Objective The aims of this study is to determine whether berberine（BBR） has a protective effect on lipopolysaccharide（LPS）-induced intercellular high permeability in Caco-2 cells in vitro. Methods Caco-2 cells was incubated and divided into four groups,e.g. control（cultured in Dulbecco's modified eagle medium）,LPS（co-incubated with medium and 2 μg/ml of LPS,BBR （co-incubated with medium and 10μM BBR） and BBR/LPS group （co-incubated with medium,2μg/ml of LPS and 10μM BBR）. The morphological features of cell growth were observed under inverted microscope. Paracellular permeability was assessed by measuring transepithelial fluorescein permeability. Tight junction protein occludin and Toll-like receptors-4（TLR4） were detected by Western blotting. The expression of downstream signal molecule,MyD88,was detected by immunofluorescence. Results We observed that the intercellular junction were long and thin in control and BBR group, while a saw tooth fracture in intercellular junctions was found in LPS group and a coarse margin but without interruption was observed in BBR/LPS group;there were no significantly differences between control and BBR group as respect to fluorescein permeability （683.3±; 98.9 μg/ml vs. 849.0±; 89.7 μg/ml,respectively）,and the expression of occludin,TLR4 and MyD88 （P>; 0.05）;the fluorescein penetrating concentration （1886±; 176.0 μg/ml） was much higher,TLR4 expression increased,occludin expression decreased,and enhanced MyD88 fluorescence signal in cytoplasm was observed in LPS group as compared with in control group（P<; 0.05）;the fluorescein penetrating concentration（1071.0±; 65.9 μg/ml） and TLR4 expression decreased,occludin expression increased, and weakened MyD88 fluorescence signal in cytoplasm was observed in BBR/LPS group as compared with LPS group （P<; 0.05）. Conclusion Our findings suggest that BBR alleviates LPS-induced intercellular high permeability by weakening TLR4/MyD88 activity and increasing the expression of occludin.

Objective To investigate the effect of cytokine-induced apoptosis inhibitor 1 （CIAPIN1） gene on the proliferation of HepG2 cells and the mechanism involved. Method Recombinant lentiviral CIAPIN1 expression vector and CIAPIN1 silencing vector were constructed and used to infect HepG2 cells in vitro to obtain cells with stable high and low expression of CIAPIN1 gene. The experiment included four groups,e.g. CIAPIN1 overexpression,CIAPIN1 low expression,unrelated silent RNA（siRNA） interference,and blank control group. The CIAPIN1 mRNA and its protein,cell proliferation,cyclinD1,CDK4,cyclin E,CDK2,IKKβ,phosphorylated IKBα,p65 and phosphorylated p65 in each group were detected by RT-PCR, FCM and Western bloting. Results The proliferation of CIAPIN1 in low expression group was significantly inhibited,with the cell ratio of G0/G1 was much higher than that in CIAPIN1 high expression group [（73.2±2.5）% vs. （58.8 ±2.2）%,in siRNA interference group （62.4±1.8）%,or in the control group （63.2±2.6）%,P<0.05];the expression of cyclinD1,CDK4,cyclin E,CDK2 in CIAPIN1 overexpression group were much higher than those in other groups（P<0.05）;the relative expression of phosphorylated IKBα and phosphorylated p65 in CIAPIN1 overexpression group were （1.335±0.182） and（0.731±0.106）,respectively,both significantly higher than those in GIAPIN1 low expression group [（0.108±0.035） and （0.028±0.010）],in siRNA interference group [（0.251±0.082） and （0.318±0.058）],as well as in control group[（0.238±0.067） and（0.322±0.061）,P<0.05]. Conclusion CIAPIN1 can promote the proliferation of HepG2 cells, which may be related to the activation of NF-кB signaling pathway.

Objective To investigate the anti-fibrotic effects of cyperus rotundus polysaccharides and the changes of serum matrix metalloproteinase 2（MMP-2）,tissue metalloproteinase inhibitor-2（TIMP-2） and transforming growth factor-beta1（TGF-β1） in rats with bovine serum albumin（BSA）-induced hepatic fibrosis. Methods 60 Sprague-Dawley rats were randomly divided into normal control group, model group,colchicine group （0.1 mg·kg^-1）,large dose of polysaccharide group （200 mg·kg^-1）,middle dosage group （100 mg·kg^-1） and low-dose polysaccharide group （50 mg·kg^-1）. The rats were intragastrically given cyperus rotundus polysaccharide, colchicine or normal saline for 60 days. After the last administration,the blood was obtained by through abdominal aorta, sera were collected and the liver tissues were taken. Serum levels of MMP-2,TIMP-2 and TGF-β1 were measured by ELISA and the pathological changes of liver tissues were observed in each group. Results Serum levels of ALT,AST,TP and ALB in large dose group,middle dose group and low dose group were significantly decreased（P<0.05）,and serum levels of LN,HA,PC-Ⅲ and Ⅳ-C were significantly reduced as compared with in the model group （P<0.05）;serum MMP-2 levels in the large,middle and low dose groups were （221.58±23.76） ng/mL,（291.12 ± 29.35） ng/mL,and（375.14±38.21） ng/mL,serum TIMP-2 levels were （161.89±16.12） μg/ml,（180.34±17.12） μg/ml,and （266.56±19.34） μg/ml,and serum levels of TGF-β1 were（206.23±21.45） ng/mL,（251.53±26.10） ng/mL,and（302.09±31.21） ng/mL,respectively,all being obviously improved as compared to those in the model group（P<0.05）;histopathological examination results showed that the liver fibrosis of the rats in the large,middle and low dose groups were significantly alleviated as compared with in the model group. Conclusion The cyperus rotundus polysaccharides has a good effect on hepatic fibrosis,and the mechanism by which it works might be related to the restored inbalance of serum MMP-2 and TIMP-2 and decreased TGF-β1 in rats with hepatic fibrosis.

Objective To investigate the protective effects of Shuanghuanglian,a herbal compound,in mice with murine hepatitis virus strain 3（MHV-3）-induced fulminant liver failure （FLF）. Methods 36 BABL/36 cJ mice were randomly divided into control,model and Shuanghuanglian-intervened group,and the model of FLF was established by intravenous injection of 1×10⁶ PFU/ml MHV-3. 10% of Shuanghuanglian compound or normal saline was given by gavage for 7 days after the model was successfully established. The chemokine IP-10 mRNA in liver tissues and serum MHV-3 DNA loads were quantitatively assayed by RT-PCR,and serum transforming growth factor beta 1（TGF- beta 1）,interleukin-10 （IL-10）,laminin（LN）,hyaluronic acid （HA） and liver function index were detected routinely. Results Serum ALT levels in the model and Shuanghuanglian-intervened group at end of 7 days were （229.03±30.56） U/L and （22.83±6.02） IU/L,AST were （139.01±11.75） U/L and （32.45±4.59） U/L. LN were （99.86±10.57） nmol/L and （57.02±7.24） nmol/L, HA were （117.05±16.72） nmol/L and （53.01±11.35）nmol/L,TGF-beta l were （319.46±39.12） pg/ml and （93.87±11.20） pg/ml,IL-10 were （25.70±3.87） pg/ml and（1.07±0.09） pg/ml,MHV-3 DNA were（12.47±3.05） lg copies/mL and（1.24±0.10） lg copies/mL,and IP-10 mRNA in liver tissues were[（25.70±3.87）and（12.79±3.08）,P<0.05]. Conclusion Shuanghuanglian,a herbal compound,has a certain effect of anti MHV-3 virus,and the mechanism by which it works might be through inhibiting the expression of IP-10 mRNA,reducing the inflammatory damage of IL-10 to the hepatocytes,preventing liver fibrosis and promoting the recovery of liver functions.

Objective To study the impact of nucleos（t）ide analogues on estimated glomerular filtration rate（eGFR） in patients with chronic hepatitis B. Methods A retrospective study of 40 patients treated with tenofovir （TDF）,56 patients with telbivudine （LDT） and 68 patients with entecavir （ETV） were conducted in this study,and all CHB patients were naive,and the eGFR was evaluated by using the Cooperative Formula for Chronic Kidney Disease Epidemiology（CKD-EPI） equation. Results The eGFR in ETV-treated and TDF-treated group at the end of 24 month treatment were （89.5±13.2） ml·min^-1·1.73 m^-2 and （93.8±13.2） ml·min^-1·1.73 m^-2, both significantly lower than those at baseline【（93.4±9.8） ml·min^-1·1.73 m^-2,P=0.041 and （98.6±11.2） ml·min^-1·1.73 m^-2,respectively,P=0.016】,while the eGFR in LDT-treated group was（108.5±10.9） ml·min^-1·1.73 m^-2, significantly higher than that at baseline 【（96.6±10.3） ml·min^-1·1.73 m^-2,P=0.002】;the eGFR in 3 groups at baseline was not statistically significantly different（P=0.870）,while they were statistically significantly different in the three groups as respect to the proportion of eGFR less than 90 ml·min^-1·1.73 m^-2（P=0.028）;at the end of 24 month treatment,16.7% （3/18） in ETV-treated, and 44.4% （4/9） in TDF-treated groups with normal renal function at baseline progressed to eGFR <90 ml·min^-1·1.73 m^-2,while 69.2% （9/13） of LDT-treated patients with renal impairment at baseline got renal function returned to normal （≥90 ml·min^-1·1.73 m^-2）. Conclusion The long-term application of LDT might have a protective effect on renal function, whereas the administration of TDF and ETV might result in decreased of eGFR.

Objective To investigate the clinical efficacy of combination of adefovir or entecavir and diammonium glycyrrhizinate in the treatment of patients with chronic hepatitis B （CHB）. Methods A total of 200 patients with CHB were recruited in our hospital between February 2013 and January 2016,and were randomly divided into control group （n=80） receiving diammonium glycyrrhizinate orally,or combination of adefovir （n=60） or entecavir and diammonium glycyrrhizinate（n=60） therapy for 12 months. The negative conversion rate of hepatitis B virus deoxyribonucleic acid （HBV DNA） and hepatitis B e antigen（HBeAg）,normalization rate of serum alanine aminotransferase（ALT）],and histological activity index（HAI） were compared among the three groups. Results There was no significant differences as respect to serum ALT,bilirubin and AST levels among the three groups before treatment（P>0.05）;At the end of 12 month treatment,the negative conversion rates of serum HBV DNA,negative conversion rates of serum HBeAg and normalization rates of ALT in the adefovir-treated group were 91.7%,18.3% and 86.7%,and were 88.3%,16.7%and 85.0% in entecavir-treated group,both significantly higher than 15.0%,6.3% and 51.3% in the diammonium glycyrrhizinate alone treated group （P<0.05 or P<0.01）;the HAI scores,ALT,TBIL and AST levels in the adefovir-treated group were（3.5±1.3）,（54.1±12.2） U/L,（16.4±4.1） μmol/L and （35.3±6.1） U/L,and were （3.2±1.5）,（53.4±13.0） U/L,（16.0±4.1）μmol/L and （34.1±6.3）U/L in the entecavir-treated group,significantly lower except TBIL and AST than （6.3±1.5）,（59.3±15.7） U/L,（18.0±4.5） μmol/L and（38.4±7.1） U/L in the diammonium glycyrrhizinate alone treated group（P<0.05）;there were no significant differences as respect to the above indexes between adefovir-treated and entecavir-treated groups （P>0.05）. Conclusion Combination of adefovir or entecavir and diammonium glycyrrhizinate in the treatment of patients with CHB is efficient,as the regimen might take an advantages in inhibiting replication of hepatitis B virus and alleviating the activity of inflammation in liver tissues.

Objective To investigate the efficacy of serum HBsAg by two quantitative methods in predicting liver histopathological grading and staging in patients with chronic hepatitis B. Methods 132 HBeAg-positive and 115 HBeAg-negative patients with chronic hepatitis B,who had underwent liver biopsy,were enrolled in the present study. Liver histopathological diagnosis was made with reference to the Scheuer scoring system and serum HBsAg levels were detected by Maccura IS1200 （HBsAg-IS1200） and by Architect I2000 （HBsAg-I2000）. Results In both HBeAg-positive and HBeAg-negative patients,HBsAg-IS1200 was significantly positively correlated with HBsAg-I2000（r=0.937,P<0.0001 and r=0.964,P<0.0001）,and had a close linear correlation with HBsAg-I2000（F=935.970,P<0.0001 and F=1496.884,P<0.0001）;according to ROC curve analyses,both HBsAg-IS1200 and HBsAg-I2000 had significant predictive values for pathologic grade ≥G2,≥G3 and stage ≥2,≥S3,≥S4（P<0.005） in HBeAg-positive patients,and both HBsAg-IS1200 and HBsAg-I2000 had no significant predictive values for pathologic grade ≥G2,≥G3 and stage ≥2,≥S3,≥S4（P>0.05） in HBeAg-negative patients; there were no significant differences in all the areas under ROC curves between HBsAg-IS1200 and HBsAg-I2000 in predicting pathological grade ≥G2,≥G3 and stage ≥2,≥S3,≥S4（P>0.05） in both HBeAg-positive and HBeAg-negative patients, with reference to the optimal cut-off value based on the maximum Youden indexes,the results between HBsAg-IS1200 and HBsAg-I2000 in predicting the liver pathological grade ≥G2,≥G3 and stage ≥S2,≥S3,≥S4 had high or very high consistency （Kappa=0.7243,Kappa=0.6967 and Kappa=0.8438,Kappa=0.8308,Kappa=0.7097） in HBeAg-positive patients. Conclusion HBsAg-IS1200 is highly consistent with HBsAg-I2000 in predicting liver histopathological grading and staging in patients with chronic hepatitis B.

Objective To compare the efficacy of peginterferon α-2a and interferon α-2b combined with ribavirin in treatment of patients with chronic hepatitis C. Methods 116 chronic hepatitis C patients were selected in our hospital between May 2010 and August 2014. The patients were randomly divided into observation group and control group,with 58 cases in each group. The patients in control group were treated with interferon α-2b combined with ribavirin and the patients in observation group were treated with peginterferon α-2a combined with ribavirin. Serum HCV RNA levels and virological response,and the gender,age,body mass index in the two groups were compared and analyzed. Results Serum HCV RNA negative rates were 51.72%,60.34%,72.41%,68.97%,65.52% in patients in observation group at 12 weeks,24 weeks,48 weeks and 12 and 24 weeks after discontinuation of the regimen,which were significantly higher than those in the control group（31.03%, 48.27%,55.17%,48.27%,41.38%,respectively,P<0.05）;the RVR,EVR,ETVR and SVR in the observation group were 75.86%,84.48%,86.20%,74.14%,significantly higher than those in the control group（51.72%,60.34%,63.79%,55.17%,P<0.05）;serum levels of HCV RNA in the observation group at 4 weeks,12 weeks,24 weeks and 48 weeks were（4.72±1.30） IU/ml,（4.09±1.21） IU/ml,（3.79±1.18） IU/ml,（3.26±1.08） IU/ml,which were significantly lower than those in the control group [（5.27±1.52） IU/ml,（4.68±1.41） IU/ml,（4.15±1.37） IU/ml,（3.99±1.16） IU/ml,P<0.05];the adverse events,including fever,insomnia,fatigue and leukopenia occurred during treatment in the two groups,and there was no significant differences between them （P>0.05）;serum HCV RNA levels at presentation in patients having SVR in the observation group was（3.57±0.45） IU/ml,significantly lower than that in those without SVR [（4.92±0.09） IU/ml,P<0.05]. Conclusion s Peginterferon α-2a combinded with ribavirin treatment could improve the efficacy in patients with chronic hepatitis C,and also have a good safety. This study hints that the regimen will get a good response in patients with low HCV RNA load at admission.

Objective To investigate the changes of serum β2-microglobulin（β2-MG） and cystatin C （CysC） in evaluation of renal deficiency in newborns with hyperbilirubinemia. Methods 128 newborns with hyperbilirubinemia between January 2014 and June 2016 in Department of Pediatry in our hospital were selected and 76 were found with mild jaundice （256.5 μmol/L>TBIL≥221 μmol/L） and 52 with moderate/severe jaundice （TBIL≥256.5 μmol/L）. 60 age-and gender-matched newborns were chosen as healthy controls. The levels of serum urea nitrogen（BUN）,creatinin （sCr）,CysC,β2-MG were detected,and the changes of TBIL,BUN,sCr, CysC,β2-MG in children before and after treatment were compared among them. Results Out of 128 newborns with hyperbilirubinemia,the renal deficiency was found in 25 cases,including 20 in moderate/severe jaundice group and 5 in mild jaundice group;serum levels of BUN,sCr,CysC and β2-MG in moderate/severe group were （5.76±1.45） mmol/L,（52.35±17.16） μmol/L,（2.68±0.45） mg/L,（4.25±1.52） mg/L,respectively,which were significantly higher than those in control group[（4.20±1.06） mmol/L,（38.65±14.23） μmol/L,（0.92±0.25） mg/L,（2.15±1.24） mg/L,all P<0.01] or those in mild icteric group[（4.58±1.23） mmol/L,（43.76±15.75） μmol/L,（1.76±0.37） mg/L,（3.48±1.40） mg/L,all P<0.01];serum levels of CysC and β2-MG in mild icteric group were （1.76±0.37） mg/L and （3.48±1.40） mg/L,which were significantly higher than those in control group [（0.92±0.2） mg/L and （2.15±1.24） mg/L,respectively,both P<0.01];there was no significant difference as respect to serum BUN or sCr between the control and mild icteric group（P>0.05）;after treatment,serum bilirubin,BUN,sCr,CysC and β2-MG levels in newborns with hyperbilirubinemia were（182.42±45.25） μmol/L,（4.32±1.25） mmol/L,（45.24±14.35） μmol/L,（1.86±0.38） mg/L,（3.42±1.36） mg/L respectively,significantly lower than those before treatment[（278.65±68.46） μmol/L,（5.35±1.30） mmol/L,（50.56±16.25） μmol/L,（2.25±0.41） mg/L,（3.96±1.45） mg/L,all P<0.01]. Conclusion Severe hyperbilirubinemia can induce renal damage in newborns,however,the damage can be recovered after timely treatment. Serum β2-MG and CysC can be acted as sensitive indicators for diagnosis of early renal dysfunction in newborns with hyperbilirubinemia.

Objective To assess the state of gut inflammation in patients with non-alcoholic fatty liver diseae （NAFLD） by using fecal calprotectin measurement. Methods In NAFLD patients and healthy persons,the fecal calprotectin levels were measured by enzyme-linked immunosorbent assay,and the demographic data and biochemical parameters were collected. Results Eighty-one NAFLD patients and 91 healthy subjects were recruited in this study. The body mass index（BMI） in the healthy controls and in the NAFLD patients were （22.6±2.4） kg/m² vs. （28.5±4.0） kg/m²,waist circumference were（80.9±7.9） cm vs. （91.6±9.5） cm,AST was （19.3±4.8） IU/L vs. （33.7±18.7） IU/L,ALT was （17.5±7.1） IU/L vs. （55.0±44.5） IU/L,TG was（0.9±0.3） mmol/L vs. （2.4±2.3） mmol/L,TC was（4.3±0.6） mmol/L vs. （5.1±1.3） mmol/L,all of the difference were statistically significant（P<0.05）;the fecal calprotectin levels in the patients with NAFLD was 43.0（18.8~87.0）μg/g,much higher than 11.4（4.6~24.4） μg/g in the control （P<0.001）;There were positive correlations between fecal calprotectin levels and BMI,waist circumference,TC and GGT（r=0.725,r=0.570,r=0.292,and r=0.400,respectively,all P<0.010）;Multivariate analysis demonstrated that a low level of HDL,and a high level of TG,BMI,and TC were independent risk factors for NAFLD（OR=0.011,OR=3.558,OR=1.821,OR=3.086,respectively,all P<0.01）. Conclusion Fecal calprotectin levles increases in NAFLD patients,which might reflect the inflammation state of the gut.

Objective To analyze the changes of serum platelet derived growth factor （PDGF） and folic acid in patients with hepatitis B-induced liver cirrhosis. Methods 110 patients with hepatitis B-induced liver cirrhosis with normal renal functions between January 2015 and December 2016 were included in this study. Patients were divided into three groups based on Child-Pugh class. Serum PDGF,folic acid,liver function index,liver fibrosis index were routinely determined. Correlation of serum PDGF and folic acid levels with liver function index, liver fibrosis index were determined by using Pearson correlation analysis. Results Serum PDGF level in 32 patients with Child-Pugh class C was （190.7±11.4） pg/ml,which was much higher than （128.5±8.1） pg/ml in 42 patients with Child-Pugh class B or（79.5±4.9） pg/ml in 36 patients with Child-Pugh class A（P﹤0.05）;serum folic acid levels in patients with Child-Pugh class C was（2.7±0.5） g/L,which was lower than（5.3±0.5）μg/L in patients with Child-Pugh class B or（7.1±0.8） μg/L in Child-Pugh class A（all P﹤0.05）;serum alanine aminotransferase （ALT）,total bilirubin （TBIL） level and INR in patients with Child-Pugh class C were （102.4±6.9） U/L,（60.7±5.8） μmol/L and （1.9±0.2）,respectively,which were much higher than [（78.9±4.5）U/L,（36.4±3.2） μmol/L and （1.5±0.2）,respectively] in patients with Child-Pugh class B or [（56.8±3.9） U/L,（26.8±2.8） μmol/L and （1.2±0.1）,respectively] in Child-Pugh class A （all P﹤0.05）;serum albumin level in patients with Child-Pugh class C was（23.9±2.4） g/L,which was lower than （30.8±2.7） g/L in patients with Child-Pugh class B or in Child-Pugh class A [（41.0±3.3） g/L,P﹤0.05];serum type Ⅲ procollagen （PCⅢ）,collagen Ⅳ（Ⅳ-C）,laminin（LN） and hyaluronidase（HA） levels in patients with Child-Pugh class C were（279.7±19.2） μg/L,（140.4±8.0） μg/L,（159.7±8.2） μg/L and（237.8±9.1）μg/L,which were much higher than[（238.5±17.8） μg/L,（94.8±6.2） μg/L,（129.5±7.3） μg/L and （174.1±8.6）μg/L] in patients with Child-Pugh class B or [（158.6±13.6） μg/L,（75.4±5.1） μg/L,（96.8±6.8） μg/L and （128.3±6.9）μg/L] in patients with Child-Pugh class A （all P﹤0.05）;serum PDGF levels was positively correlated with serum ALT,TBIL,INR and liver fibrosis index and negatively correlated with ALB（all P﹤0.05）;serum folic acid level was negatively correlated with serum ALT, TBIL,INR and liver fibrosis index and positively correlated with serum ALB level（all P﹤0.05）. Conclusion Serum PDGF levels increase and folic acid decrease as the liver function deteriorates,which warrants further study.

Objective To investigate the changes of peripheral blood T lymphocyte subsets and efficacy of ursodesoxycholic acid （UDCA） and vitamin D combination in treatment of patients with primary biliary cholangitis （PBC）. Methods A total of 92 patients with PBC were randomly divided into two groups in our hospital between January 2014 and December 2015. The patients in control group were treated with UDCA,while the patients in observation group with oral vitamin D and UDCA. The serum levels of 25-hydroxy vitamin D [25（OH）D],peripheral blood CD4⁺Treg and Th17 cells,and liver function index before and after treatment were obtained. Results Before treatment,the differences of all indexes between the two groups were not statistically significantly different （P>0.05）;At the end of one-year treatment,serum 25（OH）D levels and proportion of CD4⁺Treg cells in the observation group were significant higher（P<0.05）,while the proportion of Th17 cells,alanine aminotransferas （ALT）,aspartate transaminas （AST） level,alkaline phosphatas （ALP） level,and γ-glutamyltrans-ferase（GGT） levels were significantly lower than in the control group（P<0.05）；the proportion of CD4⁺Treg cells was significantly positively correlated with peripheral 25（OH）D and GGT levels（P<0.05）. Conclusion Vitamin D supplementation is beneficial for the treatment of PBC patients，which may be related to the activation of CD4+Treg cells.

Objective To investigate the efficacy of ultrasound-guided percutaneous microwave ablation and thymosin α-1 treatment in patients with primary liver cancer （PLC）. Methods A total of 104 patients with PLC were admitted to our hospital between March 2011 and March 2013 and they were randomly divided into observation group（n=52） and control group（n=52）. The patients in control group were treated with ultrasound-guided percutaneous microwave ablation,and the ones in observation group were given subcutaneously with thymosin-α1. Results At the end of 4 week treatment,the CD3⁺ and CD4⁺ cells and the ratio of CD4⁺/CD8⁺ were 71.49±6.57%,43.12±2.89% and 15.89±3.24,significantly higher than 43.21±3.74%,24.56±2.36% and 5.42±2.13 in the control（P<0.05）;the liver function index and serum alpha-fetoprotein levels in the observation group improved or decreased significantly than in the control（P<0.05）;the complication occurrence in the observation group was 7.7%,not statistically significantly different with 11.5% in the control（P>0.05）;all patients were followed-up for 3 years,and the recurrence and metastasis in the observation group were 30.8% and 15.4%,much lower than 50.0% and 32.7% in the control（P<0.05）;the 3 a survival rate in the observation group was 23.1% （12/52）,much higher than 5.8% （3/52,P<0.05） in the control group. Conclusion Ultrasound-guided percutaneous microwave ablation followed by thymosin-α1 injection in the treatment of patients with PLC is efficient, with lower recurrence and metastasis and prolongation of survival,which warrants further investigation.

Objective To compare the diagnosis of total tumor perfusion and maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma（HCC）. Methods Fifty-six patients with hepatocellular carcinoma between January 2013 and January 2016 were recruited in this study. The 320 row volume CT perfusion imaging was performed. The parameters of hepatic perfusion were calculated, including hepatic artery perfusion （HAP）,portal vein perfusion （PVP） and hepatic perfusion index （HAPI）. The total tumor perfusion and the maximum diameter of tumors were applied to record the parameters of tumoral, peritumoral and normal liver tissues. Results The HAP and HAPI of tumors were much higher,while the PVP of tumors were much lower than those in peritumoral or normal liver tissue by both measurements （P<0.05）;there was no significant difference between parameters of tumors by both measurements（P>0.05）,and there was also no significant difference between parameters by two doctors who measure the parameters （P>0.05）. Conclusion The total tumor perfusion or maximum diameter measurement in assessing CT scan imaging in patients with hepatocellular carcinoma is good,but the latter might be convenient and simple.

Objective To investigate the levels of hepatic miRNA-155 in prognosis of patients with hepatocellular carcinoma （HCC）. Methods Cancerous tissues in 50 patients with HCC and 50 normal liver tissue samples in our hospital between January 2013 and May 2014 were obtained. The miRNA levels in cancerous and liver tissues were detected by RT-PCR,and the relationship between miRNA-155 and prognosis was conducted. Results miRNA-155 in normal liver tissues （1.06±0.1） were lower than in HCC,and the miRNA-155 levels increased as HCC grading increased （P<0.05）;the survival rate （24.00%） in patients with low hepatic miRNA-155 level was significantly higher than that in with high miRNA-155 level （9.24%,P<0.05）;the survival in patients was significantly different between different HCC classification（14.26% vs. 9.02%）,tumor size（15.68% vs. 10.02%）,tumor metastasis（8.20% vs. 14.46%）,venous invasion（9.36% vs. 14.36%）,tumor differentiation （15.20% vs. 7.84%） and different levels of miRNA-155（7.86% vs. 16.32%,P<0.05）;the tumor size （>5 cm,HR=1.46,P=0.038）,tumor metastasis（HR=1.72,P=0.026）,venous invasion（HR=1.46,P<0.001）,tumor classification （HR=1.33,P=0.012） and miRNA-155 levels （HR=1.65,P<0.001） were the independent risk factors for poor prognosis（P<0.05） in patients with HCC. Conclusion miRNA-155 levels in liver cancer tissues is obviously higher than in normal liver tissues,and the high miRNA-155 levels is independent risk factor in patients with HCC.

Objective To investigate the effect of antiviral therapy with entecavir on HBV reactivation in serum HBV DNA negative hepatitis B virus infection-reduced patients with hepatocellular carcinoma （HCC） receiving transcatheter arterial chemoemholization（TACE）. Methods Forty-five patients with serum HBV DNA negative HBV-related HCC were randomly divided into observation group（n=23） and control group（n=22）. All patients in the two groups received TACE at base of conventional supporting treatment. Patients in observation group received entecavir before and after TACE. Serum HBV markers,HBV DNA and blood biochemical parameters were routinely assayed. The efficacy was evaluated by response evaluation criteria in solid tumors （RECIST） by world health organization. Results At the end of 24 w,serum HBV DNA in the observation group was still less than 2 lg IU/mL,while it increased to（4.10±2.86） lg IU/mL in the control group（P<0.05）;Serum HBV DNA positive rate in observation group was 8.7%,significantly lower than 36.4% in the control group（P<0.01）;The incidence of liver failure in observation group and control group were 0.0% and 22.7% respectively, without significant difference between the two groups（P>0.05）;At the end of 12 w,serum level of ALT in the observation group was （56.75±20.74） IU/L,significantly lower than （125.78±42.75） IU/L in the control group, and PTA was （48.65±8.26）%,significantly higher than （42.74±7.42）% in the control group （P<0.05）;At the end of 24 w,serum ALT level and Child-Pugh scores in observation group were （50.73±18.45） IU/L and（6.26±1.46）,respectively,significantly lower than （97.48±30.56） IU/L and（7.84±1.65） in the control group,and PTA was （52.45±9.10）%,significantly higher than （39.56±6.78） % in the control group （P<0.01）;There was no significant difference in clinical efficacy by RECIST between the two groups（P>0.05）;The 2-year survival rate in the observation group was 69.6%,significantly higher than 36.36% in the control group（P<0.05）,while there were no significant differences as respect to the 1-year survival rates between the two groups（P>0.05）. Conclusion Antiviral therapy with entecavir for serum HBV DNA negative HBV-related HCC patients can prevent the reactivation of hepatitis B virus, and improve liver function after TACE.

Objective To observe the efficacy of enticavir on long-term survival in patients with serum HBV DNA negative hepatitis B-induced primary liver cancer（PLC） after transcatheter arterial chemoembolization （TACE）. Methods 82 patients with advanced HBV-related PLC were recruited and divided into observation group and control group,with 41 cases in each group. The patients in control group was treated with TACE,and the patients in observation group was treated with entecavir for antiviral therapy after TACE. The Objective remission rate,disease control rate,serum liver function index after 48 weeks and 96 weeks,the progression-free survival （PFS） and overall survival （OS） at 2 years and 3 years,and serum HBV DNA positive rate during follow-up were compared between the two groups. Results The objective remission rates in observation group and in control group were 53.6% and 50.3%,respectively,and the disease control rates were 82.9% and 85.5%,respectively（P>0.05）;there were no significant differences as respect to serum levels of liver function index and serum fetoprotein between the two groups before and after the treatment （P>0.05）;the DFS rate and OS rate at 3-year were 61.0% and 73.2% in the observation group, much higher than those in the control group （36.6% and 51.2% respectively,P<0.05）;the positive rate of serum HBV DNA in the observation group was 2.4%,much lower than that in the control group（19.5%,P<0.05）. Conclusion The application of entecavir for antiviral treatment can improve the survival rate and avoid HBV DNA back to positivity,so that benefits the PLC patients with serum HBV DNA negative after TACE.

Objective To investigate the efficacy of different hepatic inflow occlusion in hepatectomy in treatment of patients with primary large liver cancer. Method 172 patients with primary large liver cancer in our hospital and in Second Hospital affiliated to Dalian Medical University between May 2014 and May 2016 were divided into three groups according to the different methods of blood flow occlusion during hepatectomy. 52 cases received portal occlusion,44 cases received hemihepatic occlusion,and 76 cases received combination occlusion. The relevant clinical parameters among the three groups were compared. Results There was no significant differences in baseline data among the three groups （P>0.05）;there was no significant differences in blocking time, operation time and hepatic resection volumes among the three groups（P>0.05）;the amounts of bleeding in portal occlusion group was（736.38±498.36） ml,much more excessive than[（472.56±111.89） ml in hemihepatic occlusion group or （356.14±132.53） ml in combination occlusion group,P<0.05],and the blood transfusion volumes in portal occlusion group was （586.54±132.58）ml,much more massive than [（427.95±210.47） ml in hemihepatic occlusion group or（184.38±72.54） ml in combination occlusion group,P<0.05];7 days after operations,serum ALT level in portal occlusion group was（73.02±43.41）U/L,much higher than[（55.89±40.82） U/L in hemihepatic occlusion group,or （52.01±33.81） U/L in combination occlusion group （P<0.05）;there was no significant differences as respect to complication rate among the three groups（P>0.05）;the 1 a survival rate in combination group was 96.1% and the tumor relapse rate was 2.6%,much lower than 75.0% and 15.4% in portal occlusion group or 68.2% and 20.5%,respectively,in hemihepatic occlusion group（P<0.05）. Conclusion The application of Pringle method combined with inferior vena cava occlusion in blocking hepatic blood flow during hepatectomy in treatment of patients with primary large liver cancer can effectively reduce the amount of intraoperative bleeding,improve recovery,and might increase survivals.

Hepatitis B virus （HBV） infection is popular worldwide. Chronic hepatitis B infection is the leading cause of liver cirrhosis and hepatocellular carcinoma, which is also one of the important public health problems. The occurrence of HBV-induced liver cirrhosis, disease progression, and prognosis are closely related to serum HBV DNA loads. Several studies have shown that effective inhibition of hepatitis B virus replication can improve, even reverse hepatic fibrosis, reduce the probability of long-term complications in patients with cirrhosis, improve prognosis and lower the occurrence of liver cirrhosis and hepatocellular carcinoma. Thus, effective antiviral treatments in patients with liver cirrhosis is particularly important. At present, the main antiviral agents are interferon-αand nucleos(t)ide analogues, and in recent years there are lots of progresses in terms of safety and scheme selection of them.

Stem cells have the ability to undergo self-renewal, proliferation and multi-lineage differentiation. As the most promising source of seed cells, the clinical applications of stem cells have become the focus of attention for years at home and abroad. There have been many reports about the applications of stem cells in treatment of liver diseases,which show the preliminary efficacy and safety. Stem cells therapies will emerge as a new treatment strategy for liver diseases. the progress about stem cells on the following aspects in this article was reviewed,such as the classification of stem cells,cell culture and transplantation,cell tracing in the body and the therapies for various liver diseases.

Nonalcoholic fatty liver disease （NAFLD） is the hepatic manifestation of obecity and metabolic syndrome （MS）. Recently, more and more studies have shown the NAFLD is closely related to the occurrence of colorectal cancer （CRC）. The insulin resistance and systemic low-grade inflammation in the process of NAFLD may be involved in the carcinogenesis of colorectal adenoma and CRC. However, the mechanism by which the NAFLD increase the risk of CRC is not fully understood. In this article, we reviews the possible mechanisms NAFLD increase the colorectal adenomas and CRC occurrence.