Objective To investigate the anti-apoptosis effect of oridonin in mice with lipopolysaccharide （LPS）/D-galactosamine（D-Gal）-induced acute liver failure （ALF）. Methods 25 mice were randomly divided into five groups（5 in each）,e.g.,normal,model,oridonin-intervened and oridonin-intervened at different doses,and oridonin for 12 days. ALF model was established in C57BL/6 mice by intraperitoneal injection of LPS/D-Gal. TUNEL,real-time PCR and Western blot were applied to related detection. Results Hepatocyte apoptosis rate in mice in model group was （36.4±1.8）%,significantly higher than that in oridonin-intervened groups [（19.4±3.3）% and （11.4±0.3）%,respectively,P<0.01];administration of oridonin significantly decreased hepatic TNF-α mRNA level in model group （P<0.01）;the expressions of mitochondrial-dependent pro-apoptotic protein such as JNK,bax,cytochrome C,cleaved caspase8/9/3 were upregulated in the model group as compared to in the control group; Pretreatment with oridonin significantly reversed the changes of apoptosis signal pathway induced by LPS/D-Gal, the expression of caspase 8 was not significantly changed and the expression of anti-apoptotic protein bcl-xl increased. Conclusion Oridonin has an anti-apoptosis effect on LPS/D-Gal-induced ALF in mice,and its mechanism may be related to the suppression of pro-apoptotic cytokine TNF-α and JNK-related pro-apoptotic signaling.

Objective To study the expression and effect of silent mating type information regulation 2 homolog 3（SIRT3） in rats with nonalcoholic steatohepatitis（NASH） and evaluate the beneficial intervention of resveratrol on it. Methods The 60 rats were randomly divided into three groups（20 in each）,e.g. normal,NASH and resveratrol-intervened groups. At the end of 24th week,all the rats were sacrificed. Serum biochemical parameters and liver histological ultrastructural characteristics were observed. Reactive oxygen species（ROS） and superoxide dismutase（SOD） in the liver tissues were determined,and SIRT3 protein was assayed by immunohistochemical staining and Western blot. Results The liver index,serum ALT,AST,TG,TC,LDL-C and oxidative stress levels in model rats were significantly higher than those in the normal control（P<0.01）,and all those indicators in resveratrol-intervened group showed significantly lower than in the model group（P<0.01）;the nonalcoholic fatty liver disease activity score（NAS） in model group was （6.83±0.41）,significantly higher than that in the normal group [（0.24±0.08）,P<0.01],and in the treatment group was（3.27±0.29）,significantly lower than in the model group （P<0.01）;the Flameng semiquantitative score of hepatic mitochondria in the model group was （3.24±0.21）,significantly higher than that in the normal group [（0.17±0.03）,P<0.01],and in the treatment group was（1.39±0.12）,significantly lower than that in the model group（P<0.01）;immunohistochemical staining showed that SIRT3 protein appeared both in the cell nucleus and cytoplasm,and the Western blot quantitative detection of SIRT3 protein showed that it was（0.24±0.03） in the model group,significantly lower than that in the normal group[（0.58±0.02）,P<0.01],and in the treatment group was （0.46±0.03）,significantly higher than that in the model group （P<0.01）. Conclusion The SIRT3 expression is decreased in liver tissues of rats with NASH,and resveratrol intervention can improve the expression of the protein,which might alleviate NASH.

Objective To investigate the clinical efficacy of plasma exchange in treatment of patients with hepatitis E and hyperbilirubinemia. Methods 61 patients with hepatitis E and hyperbilirubinemia were recruited in this study between February 2011 and May 2016,and the patients were divided into two group,with 32 cases receiving conventional treatment and 29 cases receiving plasma exchange （PE） at the base of conventional therapy. The clinical symptoms and serum parameters were measured. Results At the end of four week treatment,the total efficient rate in the PE-treated group was 96.6%,much higher than 62.5% （P<0.05） in the control;serum bilirubin,alanine aminotrasferase and gamma glutamyl transferas levels in the PE group were（73.4±52.）μmol/L,（75.9±58.4） U/L and（48.6±19.0） U/L,much lower than in the control【（166.3±81.2.） μmol/L,（147.8±47.0） U/L and（150.8±68.5） U/L,respectively,P<0.05】;serum renal function tests in the two groups were not significantly changed;all patients completed the PE procedure and survived without death,while three patients in the control died;the side effect including 9 allergic reaction and one hypotension occurred during PE,and all disappeared with appropriate management. Conclusions PE can remarkably decrease blood bilirumin levels and improve clinical symptoms,which might give the chance for further intervention for patients with hepatitis E and hyperbilirubinemia.

Objective To investigate the curative effect of silybin meglumine combined with phosphatidylcholine in treatment of patients with alcoholic fatty liver （AFL）. Methods 164 patients with AFL were recruited in our hospital between October 2014 and October 2015. Patients were randomly divided into two groups, and 82 patients were treated with phosphatidylcholine as control group,and another 82 patients were treated with silybin meglumine combined with phosphatidylcholine as observation group. Indexes of blood lipid,liver function and imaging examination were compared before and after treatment between the two groups. Results At the end of three month treatment,serum total cholesterol,triglyceride,low density lipoprotein cholesterol,alanine aminotransferase,aspartate aminotransferase and glutamyltranspeptidase levels in observation group were（3.8±0.6） mmol/L,（1.3±0.2） mmol/L,（2.3±0.2） mmol/L,（47.3±7.2） U/L,（41.7±8.0） U/L and（46.5±7.3） U/L,respectively,significantly lower than those in the control group [（4.4±0.5） mmol/L,（1.5±0.2） mmol/L,（2.8±0.3） mmol/L,（58.1±12.4） U/L,（55.6±9.9） U/L and（67.8±10.1） U/L,respectively,P<0.01];serum high density lipoprotein cholesterol level in observation group was（1.3±0.2） mmol/L,which was significantly higher than that in the control group[（1.1±0.2） mmol/L,P<0.01];Imaging examination showed that the numbers of severe,moderate,mild fatty liver and normal liver manifestation in observation group were 1 case（1.2%）,11 cases （13.4%）,33 cases （40.2%） and 37 cases（45.1%）,respectively,significantly better than those in the control group [6 cases （7.3%）,19 cases （23.2%）,45 cases （54.9%） and 12 cases （14.6%）,respectively,P<0.01]. Conclusion Silybin meglumine combined with phosphatidylcholine can significantly improve blood lipid and liver function indexes in patients with AFL.

Objective To investigate the diagnostic value of serum TG/HDL-C ratio in patients with nonalcoholic fatty liver disease（NAFLD）. Methods 120 patients with NAFLD diagnosed by B-ultrasound examination in our hospital between January 2012 and May 2015 and 120 healthy persons with normal examination results in the same period were included in this study. Serum ALT,AST,triacylglyceride （TG）,HDL-C,TG/HDL-C ratio,GGT and liver/spleen CT ratio were compared between the two groups. Then NAFLD patients were divided into mild,moderate and severe fatty liver groups according to the liver/spleen CT ratio. Pearson correlation analysis was performed to get the correlation between TG,TG/HDL-C ratio,GGT and the degree of fatty liver disease. The ROC curve was used to analyze the diagnostic value of serum TG/HDL-C ratio in these patients. Results Serum ALT,AST,TG,TG/HDL-C ratio and GGT level in patients with NAFLD were（39.9±4.3） U/L,（39.5±3.8） U/L,（2.4±0.4） mmol/L,（3.2±0.6）,and （60.7±4.5） U/L,all significantly higher than those in the controls [（20.6±3.2） U/L,（18.0±2.9） U/L,（1.1±0.3） mmol/L,（0.9±0.4）,and （27.0±3.5） U/L,respectively,P<0.05];serum HDL-C and liver/spleen CT ratio in NAFLD patients were （0.9±0.2） mmol/L and（0.6±0.2）,much lower than those in the controls [（1.2±0.3） mmol/L and（0.9±0.1）,respectively,P<0.05];serum ALT,AST,TG,TG/HDL-C ratio and GGT level in 20 patients with severe fatty liver were （52.2±4.3） U/L,（51.8±4.0） U/L,（3.4±0.4） mmol/L,（4.8±0.5） and （77.5±3.9） U/L,all significantly higher than those in 49 patients with moderate [（45.9±4.1） U/L,（46.1±3.8） U/L,（2.8±0.3） mmol/L,（3.5±0.3）,（65.9±3.7） U/L] or 51 patients with mild fatty liver [（29.4±3.5）U/L,（28.3±3.2） U/L,（1.7±0.3） mmol/L,（1.5±0.2） and（49.2±3.4）U/L,respectively,P<0.05];serum HDL-C level in patients with severe fatty liver was （0.7±0.2） mmol/L,not significantly different as compared with that in moderate [（0.8±0.2） mmol/L] or with in mild group[（1.1±0.2） mmol/L,P>0.05];the CT liver/spleen ratio in patients with severe fatty liver was（0.4±0.1）,much lower than that in patients with moderate（0.6±0.1） or in with mild fatty liver[（0.8±0.1）,P<0.05];Pearson correlation analysis showed that there were negative correlations between serum TG,TG/HDL-C ratio,GGT levels and CT liver/spleen ratio,and there were positive correlations between serum TG,TG/HDL-C ratio,GGT level and serum ALT and AST levels;ROC curve showed that the AUC of TG/HDL-C ratio was 0.783,and when the cut-off value was 1.41,the diagnosis of NAFLD might exist. Conclusion Serum TG/HDL-C ratio might be an alternative for diagnosis of NAFLD in clinical practice.

Objective To investigate the pathological changes of liver tissues in patients with nonalcoholic fatty liver disease（NAFLD） and type 2 diabetes mellitus （T2DM）. Methods The clinical data of 240 patients with biopsy proven NAFLD were analyzed. Histopathology findings of livers were compared between patients with and without T2DM. Results Out of the 240 patients,there were 80（33.3%） patients with NAFLD and T2DM,and 160 （66.7%） patients with NAFLD without T2DM;Nonalcoholic steatohepatitis （NASH） and liver fibrosis were found in 60 and 20 patients with NAFLD and T2DM,while they were in 68 and 98 patients with NAFLD without T2DM;Patients with NAFLD and T2DM had higher rates of liver fibrosis score≥2（37.5%,n=30）,ballooning score≥2（28.8%,n=23） and Mallory body（27.5%,n=22） compared to patients with NAFLD without T2DM （12.5%,n=20;13.8%,n=22 and 18.8%,n=30,P<0.05）;T2DM was independently associated with NASH （OR = 3.27,95%CI:1.42-7.55） and advanced fibrosis（OR=3.35,95%CI:1.55-7.63） in all patients with NAFLD. Conclusion The liver pathological changes in patients with NAFLD and T2DM might be severe,which warrants more attention.

Objective To summarize the clinical characteristics of amiodarone-induced acute liver injury. Method 23 patients with acute liver injury after intravenous administration of amiodarone were selected in our hospital between February 2010 and February 2016. The underlying diseases,medical regimen,the use of amiodarone indications,combined medication,the time of liver damage,liver function recovery and outcome were recorded. Results After intravenous administration of amiodarone,2 cases （8.7%） showed liver damage in 8 h, 8 cases （34.8%） hade liver damage between 9~48 h,5 cases （8.7%） with 49~72 h,7 cases （30.4%） in 73~96 h,1 cases （4.3%） after 96 h;serum aspertate aminotransferase levels peaked up at 17468 U/L,with average of （3648±3889） U/L,alanine aminotransferase peaked up at 13437 U/L,with average of（3142±1846） U/L,and 15 cases（63.2%） had jaundice;19 patients recovered with liver function back to normal within 2~91 days,and the average time was（33.76±19.38） days after withdrawal of amiodarone and having an active treatment,1 patients died of cardiac shock,2 patients died of acute liver and kidney insufficiency and 1 patients died of hepatic encephalopathy. Conclusion The specific mechanism of liver damage by amiodarone is not yet clear,and we can not completely eliminate the effect of other medications on the liver function abnormal,but there is no doubt that amiodarone is an important factor causing liver damage.

Objective To investigate the prevalence of renal function insufficiency in patients with hepatitis B（HB） related cirrhosis and to explore the risk factors for renal insufficiency. Methods 289 patients with HB-related cirrhosis were recruited in our hospital between Jan.2015 and Dec. 2015. The renal function was evaluated by serum creatinine（sCr）,endogenous creatinine clearance （cCr） or the estimated glomerular filtration rate （eGFR） levels. The risk factors affecting renal function were screened by applying Logistic regression analysis. Results A total of 289 hospitalized patients with HB-related cirrhosis were enrolled,including 95 Child-Pugh class A,122 Child-Pugh class B and 72 Child-Pugh class C. The incidence of renal insufficiency assessed by eGFR as <90 ml·min^-1·1.73 m² was 20.76%,significantly higher than 3.81% assessed by sCr or 13.15% by cCr（P<0.05）;the incidence of renal insufficiency in Child-Pugh class C was 29.17%,significantly higher than 13.68% in Child-Pugh class A or 21.31% in Child-Pugh class B（P<0.05）;Univariate Logistic regression analysis showed that age,Child-Pugh classification,hyperuricemia and hyponatremia were related to the occurrence of renal insufficiency,while multivariate Logistic regression analysis identified age,hyperuricemia and hyponatremia as independent risk factors for renal insufficiency,in patients with hepatitis B-related cirrhosis（P<0.05）. Conclusion eGFR assessment might reflect the existence of renal insufficiency earlier than by sCr or cCr assessment. Development of renal insufficiency in patients with hepatitis B-related cirrhosis is associated with Child-Pugh scores,while age,hyperuricemia and hyponatremia are independent risk factors for the occurrence of renal injuries.

Objective To analyze the risk factors for gastric bleeding in patients with hepatitis B-induced liver cirrhosis and portal hypertensive gastropathy （PHG）. Methods 128 hepatitis B liver cirrhosis patients with PHG were retrospectively analyzed between January 2014 and December 2015. The incidence of gastric bleeding in each condition was compared. The multivariate Logistic regression analysis was performed to get independent risk factors when any significant statistical results were found. Results In 128 eligible patients with hepatitis B cirrhosis and PHG,49 patients（38.3%） had acute gastric bleeding;the prevalence of acute gastric bleeding in patients with and without underlying gastric diseases were 60.0% vs. 30.1%（P<0.05）,with and without Helicobacter pylori infection were 54.8% vs. 33.0% （P<0.05）,with and without ascites were 46.3% vs. 23.9% （P<0.05）,with Child-Pugh class C,class B and class A were 58.3%,41.5% and 15.4%（P<0.05）,with severe, moderate and mild esophageal varices（EV） were 51.8%,41.9% and 6.9%（P<0.05）,with and without regular antiviral therapy were 55.6% vs. 31.5% （P<0.05）,with portal vein diameter wider than and less than 14 mm were 48.3% vs. 30.0% （P<0.05）,with splenic vein diameter wider than and less than 9 mm were 48.4% vs. 28.8% （P<0.05）;Multivariate analysis showed that underlying gastric diseases,poor Child-Pugh classification, severe EV degree and wider portal vein diameter were the independent risk factors for acute gastric bleeding in patients with hepatitis B cirrhosis and PHG. Conclusion The patients with hepatitis B cirrhosis and PHG have a risk of gastrointestinal bleeding,and should be supervised for early prophylaxis and treatment.

Objective To analyze the risk factors for acute myocardial damage in patients with hepatitis B cirrhosis complicated by esophageal and gastric variceal bleeding. Methods Clinical data of 152 patients with hepatitis B cirrhosis and esophageal and gastric variceal bleeding between July 2010 and December 2015 were retrospectively analyzed. Acute myocardial damage were recorded. Independent risk factors were obtained by multivariate Logistic regression analysis. Results There were 65 patients （42.76%） having acute myocardial damage among the 152 patients with hepatitis B liver cirrhosis complicated by esophageal and gastric variceal bleeding;Univariate analysis showed that patients who were younger than 52 years,whose body mass index （BMI） less than 26 kg/m²,had liver function of Child-Pugh class A,had no hypertension,had no diabetes,had no history of heart disease,whose serum creatinine（sCr） levels being lower than 81 μmol/L and C-reactive protein （CRP） levels being lower than 16 mg/L,and blood potassium being lower than 3.7 mmol/L had lower incidence of acute myocardial damage as compared to those in the opposite ones（P<0.05 for all）;the multivariate logistic regression analysis revealed that age,liver function class,diabetes mellitus,heart disease history,sCr level,serum potassium and CRP levels were the independent risk factors for acute myocardial damage in patients with hepatitis B cirrhosis and esophageal and gastric variceal bleeding. Conclusion The incidence of acute myocardial damage in patients with hepatitis B cirrhosis and esophageal and gastric variceal bleeding is high,which must be taken into consideration in clinical practice.

Objective To explore the non-invasive predictors of esophageal varices in patients with primary biliary cirrhosis（PBC）. Methods A total of 122 hospitalized PBC patients were retrospectively analyzed in this study. The degree of esophageal varices was judged by endoscopy,and other examinations including routine blood biochemical tests and abdominal ultrasonic as well as computer tomography were conducted. Child-Pugh score,model for end stage liver disease （MELD） score and Mayo score were calculated. Logistic regression analysis was used to identify the predictors of esophageal varices in PBC patients. The best cut-off values were calculated based on receiver operating characteristic curves （ROC）. Results Out of 122 PBC patients,16（13.0%） were found without,while 106 （87.0%） with mild to severe degree of esophageal varices;Mayo score,albumin,cholinesterase,platelet count and the diameters of portal vein （PV） and splenic vein （SV） between the two groups were found with statistical difference in univariate analysis,but only the diameter of SV was found with statistical difference in the further multivariate analysis;When the cut-off value of SV was set as 8.5 millimeter,the area under ROC was 0.843 and the sensitivity,specificity,positive predictive value and negative predictive value were 72%,92.9%,98.6% and 31.7%,respectively. Conclusions The diameter of SV is the only predictor of esophageal varices in patients with PBC.

Objective To evaluate the clinical efficacy of ursodeoxycholic acid （UDCA） and prednisolone combination in the treatment of patients with primary biliary cirrhosis （PBC） and to investigate effective method of treating PBC. Methods 106 patients with PBC in our hospital between January 2010 and December 2015 were randomly divided into two groups. Fifty-three patients with PBC in the control group were treated with oral administration of ursodeoxycholic acid at dose of 13~15 mg·kg^-1·d^-1,and fifty- three patients with PBC in the observation group received oral prednisolone on the basis of UDCA at same dose as in the control group. At presentation and 3 months,6 months and 12 months after treatment,the clinical manifestations of the patients were observed and serum ALP,albumin,and bilirubin levels and serum IgM,IgG and IgA were measured routinely. Results The clinical symptoms improved both in the observation group and control group after treatment,and the patient's fatigue and skin itching significantly improved in the combination group;serum ALP,GGT and bilirubin levels in the two groups were significantly improved after treatment（P<0.05）,and the above indexes decreased rapidly in the two groups after 3 months,and the improvement in the observation group was significantly better than in the control group （P<0.05）;at 6 months and 12 months of treatment,the improvement in the two groups was not obviously different（P>0.05）;There was no significant difference in blood albumin levels between the two groups（P>0.05）;blood IgM levels in both groups significantly decreased after treatment（P<0.05）,and there was a significant difference between the observation group and the control group at 3 months（P<0.05）,while there was no significant difference as respect to blood IgM between the two groups at 6 months and 12 months（P>0.05）;There was no significant difference as respect to blood IgA and IgG levels between the two groups before and after treatment at any time point （P>0.05）. Conclusion The combination of UDCA and prednisolone can in the short term improve the clinical manifestation,the main biochemical indexes and decrease serum IgM levels in PBC patients,which needs further investigation.

Objective To explore the application of multi-b-value diffusion weighted imaging （DWI） sequence and apparent diffusion coefficient（ADC） combined with three-dimensional volumetric rapid liver multiphase dynamic enhancement technology（LAVA） in the differential diagnosis of benign and malignant liver tumors. Methods 80 patients with hepatic lesions（124 lesions） were examined by T1WI,T2WI routine scanning,and DWI （b=0,50,100,150,200,250,300,500,750 and 1000s / mm²,respectively）,and we found out 124 lesions out of these patients including hepatic angeioma in 17 （27 lesions） and hepatic cyst in 23（31 lesions）,as well as hepatic metastasis in 14（23 lesions） and hepatocellular carcinoma in 26 （43 lesions）. Results 31（72.1%） lesions of hepatocellular carcinoma showed“rapid in and rapid out” enhancement,19（82.6%） metastatic lesions showed strengthened annular edge,21（77.8%） hemangioma showed “filling style”enhancement,31 cystic lesions were without enhancement;the ADC10b,ADChigh and ADC3b in benign lesions were significantly higher,while the ADCperf in benign lesions was significantly lower than those in malignant tumors （P<0.05）;the detection of lesions by routine T1WI,T2WI and DWI scanning,or conventional T1WI,T2WI scanning and LAVA,or routine T1WI,T2WI scanning,DWI LAVA was 100%,but the accuracy was significant different（P<0.05）,e.g. the highest（92.7%） by routine T1WI,T2WI scanning,DWI LAVA,in the middle（83.9%） by conventional T1WI,T2WI scanning and LAVA,and the lowest（71.8%） by routine T1WI,T2WI and DWI scanning. Conclusion The ADC10b,ADChigh,ADC3b and ADCperf can distinguish benign and malignant lesions,LAVA can clearly show the characteristics of blood supply of liver lesions at different periods,and both DWI and LAVA technology can improve the diagnosis of hepatic lesions.

Objective To compare laparoscopic left hepatic resection（LLLR） and laparoscopic left hepatic resection （OLLR） in treatment of patients with left lateral lobe hepatocellular carcinoma （HCC）. Methods 94 patients with left lateral HCC in our hospital between April 2011 and June 2013 were recruited in this study,and they were randomly divided into control and observation group,with 47 cases in each group. The patients in control group received OLLR,and those in observation group were treated with LLLR. Serum ICAM-1,MMP-13 and IL-6 levels were detected by ELISA. All patients were followed-up for 3 years,and the survival rates at 1 year,2 years and 3 years after operation were recorded. Results The amount of bleeding in the observation group was （134.94±23.51） ml,significantly lower than in the control group [（290.18±30.76） ml,P<0.01],eating after operation was（2.29±0.51） d,significantly shorter than in the control group[（3.80±0.87） d,P<0.01], hospitalization stay was（7.43±2.39） d,significantly shorter than in the control group [（11.42±3.08） d,P<0.01]; serum ICAM-1 levels after operation in observation group was （8.08±2.13） ng/ml,significantly lower than in the control group [（3.27±2.60） ng/ml,P<0.01],MMP-13 was（113.65±21.92） ng/ml,significantly lower than in the control group [（171.02±27.85） ng/ml,P<0.01], PCT was （7.23±0.74） g/L,significantly lower than in the control group [（11.24±1.53） g/L,P<0.01],IL-6 was （11.49±2.78） pg/L, significantly lower than in the control group [（19.06±3.27） pg/L,P<0.01];serum IgA,IgM and IgG levels were significantly higher than in the control group （P<0.01）;the incidence of complica-tions in the observation group （12.8%） was signifi-cantly lower than in the control group （42.5%,P<0.05）;there was no significant difference as respect to the survival rates between the two groups in three year follow-up. Conclusion LLLR is an alternative approaches in the treatment of patients with left lateral lobe HCC,as it could significantly reduce the postoperative complications,inflammatory reactions and protect the immune functions with the similar long-term efficacy.

Objective The aim of this study is to compare the impact of interferon alpha and nucleos（t）ide analogues in treating patients with chronic hepatitis B on incidence of hepatocellular carcinoma. Methods A series of patients with chronic hepatitis B（CHB） aged 30 to 60 years old were enrolled between January 2007 and December 2010 in our hospital. 210 patients with CHB were treated with interferon alpha 2b（IFN-α2b） for 72 weeks, 222 with nucleos（t）ide analogues（NAs） as a long-term treatment and 136 cases didn’t received antiviral therapy. All the patients were followed-up for six years. All data were analyzed by SPSS 19.0 statistics software. Results At the end of 72 week treatment,serum HBeAg positivity rate in IFN-α2b-treated group was much lower than in NAs-treated or in non-antiviral group（P<0.05）,while serum HBV DNA and alanine aminotransferase levels in NAs-treated group were much lower than in IFN-α2b-treated group or in non-antiviral group（P<0.05）;serum chileglycine,collagen peptide Ⅲ,Ⅳ collagen,hyaluronic acid and laminin levels in IFN-α2b-or NAs-treated group were not significantly different（P>0.05）,while all were much lower than in non-antiviral group（P<0.05）;At the discontinuation of six year follow-up,the incidence of HCC in non-antiviral group was 16.91%（23/136）,much higher than 9.46%（21/222,x²=4.345,P=0.037） in NAs-treated or 0.0% （0/210,x²=38.044,P=0.000） in IFN-α2b-treated group,and the incidence of HCC in NAs-treated group was much higher than in IFN-α2b-treated group（x²=20.880,P=0.000）. Conclusions The efficacy of IFN-α2b therapy on HCC occurrence in patients with CHB is much stronger than NAs treatment.

Objective To study the non-chemotherapeutic factors influencing postoperative nausea and vomiting in patients with hepatocellular carcinoma（HCC） after transcatheter arterial chemoembolization （TACE）. Methods 360 patients with HCC were recruited in our hospital between 2014 and 2016,and we collected the patient’s gender,age,body mass index,right upper quadrant pain,tumor size,the metastasis,fever,abdominal distention,dose of iodized oil,and the Logistic regression analysis was used to analyze the influencing factors of postoperative nausea and vomiting in patients with HCC after TACE. Results According to degree of nausea language description,the grade 2 nausea was found in 58 cases （16.11%）,grade 1 nausea in 83 cases （23.06%）,and grade 0 nausea in 219 cases（60.83%） out of the 360 patients with HCC;the age was negatively correlated（r=-0.303,P<0.05）,while the right upper quadrant pain and abdominal distention were positively correlated to the degree of nausea and vomiting （r=0.299,r=0.497,P<0.05）;the longer the pain lasted, the more severe the nausea and vomiting（r=-0.203,P<0.05）;Logistic analysis showed that the elderly was a protected factor for the occurrence of nausea and vomiting in patients with HCC after TACE, while long time abdominal pain and distention were the independent factors for it; the results of the structural equation model showed that the abdominal pain and distention stimulated nausea and vomiting （β=0.39,β=0.69,P<0.01）,age promoted abdominal distention （β=0.02,P<0.01）,while age down-regulated abdominal pain （β=-0.02,P<0.01）. Conclusion There are a variety of factors including age,abdominal pain and abdominal distention involved in the occurrence of nausea and vomiting in patients with HCC after TACE, and the old age is a protective factor of postoperative nausea and vomiting,while the long time abdominal pain and abdominal distention are the risk factors for it.

Objective To explore the application of ultrasound contrast and micro blood flow imaging in differential diagnosis of atypical primary liver cancer （PLC） and focal nodular hyperplasia （FNH）. Methods 35 patients with atypical PLC and 40 with FNH were selected in our hospital between January 2014 and December 2015. All the patients underwent ultrasound contrast and micro blood flow imaging,and the features of PLC and FNH were analyzed and compared. Results The ultrasound contrast showed that the arrive time of contrast agent [（4.1±0.7） s] and the time to peak [（37.8±11.4） s] in the PLC group were significantly longer than those [（2.5±1.0） s and （24.2±9.5） s] in the FNH group,while the peak strength[（23.1±5.7） dB] was obviously lower than [（30.6±4.3） dB] in the FNH group（P<0.05）;As showed by the ultrasonogram of liver tumors in enhancement,there were 19 foci being with patchy enhancement and 16 with ring-enhancement in the PLC group,while in the FNH group,there were 29 foci being with annulare enhancement and 11 with eccentric enhancement in arterial phase,40 foci showing hyper-enhancement in portal phase,16 being with hyper-enhancement,22 with same enhancement and 3 with low-enhancement in delayed phase（P<0.05）;the results of micro blood flow imaging showed that the maximum artery blood flow velocity （Vmax） was[（64.7±3.3） v·cm^-1·s^-1] in patients with PLC, obviously lower than[（77.8±5.1） v·cm^-1·s^-1] in the FNH group,while the resistant index （RI） was [（0.70±0.05）],much higher than [（0.53±0.03）] in the FNH group （P<0.05）;There were 3 foci（8.6%） with blood signals of grade 1,19（54.3%） with that of grade 2 and 13（37.1%） with that of grade 3 in the PLC group,while there were 33 foci （82.5%） with blood signals of grade 0 and 7 （17.5%） with that of grade 1 in the FNH group （P<0.05）. Conclusion The ultrasound contrast and micro blood flow imaging could distinguish atypical PLC and FNH by the characteristics of time phase,contrast enhancement and the hemodynamic changes.

Objective To investigate the clinical effect of transcatheter hepatic arterial chemoembolization (TACE) combined with CT-guided precision microwave ablation on patients with primary liver cancer and its influence on immune founction. Methods 60 patients with primary liver cancer including 42 men and 18 women admitted to our hospital between January 2010 and December 2014,and they were divided into control and observation group with 30 cases in each group according to the hospitalization order. Patients in control group were treated with TACE,and in observation group received TACE combined with CT-guided precision microwave ablation. The clinical effect,2 annual survival rate,the relapse rates and the subsets of T-lymphocytes and serum alpha-L-fucosidase levels were compared between the two groups. Results At the end of three month therapy,the clinical effect in observation group was 83.3%（25/30）,significantly higher than 50%（15/30） in the control group （P<0.05）;the two annual survival rate in the observation group was 70.0%,much higher than 43.3% in the control group（P<0.05）;the relapse rate in the observation group was 10.0%, significantly lower than 36.7% in the control （P<0.05）;After therapy,the percentage of CD4⁺T-lymphocytes,CD8⁺T-lymphocytes, the ratio of CD4⁺/CD8⁺,serum alpha-L-fucosidase levels in the observation group was（39.05±4.07）%,（21.35±3.24）%,（1.67±0.21）,（17.91±2.98） u/L,markedly improved as compared to those in the control group[（28.63±3.61）%,（35.12±4.62）5,（0.96±0.11）,（26.03±4.75）u/L,respectively,P<0.05];Additionally,all patients appeared some mild reactions after TACE,such as backache,abdominal distension,nausea,etc,and they disappeared after symptomatic treatment and nursing. The adverse reactions between the two groups showed no statistically difference. Conclusion Transcatheter hepatic arterial chemoembolization combined with CT-guided precision microwave ablation have definite curative effect on patients with primary liver cancer,which could improve the survival rate,and decrease relapse rate.

Objective To evaluate the clinical efficacy of TACE and radiofrequency ablation（RFA） in treatment of patients with primary liver cancer（PLC）. Methods Sixty patients with PLC in the center of liver diseases in our hospital between April 2012 and March 2013 were randomly divided into two groups,with 30 cases in each group,and the patients were given RFA after TACE or TACE alone therapy. The short-and long-term clinical response were compared. Results There was no significant difference at baseline between the two groups as respect to gender,age,hepatitis B surface antigen positive,liver function index,α-fetoprotein （AFP）,tumor numbers and tumor diameters（P>0.05）;the complete and partial remission rates in the combination group（26.7% and 50.0%,respectively）were much higher than those（6.7% and 23.3%,respectively）in the TACE group （P<0.05）;the survival periods in the combination group（2.86±0.48 years）was much longer than that （0.93±0.27 years）in the TACE group（P<0.05）;serum AFP level at the end of first,second and third year after treatment in the combination group[（475.4±200.7） μg/L,（416.4±229.0） μg/L and （320.4±243.5） μg/L] were lower than those [（639.1±190.9） μg/L,（623.4±234.6） μg/L and（674.4±300.2 ）μg/L] in TACE group （P<0.05）;the 1 a,2 a and 3 a survival rates after treatment in the combination group（86.7%,66.7% and 56.7%） were significantly higher than those（46.7%,26.7% and 10.0%）in the TACE group（P<0.05）. Conclusion Combination of TACE and RFA has a remarkable clinical efficacy for patients with PLC,which is worthy of further investigation.

Objective To explore the application of indocyanine green （ICG） clearance test,single photon emission computed tomography （SPECT ） and three-dimensional resconstruction in patients with primary liver cancer before hemihepatectomy. Methods Clinical data of 50 patients with PLC who had underwent hemihepatectomy were collected and analyzed. Among them,twenty-six patients underwent preoperative evaluation of ICG clearance test,SPECT and three-dimensional reconstruction technique before operation as observation group,and twenty-four didn't get the evaluation as the control. The operative and postoperative indicators in the two groups were compared,and the differences of postoperative liver dysfunction and other complications were analyzed. Results The operative times in the observation and control were （134.2±40.7）min and（157.0±33.2）min,hospitalization days after operation were（12.2±4.7） d and（14.8±3.4） d,respectively,with the differences significantly different（P<0.05）,while the blood loss and tube drawing in the two groups were not significantly different（P>0.05）;the incidence of postoperative complications,such as bile leakage,ascites,pulmonary infection,infection of incisional wound and liver deficiency in the observation group was 19.2%,significantly lower than that in the control group（45.8%,P<0.05）. Conclusion The preoperative evaluation by ICG clearance test,SPECT and three-dimensional reconstruction is helpful in guiding hemihepatectomy in patients with PLC before operation.

Bacterial infection is a common complications in patients with liver cirrhosis. Once the patients with liver cirrhosis got bacterial infections,the disease might progress quickly to liver failure,multiple organ failure and the mortality was high,which might be due to latent onset,difficult early diagnosis and the growing spread of multi-resistant pathogens. In this reviews,we will take focus on the clinical types of infections, the consequences of infections,the changes of bacterial spectrum, and the strategies in diagnosis and the current treatment.