu-kang（GFK）on hepatic expression of integrinα5β1/ focal adhesion kinase（FAK） in carbon tetrachloride-induced liver fibrosis in rats. Methods SD rats were randomly divided into control,model,low,middle and high dose of GFK treatment groups. Liver fibrosis models of rats were made by subcutaneously injecting with 10%CCl₄. GFK was orally given daily with GFK from week 9 to 20. The expression of integrinα5 and integrinβ1 protein and FAK mRNA were detected by immunohistochemical and RT-PCR techniques,respectively. Results The level of integrinα5 expression in model group（0.50±0.01）was obviously increased as compared with that in control group（0.23±0.13,P<0.01）,and it was obviously downregulated in high,middle and low dose of GFK treatment groups respectively （0.35±0.03,0.33±0.01,0.38±0.02）as compared with model group（P<0.01）; Similarly,the level of integrinβ1 expression in model group（0.44±0.02） was obviously increased as compared with that in control group（0.27±0.01,P<0.01）,and it was decreased in high,middle and low dose of GFK treatment groups respectively（0.37±0.01,0.34±0.01,0.39±0.01） as compared with model group（P<0.01）;At the same time,FAK mRNA level in model group（0.73±0.01）was obviously higher than that in control group（0.11±0.02,P<0.01）,while it was lower in high,middle and low dose of GFK treatment groups respectively（0.33±0.03,0.28±0.01,0.18±0.01）than that in model group（P<0.01）.Conclusion The activated integrinα5β1/FAK signal pathway may play an important role in liver fibrosis,and the therapeutic mechanisms of Gan-fu-kang on hepatic fibrosis may be related to the inhibition of this signal pathway.

Objective To investigate the mechanisms by which Gan-fu-kang inhibiting Raf/ERK signal transduction pathway in rats with hepatic fibrosis. Methods The rats with liver fibrosi were made by subcutaneously injecting with 10%CCl4 and treated with Gan-fu-kang. Expression of Raf,ERK and collagen Ⅲ mRNA were detected by RT-PCR. The ERK expression in liver tissues were detected by immunohistochemistry staining. Results The levels of Raf,ERK and collagen Ⅲ mRNA in model group increased than in control group（P<0.01）;In the immunohistochemistry staining, the expression of ERK protein in model group was obviously elevated than in Gan-fu-kang treatment group. Conclusion Ganfukang has effective treatment on liver fibrosis and its treatment mechanisms probably involved in ERK-induced signal transduction pathway.

Objective To investigate the influence of Gan-fu-kang on hepatic PDGF expression in rats with hepatic fibrosis. Methods The rats with liver fibrosis were made by subcutaneously injection of 10%CCl₄ and treated with Gan-fu-kang,a herbal medicine. Serum albumin,globulin,ALT and AST were measured. The PDGF expression in liver tissues were detected by immunohistochemistry staining. The collagenⅠmRNA were detected by RT-PCR. Results Compared with in model group,the levels of serum ALT,AST and globulin decreased,and albumin and the ratio of albumin to globulin increased （P<0.01） in Gan-fu-kang treatment group; the expression of PDGF in liver tissues in model group was obviously elevated than in Gan-fu-kang treatment group（P<0.01）. the collagenⅠmRNA level in model group increased than in control group and in treatment group（P<0.01）. Conclusion Gan-fu-kang has some effects on liver fibrosis by decreasing PDGF expression and inhibiting collagenⅠsynthesis.

Objective The virtual touch tissue quantification（VTQ） technique was used to measure spleen shear wave velocity（SWV） for the evaluation of liver fibrosis in patients with chronic hepatitis B. Method 51 patients with chronic hepatitis B,39 with liver cirrhosis and 32 healthy persons were included and their values of SWV in regions of interest of spleen were performed by VTQ technique. Result The values of SWV were 2.0±0.2,2.3±0.4 and 3.1±0.5,respectively in healthy persons,patients with hepatitis B and liver cirrhosis,and they were significantly different among the three groups（P=0.000）;The SWV values increased as the severity of liver fibrosis progressed. Conclusion The VTQ technique could quantitatively reflect the SWV values and noninvasively evaluate the spleen stiffness,which might be an alternative assessment of liver fibrosis in patients with hepatitis B.

Objective To explore the value of contrast-enhanced ultrasonography in diagnosis of liver fibrosis in patients with chronic hepatitis B. Method 80 patients with chronic hepatitis B and 10 healthy persons were recruited in this study. The ultrasound contrast agent,SonoVue,was injected through cubital vein,then the hepatic artery arrival time（HAAT）,portal vein arrival time（PVAT） and hepatic vein arrival time（HVAT） were recorded,and the interval time between hepatic artery arrival time and hepatic vein arrival time（HAVTT） was calculated. Result HVAT and HAVTT shorten in hepatic fibirosis S₃ and S₄（P<0.05）;the areas under ROC curve of HVAT and HAVTT were 0.87 and 0.89,respectively,for the diagnosis of hepatic fibrosis S₄（P<0.01）;When HVAT≤21s as the cut-off value for diagnosis of hepatic fibrosis S₄,the sensitivity was 88%,the specificity was 95%;when HAVTT≤10s as the cut-off value for diagnosis of hepatic fibrosis S₄,the sensitivity was 90%,the specificity was 97%. Conclusion Contrast-enhanced ultrasonography has some value in diagnosis of obvious hepatic fibrosis,but it might skip over some mild hepatic fibrosis in patients with chronic hepatitis B.

Objective To investigate the relationship of HBV genotype to liver biopsy and the antiviral therapy of nucleoside analogs. Methods We collected 541 patients with chronic hepatitis B virus infection. The patients were divided into 4 groups at random,e.g. lamivudine（n=136）,telbivudine（n=135）,entecavir（n=135）and adefovir（n=135cases）. The treatment lasted for 48 weeks. The genotype of HBV were determined by PCR before therapy. We also checked the liver function, HBV DNA and HBV M. Moreover,we performed the liver biopsies in 109 cases. Results The genotype B of HBV was 94 cases（17.38%）,type C was 410 cases（75.79%）,the type B/C was 37 cases（6.84%）,and no other types of genotype had been detected;in HBV genotype B,G3 in liver tissues accounted for 37.3% and S3 for 13.0%,while in HBV genotype C,G3 accounted for 8.7% and S3 for 22.7%（P<0.05）;in patients treated with lamivudine,telbivudine or entecavir,the efficacy in genotype B was better than patients with genotype C and B/C infection （P<0.05）. when we used adefovir therapy,there was no statistical significance（P>0.05）between genotype B and genotype C or B/C infection. Conclusion HBV genotype has close relationship with liver lesions and the antiviral therapy of nucleosides.

Objective To evaluate the clinical effects of combination of peginterferon and ribavirin in the treatment of patients with chronic hepatitis C. Method 58 patients with chronic hepatitis C received a combination of Pagasys（180μg/week）and ribavirin（800~1200mg/d）for 48 weeks. Liver function and level of HCV RNA were determined at the 12th,24th and 48th week during the treatment. Result The early virological response （EVR）rates and sustained virological response（SVR）rates in patients with genotype 1 were 57.1% and 53.6%,but in genotype non-1 patients those were 76.7% and 80%,respectively（P<0.05）;the early virological responserate in patients with high serum HCV RNA level was 56.3%,much lower than 80.8%（P<0.05）in patients with low serum HCV RNA level. Conclusion The response to the combination treatment in patients with chronic hepatitis C is influenced by genotype and the serum level of HCV RNA.

Objective To investigate the effect of 5 fluorouracil on the biological characteristics of BEL-7402 and SMMC-7721 cell line. Methods The proliferation of the two cell lines with 5-FU treatment was detected by cell counting Kit-8;the cell cycle and the ratio of cells with positive expression of tumor stem cell surface markers,EpCAM,ABCG2 and ICAM-1 were detected by flow cytometry. Results The proliferation of the two cell lines at 10μg.ml^-1 5-FU treatment was obviously inhibited;the ratio of the rest phase cells（G0/G1 phase）in the experimental group was significantly higher than in the control group（P<0.05）. Meanwhile,the proportion of EpCAM,ABCG2 and ICAM-1 positive cells increased as compared to control group（P<0.05）. Conclusion Tumor stem cell population in BEL-7402 and SMMC-7721 cell line can escape from the killing effect of 5-FU,which might be a vital important cause of chemotherapy failure in clinic practice.