Objective To investigate the co-infection of hepatitis B virus,human immunodeficiency virus and treponema pallidum in patients with chronic hepatitis C. Methods HBV markers and anti-TP and preliminary screening of anti-HIV were detected by ELISA,and anti-HCV was detected by chemiluminescence,and western blot was applied to confirm the HIV infection. Results In 169 patients with HCV infection,25（14.8%） had HBsAg,4（2.4%） had anti-HIV,9（5.3%） had anti-TP,2（1.2%） had HBsAg and anti-TP,and 2（1.2%） had HBsAg and anti-HIV positive;The co-infection with HIV（6.7%） and TP（11.1%） in intravenous drug users were higher than those in patients without history of intravenous drug use（P<0.05）;The proportion of co-infection with HBV（19.7%） in male patients was higher than that in female patients（3.8%,P<0.01）;The proportion of co-infection with TP（11.5%） in female patients was higher than that in male patients（2.6%,P<0.05）;The patients older than 40 years were mainly co-infected with HBV （20.9%）,and the proportions of co-infection with HIV （3.9%） and TP （7.8%） increased significantly in the younger patients. Conclusions It is not uncommon in patients with chronic hepatitis C co-infected with other blood-borne pathogens.

Objectives To investigate the genotypes of hepatitis C virus in patients with chronic hepatitis C. Method The genotypes of hepatitis C virus was detected by gene chips and serum hepatitis C viral RNA was assayed by RT-PCR. Results Out of 570 sera,552（95%） were positive for HCV RNA,and 1b were positive in 400 （72.4%）,2a in 63（11.4%）,3a in 20（3.6%）,3b in 20 （3.6%）,1b+2a in 12 （2.1%）,1a in 2 （0.4%）,6 in 7（1.26%）,1b+3a in one（0.18%）,2a+1b in 3（0.5%）,and unknown in 24（4.3%）;Serum HCV RNA levels in patients with different hepatitis C viral genotype infection were not significantly different（P>0.05）. Conclusion The hepatitis C virus of genotype 1b dominated,and 2a in the second place in our series; Some mix infection with multiple genotypes needs further investigation.

Objective To investigate the efficacies of interferon alfa-1b and ribavirin in treatment of patients with chronic hepatitis C of different genotypes. Methods The genotypes of hepatitis C virus in 106 patients with hepatitis C were detected by genotype-specific probes. The patients with hepatitis C were treated with interferon alfa-1b and ribavirin for 48 weeks. Results Out of 106 patients with hepatitis C,the HCV genotype 3b accounted for 45.3%,1b for 20.8%,and 3a for 18.9%,while we still detected some 6a（9.4%）and 2a（5.7%） positive;Nine out of 22 patients with hepatitis C of 1b and other 82 with non-1b finished the regimen;the rapid virological response and early virological response in patient with non-1b were 50% and 86.6%,respectively;22.2%（2/9）of 1b infected patients got sustained virological response,while 76.8%（63/82）of non-1b got SVR。Conclusion Interferon alfa-1b and ribavirin regimen can be selected for hepatitis C patients with non-1b infection.

Objective To investigate the impact of infection route and age on responses to antiviral therapy in patients with chronic hepatitis C. Methods 113 patients with chronic hepatitis C were treated with pegylated interferon and ribavirin. The level of serum HCV RNA was measured with real-time quantitative reverse-transcription polymerase chain reaction and HCV genotypes were determined by core-envelope 1 region nucleotide sequencing followed by phylogenic analysis. Results The rate of sustained virological response （95.0%） in 20 patients with intravenous drug use was significantly higher than that in 54 patients with iatrogenic infection （75.9%,P<0.05） and 39 with unknown infection route（69.2%,P<0.05）;the rate of sustained virological response （82.9%） in patients under 40 years old was significantly higher than that in patients older than 40 years （65.1%, P<0.05）;the patients with intravenous drug use was mainly infected with HCV genotype 3（45%） and genotype 6（50.0%）,and the proportion of HCV genotype 1b in patients with iatrogenic infection and those with unknown infection route were 51.9% and 43.6%,respectively;64.7% of patients younger than 40 and without drug use were infected by HCV genotypes non- 1（2,3-and 6-type）,while 64.3 % of patients older than 40 were infected by HCV genotype 1（P<0.05）. Conclusions The patient's age and infection route could be important factors for predicting response to antiviral therapy.

Objective To investigate the clinical and pathological features of HBeAg negative and positive chronic hepatitis B patients complicated with fatty liver. Methods In 120 patients with chronic hepatitis B（CHB）,the liver biopsy was conducted,and blood biochemical parameters and serum HBV DNA were tested respectively. Results Among 120 patients with CHB,68 were HBeAg positive（56.7%）,and 52 HBeAg negative （43.3%）. In patients with HBeAg positive,we found fatty liver disease in 11（16.2%）,much lower than 18（34.6%,P<0.05）in HBeAg negative patients;Serum triglyceride and γ-glutamyltranspeptidase levels in HBeAg positive patients with fatty liver disease were higher than in HBeAg positive patients without（P<0.05）;In patients with fatty liver disease,the average ages（36.2±14.6y-o）and hepatic fibrosis scores（2.6±0.8）in HBeAg negative were significantly higher than in HBeAg positive group（28.2±11.3y-o and 2.0±0.7,respectively,P<0.05）,while body mass index（20.1±5.1）,triglyceride（1.5±0.4mmol/L）and HBV DNA load（4.4±2.6 lgcopies/mL）were lower than in HBeAg positive（27.3±4.0,3.7±0.4 mmol/L,6.8±1.3 lgcopies/mL,respectively（P<0.05）. Conclusion The prevalence of fatty liver disease in HBeAg negative CHB patients is relatively higher,so they should be checked-up as early as possible.

Objective To characterize the dendrictic cell subsets in peripheral blood and liver tissues of patients with hepatitis B-related acute-on-chronic liver failure（ACHBLF）. Methods 11 patients with ACHBLF who had undergone liver transplantation,10 patients with chronic hepatitis B and 5 healthy persons were enrolled in this study,and their liver tissue samples and peripheral blood were collected. The proportion of myeloid DC（mDC）and plasmatoid DC（pDC）in peripheral blood mononuclear cells（PBMCs） and liver-infiltrating lymphocytes（LILs） were detected by flow cytometric analysis. The IFN- alpha,IL-12 and IL-10 levels in the supernatants by PBMCs and LILs were investigated by ELISA when they were stimulated with polyI:C or CpG2216,respectively. The prevalence of pDC and mDC in liver tissues were also assessed by immunohistochemical techniques. Results The number of intrahepatic pDCs was significantly higher than in peripheral blood in ACHBLF patients,but no difference was found between in mDC and PBMCs;The IFN-alpha and IL-12 levels were remarkably lower in LILs than in PBMCs,but IL-10 was higher when stimulated with DC-specific stimulator,polyI:C,CpG2216 and IL-3;The mDCs and pDCs were found to be infiltrated in the livers of ACHBLF patients as compared with CHB or healthy subjects. Conclusions The intrahepatic DC subsets preferentially produces IL-10,which might exert an important role in immune regulation in situ of livers of ALHBLF patients.

Objective To investigate the effect of compound embryonic bovine liver extract and adefovir dipivoxil treatment on patients with chronic hepatitis B. Methods 42 patients with choronic hepatitis B were divided randomly to two groups. Treatment group was treated with compound embryonic bovine liver extract tablets and adefovir dipivoxil tablets,and control group was treated with adefovir dipivoxil tablets. The regimen lasted for 48 weeks in the two groups. The liver inflammation activity grades and fibrosis stages and serum hyaluromic acid（HA） level before and after treatment in two groups were obtained. Results Grades of liver inflammation activity and stages of fibrosis decreased obviously in treatment group than in control group（P<0.05）. At the end of the therapy,serum HA level decreased significantly in treatment group（P<0.001）and there was no decrease in control group（P<0.001）. Conclusion Combined therapy of compound embryonic bovine liver extract tablets and adefovir dipivoxil tablets was better than adefovir dipivoxil tablets alone in patients with chronic hepatitis B.

Objective To analyze the therapeutic effects of 48-week entecavir treatment in patients with decompensated cirrhosis caused by hepatitis B virus（HBV）. Methods In this cohort study,98 patients with liver cirrhosis caused by HBV were divided into three groups randomly: entecavir（ETV） group （n=32）,lamivudine （LAM） group（n=42）,and control group（n=24）:conventional liver protection treatment. The course of treatment lasted 48 weeks. The virological and biochemical parameters,PT,hepatic fibrosis index and Child-Pugh scores were observed at different time points during treatment. Results The HBV DNA levels in entecavir group were significantly decreased. The negative rates of HBV DNA（<500 copies/ml） were correspondingly and significantly higher than those in lamivudine group and control group（P<0.05）. At week 24 and 48,the negative rates of hepatitis B e antigen（HBeAg） and the rates of HBeAg/anti-HBe sero-conversion in entecavir group were higher than those in control group（P<0.05）. ALT,AST,total bilirubin, hepatic fibrosis index and Child-Pugh scores were significantly improved in entecavir group and lamivudine group after treatment（P<0.05）. Conclusion Entecavir can rapidly and effectively inhibit HBV DNA replication and improve liver function,hepatic fibrosis index and Child-Pugh scores in patients with liver cirrhosis caused by HBV.

Objective To investigate the clinical features of portal hypertensive gastropathy（PHG）. Method The retrospective analysis was conducted in 77 patients with PHG. The Child-Pugh scores of liver function,the severity of esophagus varices（EV）,diameters of portal vein and splentic vein,and helicobacter pylori infection were evaluated. Results Out of 77 patients with PHG,the foci located in the fundic in 56（72.7%）;according to Tanoue classification,25 cases was grade I,35 cases was grade Ⅱand 17 was grade III;The extent of PHG was related to Child-Pugh scores of liver function,the degree of EV and diameter of portal vein or splentic vein（P<0.05）;However,HP infection was not different in different PHG patients（P>0.05）. Conclusion Child-Pugh scores,EV and diameter of portal vein or splentic vein are related to the extent of PHG.

Objective To investigate the implication of serum hepatitis B viral HBV DNA in patients with primary liver cancer. Methods 151 patients with primary liverc cancer,132 patients with chronic hepatitis B,and 140 patients with liver cirrhosis were enrolled and serum markers of hepatitis B virus and HBV DNA were detected by using chemiluminescence and fluorescenct quantitative polymerase chain reaction. Results The serum markers of hepatitis B virus in 147 patients（97.35%） with primary liver cancer were positive,and serum HBV DNA positive rate was 74.8%（113/151） with an average load of 5.6±1.1 lgcopies/ml;in 90 patients（59.60%）with serum HBsAg,anti-HBe and anti-HBc positive,the serum HBV DNA positive rate was 76.7% with the average load of 5.1±0.9 lgcopies/ml,while in 38 patients（25.2%） with HBsAg,HBeAg and anti-HBc positive,the serum HBV DNA positive rate was 100.0% with the average HBV DNA load of 6.4±0.9 lgcopies/ml. Conclusion Hepatitis B virus infection rate was high in liver cancer patients,and it might play an important role in the hepatocarcinogenesis.

Objective To compare the clinical effects of two different microwave antennas in the treatment of patients with hepatocellular carcinomas（HCCs）. Methods Under the guidance of ultrasonography,forty-three patients with HCC were ablated using the internally-cooled microwave antenna,and 17 patients with HCC were ablated using the non-internally cooded antenna. The therapeutic effects of the two antennas were compared. Results During therapeutic period,the complications（including local pain,the difficulty of drawing out the antenna,bleeding and skin burning） in the internally cooled antenna were fewer than those in the non-internally cooled antenna（P<0.05）;The coagulation necrosis by the internally-cooled antenna took a more round shape（P<0.01）,and the rate of carcinoma-remained in the ablation sites and 12-month recurrence in ablation by internally cooled antenna were obviously lower than in the non-internally cooled antenna（P<0.05）,while the rate of 12-month recurrence in liver in the two groups had no significant difference（P>0.05）. Conclusions Compared with the non-internally cooled microwave antenna,the internally cooled antenna boasts less complications and lower local recurrence for microwave ablation of HCCs.

Objective To investigate the feasibility of apparent diffusion coefficients（ADC） in diffusion weighted MR imaging in predicting response to chemotherapy in patients with hepatic metastatic tumors. Methods Forty-three consecutive patients with hepatic metastases from gastric and colorectal cancer,breast cancer and other tumors underwent MRI diffusion-weighted imaging（DWI） sequences before and 2 to 3 weeks following chemotherapy for assessing the ADC value of lesions. RECIST was utilized to evaluate the efficacy of the chemotherapy. Results A total of 68 lesions in the 43 patients were observed,and the sizes of hepatic metastases decreased in 30 ones（the respond group） and increased or did not change in 38 ones （the non-respond group） after chemotherapy. The mean ADC values of lesions were 1.22±0.39×10^-3 mm²/s in the respond group and 1.54±0.55×10^-3 mm²/s in the non-respond group（P=0.008）,respectively;After treatment,the ADC values increased to 1.43×10^-3 mm²/s（P=0.005） in the responders,whereas they decreased to 1.23×10^-3 mm²/s（P=0.13） in the non-responders;We supposed ADC equal to 1.50×10^-3 mm²/s as a threshold value for responders and non-responders,the positive predictive value,negative predictive value and accuracy were 94%,92% and 93%,respectively. Conclusion ADC value of diffusion weighted MR imaging was potential to be an imaging marker for predicting and assessing early chemotherapeutic responses of hepatic metastases.

Objective To investigate the protective effects of compound glycyrrhizin on hepatic injury induced by three-dimensional conformal radiotherapy（3DCRT） in patients with primary liver carcinoma（PLC）. Methods A total of 113 patients with advanced hepatocellular carcinoma were randomly divided into study group （n=62） and control group （n=51）. The patients in the two groups were treated with 3DCRT,and the dose was 2.6~3.2Gy each time with the total doses of 48~60Gy;and the patients in study group were also treated with injections of compound glycyrrhizin intravenously at dose of 60ml per day for 4 weeks,then the glycyrrhizin tablets were given orally for 2~3 months. Results The levels of ALT and AST after radiation in both groups were elevated as compared with that before radiation, but the elevated levels of ALT （51.6±12.6 U/L） and AST（48.3±14.4 U/L） in the study group were significantly lower than that in the control group（85.2±19.9 U/L and 73.8±17.8 U/L,respectively,P<0.01）,and the rate of radiation-induced liver disease（RILD） in the study group（4 cases,6.5%） was lower than that in the control group（10 cases,19.6%,P<0.05）. Conclusion Compound glycyrrhizin can prevent and improve the hepatic injury induced by 3DCRT in patients with PLC, and it also can reduce the rate of RILD occurrence.

Objective To investigate the changes of hepatic IL-9-secreting lymphocytes in MHV-3-induced fulminant hepatitis in mice for the analysis of involvement of IL-9 in the mechanisms of immune- mediated liver injury. Method MHV-3-induced fulminant hepatitis model was established in mice,and the percentage of hepatic IL-9-secreting T lymphocytes was determined by flow cytometry. Results The percentage of hepatic IL-9-producing CD4⁺T cells increased from 1.87±1.36% to 4.77±0.42% at 48h after viral inoculation（P<0.05）,while the percentage of hepatic CD4^-CD8^-（DN） T cells who also expressed IL-9 at 72h after infection was 7.83±3.30%,which was significantly higher than that at 24h（P<0.05）. Conclusion The increased expression of IL-9 from hepatic CD4⁺T and DNT lymphocytes may contribute to immune-mediated liver injury in MHV-3- induced fulminat hepatitis in mice.

Objective To investigate the changes of cell cycle,apoptosis and proliferation of hepatic stellate cells（HSC）-T6 by inhibition of connective tissue growth factor（CTGF）by siRNA in vitro. Methods Recombinant lentiviruses containing siRNA targeted to GTGF were constructed and we let it infected HSC-T6 cells. Cell cycles and apoptosis were detected by flow cytometry with PI staining. Cell proliferation was measured by MTT. Results Suppression of GTGF induced the apoptosis of and reduced the proliferation of HSC-T6 cells; The percentage of apoptosis cells was 17.58 ± 5.81%,which was significantly higher than in blank control （5.12 ± 1.21%）and in negative control（1.37 ± 0.31%）;The frequency of S cells was remarkably increased（53.24± 4.47%）with CTGF gene silence as compared with that（44.80± 4.701%）in blank control and that（42.10± 1.40%）in negative control;Meanwhile,the percentage of G2-M cells（0.04± 0.07%）was significantly decreased as compared with that（9.03± 0.45%）in blank control and that （12.19± 5.62%） in negative control. However,the G0-G1 cells were not influenced by inhibition of CTGF. Conclusion Inhibition of GTGF promotes the apoptosis and decreases the activation and proliferation of HSC-T6 cells. CTGF gene silence may serve as a new target to treat the liver fibrosis.