Objective To evaluate the cardiac functions in patients with liver cirrhosis and portal hypertension,and to analyze the risk factors affecting left ventricular diastolic dysfunctions. Methods A hundred and twenty-six patients with liver cirrhosis-induced portal hypertension were admitted to our Department of Gastroenterology. According to the Child-Pugh scores,these subjects were categorized into class A（n=76）,class B（n=41） and class C（n=9）,and based on the model for end-stage liver disease（MELD） scoring system,these subjects included MELD score≤9 points （n=64） and MELD score>9 points（n=62）. All patients received ultrasound,electrocardiogram and echocardiography （including pulse wave doppler and tissue doppler imaging）. The regression analysis was applied to find the relevant factors affecting diastolic dysfunctions. Results One patient（0.8%） was diagnosed with systolic dysfunction,and seventy-seven cases （61%） were diagnosed with diastolic dysfunctions. The abnormal electrocardiogram rate was 65%,and the extended propotion of corrected QT interval was 41%;There were no statistically significant differences between different Child-Pugh class or MELD groups as respect to above parameters;Age（OR=1.163,95% CI:1.086-1.244） and heart rate（OR=1.106,95% CI:1.018-1.201） were found to be the correlative risk factors affecting diastolic dysfunction by using Logistic regression analysis. Conclusion Cardiac function changes in patients with liver cirrhosis and portal hypertension mainly manifest in diastolic dysfunction and electrophysiological abnormalities,which have no relation with the severity of liver disease and massive ascites. As for the patients who are elderly and have an accelerated heart rates,we should focus on the necessity of diastolic function assessment because early diagnosis and intervention might improve the prognosis of these patients with liver cirrhosis.

Objective To investigate the efficacy of Fufangbiejia Ruanganpian,a herbal compound, and ursodeoxycholic acid（UDCA） combination in the treatment of patients with primary biliary cirrhosis （PBC）. Methods 64 patients with PBC were recruited in this study between September 2012 and September 2016,and they were randomly divided into two groups by computer-generated numbers. The patients in observation group received Fufangbiejia Ruanganpian,succinic acid adenosine methionine,and UDCA,and the patients in the control received all but the herbal compound medicines. Serum hyaluronic acid（HA）,laminin（LN）,procollagen Ⅲ N terminal peptide（PC-III） and type fore collagen（IV-C） levels were detected routinely and life quality was estimated by GQOL-74. Results At the end of observation,serum ALT,AST and TBIL levels in the combination group were（54.4±15.） U/L,（61.3±16.4） U/L and （23.7±9.5） μmol/L,significantly lower than （70.3±16.1） U/L,（75.5±16.5） U/L and（36.8±9.7） μmol/L in the control（P<0.05）;serum HA,LN,PC-III and IV-C levels were （116.9±12.5） μg/L,（103.4±11.4） μg/L,（123.6±22.8） μg/L and （80.4±9.8）μg/L,significantly lower than （156.5±12.7）μg/L,（126.9±11.2） μg/L,（155.5±22.4）μg/L and（97.6±9.9）μg/L in the control（P<0.05）;the physical function, psychological function,social function and material life scores were（78.9±8.6）,（80.8±7.5）,（89.7±9.7） and （83.7±9.3）, significantly higher than（69.7±8.3）,（71.9±7.6）,（79.7±9.5） and（75.2±9.2） in the control（P<0.05）. Conclusion The combination of the Chinese herbal compound and adenosine methionine as well as UDCA in treatment of patients with PBC is effective,which might improve the liver functions,reduce serum HA,LN,PC-III and IV-C levels,and improve the quality of life.

Objective To analyze the etiology and complications of patients with liver cirrhosis. Methods Retrospective analysis of etiology and complications of patients with liver cirrhosis was performed with data collected from 2007 to 2016 in the Department of Gastroenterology,Department of Infectious Disease,and Department of Hepatobiliary Surgery in our hospital. Results In total,the data of 2890 patients with liver cirrhosis were collected and analyzed. Among them,cirrhosis caused by chronic hepatitis B was found in 1632 cases （56.5%）,alcoholic liver disease in 216 cases （7.5%）,chronic hepatitis B and alcoholic liver disease in 475 cases （16.4%）,nonalcoholic fatty liver disease in 37 cases （1.3%）,autoimmune liver disease in 218 cases （7.5%）;Comparing to the data before 2011,the proportion of chronic hepatitis B reduced from 60.22 to 56.5%,alcoholic liver disease increased from 5.3% to 9.0%,and hepatitis C increased from 1.5% to 2.8%;The most common complications of liver cirrhosis in our series were liver cancer in 628 cases（21.7%）,spontaneous peritonitis in 596 cases （20.6%）,hyponatremia in 539 cases（18.7%）,and upper gastrointestinal bleeding in 512 cases （17.7%）;Serum levels of sodium in cirrhosis was found to be negatively correlated with Child-Pugh class,and also negatively with the occurrence of mortality,and the morbidity of hepatic encephalopathy,spontaneous bacterial peritonitis and hepatorenal syndrome. Conclusion Although the constituent ratio of HBV is decreasing during the past decade,it is still the leading etiology of liver cirrhosis. Conversely,alcoholic liver disease and hepatitis C virus infection increase. As one of the common complications of liver cirrhosis,hyponatremia is closely associated with the severity of liver disease,and has a poor prognosis. Clinicians should prevent the occurrence of hyponatremia,especially severe hyponatremia according to its causes.

Objective To investigate the predictive efficacy of serum prealbumin （PA） combined with model of end-stage liver disease（MELD） score in the prognosis of patients with decompensated hepatitis B-induced liver cirrhosis. Methods 231 patients with decompensated liver cirrhosis and hepatitis B were recruited in our hospital between December 2015 and December 2016,and all of them were followed-up for six months. Serum PA levels were collected and the MELD score and CTP score were calculated,and MELD/PA model was established. The area under curve of receiver operating characteristic （AUC） was applied to estimate the efficacy of prognosis. Results A total of 83 patients died during the 6-month follow-up period;serum PA content in the dead group was（32.2±9.3） mg/L,significantly lower than[（47.3±26.4）mg/L,P<0.05] in the survival group;the MELD score was（24.1±5.6）,significantly higher than[（18.0±6.7）,P<0.05] in the survival;the CTP score was （11.8±1.2）,significantly higher than [（9.0±2.0）,P<0.05] in the survival;the ROC analysis showed that the AUC of MELD score was 0.868 （95%CI:0.823-0.912）,much higher than[0.753（95%CI:0.690-0.816）,P<0.05] by CTP score,or [0.675（95%CI:0.606-0.743）,P<0.05] by serum PA;further comparison analysis result showed that the AUC of MELD/PA score was 0.896（95%CI:0.857-0.935）,significantly higher than by MELD（P<0.05）. Conclusion The application of serum PA levels combined with MELD score in predicting the 6 month prognosis of patients with decompensated hepatitis B liver cirrhosis is feasible,which needs further investigation.

Objective To investigate the features of liver cirrhosis in Tibetan minority. Method Two-hundred and seventy patients with liver cirrhosis were enrolled in this study. The color Doppler ultrasonography was conducted for diagnosis,and the liver and spleen stiffness measurement were carried out by Fibroscan. Serum hepatitis B and C viral makers were detected by ELISA,and electronic gastroscopy was applied to evaluate the esophageal and gastric varices （EGV）. Results Out of 270 patients with liver cirrhosis,192（71.1%） were found having EGV,and 106（39.3%） of them had red sign;the etiologic causes included hepatitis B in 141,hepatitis C in 29,primary biliary cirrhosis in 39,alcoholic in 37 and autoimmune hepatitis in 24;the differences in liver and spleen stiffness measurement among different etiologic cirrhosis were not significant（P>0.05） and the liver and spleen stiffness measurement in 96 Child-Pugh class C were significantly higher than in 68 class B（P<0.05） or 106 Child-Pugh class A（P<0.05）;the degree of EGV was positively correlated to hepatic fibrosis staging（r=0.8539,P=0.0001）,and the spleen stiffness measurement was （41.2±19.3） kPa,while it was（23.5±15.0） kPa in liver stiffness measurement,which positively correlated to each other（r=0.8539,P=0.0001）. Conclusion The etiologic distribution of Tibetan patients with liver hardness is not different from other nationality based on our materials,and the liver and spleen stiffness measurement increase as Child-Pugh class deteriorate. The degree of liver fibrosis is positively related to the degree of esophageal and gastric varices. Therefore,the patients with severe EGV is at risk of upper gastrointestinal bleeding.

Objective To investigate the clinical features,pathogenic distribution and drug susceptibility in patients with liver cirrhosis complicated by spontaneous bacterial peritonitis（SBP）. Methods 60 bacteria-culture positive patients with hepatitis B-induced liver cirrhosis complicated by SBP were analyzed in this study,and the bacteria were characterized by KB paper dispersion or MIC. Results Out of the 60 patients with SBP,we obtained Escherichia coli（E. coli） in 8（7.1%）,Klebsiella pneumoniae（KPN） in 7（11.7%）,Baumanii in 10（16.7%）,P. aeruginosa in 6（10.0%）,A. cloacae in 4（6.7%）,E. aerogenes in 3（5.0%）,coagulase-negative Staphylococcus （CNS） in 14（23.3%） and Enterococcus in 8（13.3%）;there were 2 strains of E. coli,2 strains of KPN,1 strain of Baumanii,2 strains of P. aeruginosa,2 strains of A. cloacae,and 1 strain of E. aerogenes resistant to cefoxitin; 1 strain of E. coli,1 strain of KPN,3 strains of Baumanii,1 strain of P. aeruginosa,and 2 strains of E. Aerogenes resistant to ceftriaxone;3 strains of E. coli, 3 strains of KPN,2 strains of Baumanii,1 strain of P. aeruginosa and 3 strains of E. Aerogenes resistant to imipenem;8 strains of CNS and 2 strains of Enterococcus resistant clindamycin,and 1 strain of CNS resistant to vancomycin. Conclusion s It's difficult to separate bacteria in patients with SBP,and the positive bacteria obtained in clinical practice are main Gram negative bacilli, which are susceptible to imipenem,and the Gram positive are sensitive to vancomycin.

Objective To investigate the efficacy of intrahepatic transplantation of human umbilical cord mesenchymal stem cells （UC-MSCs） combined with matrine in the treatment of patients with decompensated hepatitis B cirrhosis. Methods A total of 68 patients with decompensated hepatitis B cirrhosis were divided into the control and observation group by randomized number generated by computer,with 34 patients in each group. The patients in control group received intrahepatic UC-MSCs transplantation,and those in observation group received matrine orally after UC-MSCs transplantation. Serum laminin （LN）,hyaluronic acid （HA）,type IV collagen （IV-C）,and type III procollagen （PC III）] and peripheral blood T lymphocyte subset were detected before and after 12 months of treatment. Results During the follow-up,3 patients in the observation group and 4 patients in the control group died;at the end of 12 months of treatment,serum ALT and TBIL levels in observation group were（39.3±15.6） U/L and（26.3±10.2） μmol/L,significantly lower than（71.2±17.2） U/L and （39.2±11.2） μmol/L in the control group（P<0.05）;serum levels of LN,HA,IV-C and PC III in the observation group were（81.2±24.1） ng/ml,（135.7±48.5） ng/ml,（106.3±32.1） ng/ml and（98.7±25.6） ng/ml,much lower than（113.3±29.6） ng/ml,（174.8±51.2） ng/ml,（158.4±35.6） ng/ml and（124.2±30.3） ng/ml in the control group（P<0.05）;the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells in the observation group were（34.0±4.6） % and （1.2±0.6）,much higher than（29.3±4.1） % and（0.9±0.6） in the control group,while CD8+ cells was（26.5±4.9） %,much lower than（31.2±3.9） % in the control group（P<0.05）;there were no significant difference as respect to the incidence of liver transplantation or liver cancer between the two group（2.9% and 5.9%,vs. 5.9% and 11.8%,respectively,P>0.05）. Conclusion HU-MSCs transplantation and matrine could obviously relieve liver fibrosis,and improve liver function in patients with decompensated liver cirrhosis.

Objective To analyze the clinical efficacy and related risk factors of complications in alcoholic liver cirrhosis patients with gallstone after laparoscopic cholecystectomy（LC）. Methods 120 alcoholic liver cirrhosis patients with gallstones were recruited and treated in our hospital between December 2013 and December 2016. The patients were divided into two groups,60 of them received cholecystectomyby conventional right upper abdominal incision,and another 60 underwent LC. The surgery parameters and postoperative complications in the two groups were compared,and univariate and multivariate Logistic regression analysis were used to analyze the related factors of postoperative complications in the LC group. Results The bleeding in LC group was（100.6±24.9） ml,lesser than （139.6±38.6） ml in conventional group （the difference was statistical significant,P<0.05）;the operative time was（53.9±18.6） min,much shorter than （76.2±23.1） min in the conventional group （the difference was statistical significant,P<0.05）;the postoperative exhaust time was（28.4±8.6） h,apparently shorter than（50.6±13.6） h in the conventional group（the difference was statistical significant,P<0.05）;the hospitalization time was （5.8±2.9） d,obviously shorter than （10.0±4.6） d in the conventional group （the difference was statistical significant,P<0.05）;the incidence of postoperative complications was 8.3%,significantly lower than 21.7% in the conventional group（the difference was statistical significant,P<0.05）;the gallbladder wall thickness,Calot triangle adhesion,surrounding organ adhesion and gallbladder neck stone were found to be the related risk factors for complications after LC,and the finding was confirmed by multivariate Logistic regression analysis.Conclusion LC has significant efficacy in treatment of alcoholic liver cirrhotic patients with gallbladder stones,and the main risk factors for postoperative complications occurrence are calot triangle adhesion,adhesion of peripheral organs,gallbladder neck stone and the increased thickness of gallbladder wall. Surgeon might pay attention to prevent the postoperative complications after LC by strict control of surgical process.

Objective To investigate the clinical application of enhanced recovery after surgery （ERAS） program in patients with portal hypertention underwent pericardial devascularization with splenectomy. Methods Eighty patients with portal hypertension were recruited in our hospital in recent two years,and they were randomly divided into two groups. Forty patients underwent ERAS management during the perioperative period,and another forty patients underwent conventional perioperative treatment as control groups. Results The pain score 24 h and 48 h postoperation in the ERAS group were （2.1±0.6） and （2.2±0.6）,much lower than （3.7±0.8） and （3.0±0.6） in the control（P<0.01）;the postoperative anal exhaust time,extubation time and hospital stay in the ERAS group were （2.4±0.5） d,（5.2±0.8） d and （8.5±2.2） d,much shorter than （3.5±0.7） d,（7.6±3.0） d and （11.6±5.3） d in the control（P<0.01）;serum alanine transaminase,total bilirubin and albumin levels 5 day after surgery were（27.6±11.3） U/L,（18.3±6.2） μmol/L and （41.8±5.4） g/L,while they were [（48.6±44.3） U/L,（23.3±11.5） μmol/l and （37.1±5.1） g/L,respectively,significantly different between the two groups（P<0.01）;there were 19 cases （47.5%） having complications after operation in the ERAS group,much lower than 29 cases（72.5%） in the control group（P<0.05）. Conclusion ERAS in the perioperative management of patients with portal hypertension is effective and safe,which might accelerate the recovery of patients.

Objective To investigate the safety and efficacy of percutaneous transhepatic intrahepatic portosystemic shunt（PTIPS） in management of patients with portal thrombosis after splenectomy. Methods Thirty patients with portal thrombosis after splenectomy were recruited in our hospital between January 2011 and December 2015. All patients received PTIPS,checked-up by CT scan and followed-up for（22.1±3.8） m. Results The success rate of the operation was 90%（27/30）,and 3 patients failed to opening their portal vein occlusion during operation. No serious complications such as surgical related death were found in this series. The portal-systemic pressure gradient decreased from （21.5±3.4） mmHg to （13±2.8） mmHg in the 27 patients with successful operation. During the follow-up period, 4 patients（13.3%） got the shunt stent occlusion,and repatency by balloon dilatation and a new stent placed instead. 2 patients（6.7%） had hepatic encephalopathy within 1 months after the operation,and were improved after appropriate treatment. 5（16.7%） patients died of hepatic failure or cerebral hemorrhage. Conclusion The application of PTIPS in the management of patients with portal thrombosis after splenectomy is effective,and the procedure is feasible and safe. Further study is still needed in the future to get the indications of this operation.

Objective T his study was aimed to investigate the repair potential of hepatic fibrosis in rats with carbon tetrachloride （CCl4）-induced liver fibrosis after hepatic progenitor cell （HPC） transplantation. Methods CCl4 was intraperitoneally injected for 4 weeks,8 weeks and 12 weeks to establish the model. Immunohistochemical staining was used to detect the expression of OV6-positive HPCs in liver tissues. 14 male SD model rats were randomly divided into spontaneous reversal group （n=7） and HPCs transplantation group （n=7）. HPCs transplantation was conducted by intrasplenic injection with 5×106 HPCs/0.5 ml. Liver tissues was stained with hematoxylin-eosin and sirius red,and histopathological changes were observed. The expression of OV6 and α-smooth muscle agonists（α-SMA） in liver tissues were detected by immunohistochemical staining,and the α-SMA and tissue inhibitor of matrix metalloproteinases （TIMP）-1 were detected by Western bloting. Serum type I collagen and albumin levels were measured by ELISA. Results The number of OV6 positive cells in liver tissues reached the peak at 8 weeks after intraperitoneal injection of CCl4,and decreased at 12 weeks;the degree of fibrosis was reduced in HPCs-transplanted group,and the area of collagen was significantly decreased as compared with in the spontaneous reversal group[（3.14±0.99） vs.（5.05±0.89）,P<0.05];the relative quantification of α-SMA [（1.22±0.10） vs. （0.31±0.08）] and TIMP-1 protein [（0.43±0.09） vs.（0.25±0.032）] in spontaneous reversal group was much higher as compared with in HPCs transplantation group;serum type I collagen levels in the spontaneous reversal group was higher than in the HPCs transplantation group[（41.33±8.08） ng/ml vs.（31.12±10.08） ng/ml,P<0.05]. serum albumin levels in spontaneous reversal group was remarkably lower than that in the HPCs transplanta-tion group [（33.18±4.69） g/L vs. （48.30±2.15） g/L，P<0.05]. Conclusion Hepatic progenitor cell transplantation have the potential to accelerate the reverse of liver fibrosis and improve liver function in rats with liver fibrosis.

Objective To explore the effects of Yinzhihuang oral solution on steatosis in rats with methionine and choline deficient diet （MCD）-induced non-alcoholic steatohepatitis （NASH）. Methods 30 male rats were randomly divided into control,MCD,and Yinzhihuang-intervened group. The animals in control group was given a standard diet,and those in MCD and Yinzhihuang group were given MCD diet. At the end of forth week,saline or Yinzhihuang oral solution were administered intragastricly, respectively,once a day for four weeks. The liver tissues was obtained for HE and Masson staining and histological analysis was examined by NAFLD activity score （NAS） system,and the blood was analyzed for biochemical parameters. Results The body weight of rats in control and MCD group were [（487.2±6.5）g and （155.8±3.1）g,P<0.05],and the liver index were [（2.92±0.06） %and （5.09±0.19）%,P<0.05];the liver tissues in MCD group showed obvious hepatic steatosis,lobular inflammation,and ballooning of hepatocytes with mild fibrosis;the liver index in Yinzhihuang group[（4.47±0.18）%] was lower than that in MCD group（P<0.05）;the NAS scores in Yinzhihuang group and MCD group were 5.9±0.2 and 7.2±0.1（P<0.05）,and the fibrosis score were 0.3±0.2 and 0.8±0.2（P<0.05）;serum ALT levels in Yinzhihuang group and MCD group were[（68.4±6.4）U/L and（111.9±5.5）U/L,P<0.05],and AST levels were[（110.5±7.9）U/L and（170.5±10.8）U/L,P<0.05],while serum TBIL,TG,TC,LDL,HDL,and FBG had no significant difference between Yinzhihuang group and MCD group. Conclusion Yinzhihuang oral solution could improve hepatic steatosis, lobular inflammation,ballooning,and fibrosis in liver tissues,suggesting its therapeutic effects on NASH in animal models.

Objective To investigate the effect of selective β3-adrenergic receptor（β3-AR） agonist on hepatic oxidative stress and liver fibrosis in rats with nonalcoholic fatty liver disease（NAFLD）. Methods 30 male SD rats were randomly divided into control （NC）,model and and β3-AR agonist （BRL 37344） intervention group （BRL） with ten in each. Serum hyaluronic acid （HA）and transforming growth factor-β1 （TGF-β1） were detected by ELISA. The superoxide dismutase （SOD）,malondialdehyde （MDA） and glutathione peroxidase （GSH-Px） levels in liver tissue homogenates were detected by spectrophotometry. The liver tissues of rats were collected to examine the pathological changes and the degree of fibrosis. Results Serum TC,TG,ALT,AST,HA and TGF-β1 levels in BRL group were（1.95±0.43） mmol/L,（0.82±0.31） mmol/L,（71.02±11.34） U/L,（165.18±39.11） U/L, （159.64±32.50） ng/ml and（0.92±0.54） μg/ml,much higher than【（1.77±0.34） mmol/L,（0.59±0.23） mmol/L,（54.48±8.64）U/L,（134.12±37.16） U/L,（95.57±19.47） ng/ml and（0.75±0.51） μg/ml,respectively,P<0.05】 in model group,and they were all higher than 【（1.19±0.25） mmol/L,（0.35±0.19） mmol/L,（32.26±7.13）U/L,（119.64±35.16）U/L,（76.26±13.34）ng/ml and（0.69±0.46） μg/ml,respectively,P<0.05] in the NC group; hepatic SOD and GSH-Px levels in BRL were （46.31±16.39）×103U/g protein and（98.64±19.33） mg/g protein,much lower than （79.26±15.34）×103U/g protein and （126.34±21.56） mg/g protein,respectively in the model,while MDA level was（8.16±0.92）μmol/L/g protein,much higher than（5.76±0.88）μmol/L/g protein in the model （P<0.05）,and they were （113.34±12.26）×103U/g protein,（175.59±26.34）mg/g protein and（2.71±0.64） μmol/L/g protein in the control（P<0.05）;the scores of steatosis, inflammatory infiltration,ballooning degeneration and liver fibrosis in BRL were （2.71±0.34）,（2.38±0.41）,（0.86±0.21） and （4.19±0.40,much higher than【（1.94±0.34）,（1.76±0.34）,（0.61±0.16） and（3.02±0.34）,respectively,P<0.05】 in the model. Conclusion β3-AR agonist could aggravate hepatic oxidative stress and might improve liver fibrosis in rats with NAFLD,which warrants further investigation.

Objective To investigate the inhibition of proliferation and regulation of heaptic fibrosis-related genes in HSC-T6 cells by prolyloligopeptidase（POP） inhibitor in vitro. Methods The HSC-T6 cells were cultured,and the POP activity was inhibited by increasing concentrations of POP inhibitor（S17092）. The intracellular level of N-acetyl- seryl-aspartyl-lysyl-proline（Ac-SDKP） was determined by ELISA. The cell apoptosis and cell proliferation were detected by flow cytometry and CCK-8 assay,respectively. The mRNA levels of TGF-β1,α-SMA,monocyte chemoattractant protein 1（MCP-1） and collagen I（Col I） were detected by realtime-PCR,and the POP,TGF-β1,α-SMA, Smad7,p-Smad2/3 and PPAR-γ expression were detected by Western blot. Results The intracellular Ac-SDKP level decreased significantly after co-culture with S17092,the POP inhibitor（P<0.05） as compared to that in the control; the proliferation of HSC-T6 cells was significantly inhibited（P<0.05） and the cell apoptosis was not influenced obviously after S17092 intervention（P>0.05）;the Smad7（P<0.05） and PPAR-γ（P<0.05） protein levels were significantly down-regulated,and the α-SMA protein level was significantly up-regulated（P<0.05） after S17092 intervention;the MCP-1（P<0.05） and α-SMA（P<0.05） mRNA level were significantly up-regulated. Conclusion POP plays a pivotal role in anti-inflammation and anti-fibrosis in HSC cells, which might be related to the regulation of Smad7 and PPAR-γ expression.

Objective To explore the roles and potential mechanism of CCAAT/enhancer-binding protein alpha （C/EBPα） in the growth of hepatocellular carcinoma （HCC） cells in vitro. Methods The Hep3B cells were transfected with RNAi lentivirous,and the mRNA and protein of C/EBPα were detected by qRT-PCR and Western blot respectively. The growth of HCC cells in normal glucose （NG,4.5 g/L） and low glucose（LG,1 g/L） were assessed by CCK-8 assay and quantified based on the absorbance value at OD450. The protein levels of O-GlcNAcase（OGA）,O-GlcNAc transferase（OGT） and the whole O-GlcNAcylation in normal glucose and low glucose were detected by Western blot. Results The C/EBPαmRNA level was down-regulated by（7.5±2.3） folds（P<0.05） and its protein was decreased by （8.8±0.25） folds （P<0.001） in transfected with RNAi lentivirous cells （sh-C/EBPα） compared with control cell （sh-Con）. Knocking down C/EBPα promoted the growth of HCC cells in vitro. The growth rates of sh-C/EBPα cells increased by 15.4% （P<0.05） and 25.0% （P<0.01） in low glucose（LG,1 g/L） condition at 48 hours and 72 hours;The protein of OGA decreased by 70.1% （P<0.01）,51.4%（P<0.05） and 6 1.2% （P<0.05） in normal gulucose,low glucose at 24 h and 48 h. Whole O-GlcNAcylation was up-regulated by 80.6% in the C/EBPα knocked-down cells in low glucose at 48 h. Conclusion s The downregulation of CCAAT/enhancer-binding protein alpha promotes the growth of hepatocellular carcinoma cells in vitro likely by increasing O-GlcNAcylation in some extent.

Objective To construct the overexpression of c-met in human umbilical cord mesenchymal stem cells（hUMSCs） with lenti-vector transfection in vitro. Methods The phenotype of hUMSCs was determined by Flow cytometry analysis, and the hUMSCs were transfected by different multiple of infection（MOI with c-met lenti-vector. The optimal MOI was determined under fluorescence microscopy. The c-Met protein was detected by Western blot. Results P5 gegeration of hUMSCs were CD44/CD90/CD105-positive,and CD31/CD45/CD34-negative, indicating the hUMSCs were obtained with specific surface markers. The optimal MOI was 80, and after puromycin screening,the transfected efficiency was up to 100%. The c-Met protein was overexpressed in the transfected hUMSCs by Western blot detection. Conclusion c-Met overexpressing hUMSCs were successfully constructed, which might be beneficial for further study.

Objective T o explore the efficacy of serum miR-1273g-3p levels in diagnosis of liver fibrosis in patients with chronic hepatitis C（CHC）. Methods 57 patients with CHC and 21 healthy persons were recruited in our hospital,and serum miR-1273g-3p were detected by real-time polymerase chain reaction. The patients with CHC received standardized peg-interferon-α2b and ribavirin therapy for 12 months,and received liver biopsies before and after the regimen. Results Serum miR-1273g-3p levels were（1.02±0.3） in 13 CHC patients with liver fibrosis 0（F0）,（1.68±0.26） in 20 with F 1-2,and（4.21±0.42） in 24 with F 3-4,respectively,which suggested serum miR-1273g-3p levels in patients with liver fibrosis were much higher than 【（1.03±0.2）,P<0.05】 in healthy persons or in patients without;at the end of the regimen,serum miR-1273g-3p levels in patients with CHC F0,F1-2 and F3-4 were（1.03±0.4）,（1.43±0.22） and （3.97±0.2）,respectively,much lower than those before anti-viral treatment （P<0.05）;the AUC of serum miR-1273g-3p levels in diagnosing liver fibrosis and significant liver fibrosis were 0.830,95％CI为0.714~0.973 （sensitivity 72.2％ and specificity 86.4％）,and were 0.864,95％CI为0.701~0.976 （sensitivity 83.6％ and specificity 78.4％,as the cut-off-value were >1.68 and >4.20,respectively;at discontinuation of the regimen,the liver histological examination showed that the liver fibrosis was F0 in 15,F1 in 9,F2 in 14,F3 in 11 and F4 in 8. Conclusion s Serum miR-1273g-3p levels might be used to diagnose liver fibrosis in patients with CHC,which warrants further investigation.

Objective To investigate the efficacy of combination of ezetimibe and atorvastatin in treatment of patients with nonalcoholic fatty liver disease （NAFLD） complicated by coronary heart disease （CHD）. Methods 114 patients with NAFLD and CHD were recruited in our hospital between February 2014 and February 2016,and were randomly divided into the observation group and the control group with 57 cases in each group by a computer-generated numbers. The patients in the control group were given atorvastatin calcium,and those in the observation group were given combination of ezetimibe and atorvastatin therapy for six months. The left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVVED） and left ventricular posterior wall depth （LVPWd） were obtained by echocardiography,and serum interleukin -6（IL-6） and interleukin-10 （IL-10） were assayed by ELISA. Results At the end of six month observation,serum TC,TG and LDL-C levels were（4.3±1.6） mmol/L,（2.4±0.9） mmol/L and （2.8±1.1） mmol/L,respectively in the observation group, significantly lower than （5.1±1.7） mmol/L,（2.9±0.9） mmol/L and （3.3±1.2） mmol/L （P<0.05） in the control group,while serum HDL-C level was （1.3±0.5） mmol/L,significantly higher than （1.0±0.4） mmol/L（P<0.05） in the control group;serum ALT,AST and GGT levels decreased significantly in the observation（P<0.05）;the LVEF was（47.2±6.4）%,significantly higher than（42.8 ±5.8）% （P<0.05）,while LEVDD and LVPWd were（52.5±7.3） mm and（10.1±0.9） mm,significantly lower than （58.2±7.6） mm and （11.4±1.1） mm,respectively （P<0.05） in the control;serum levels of ADMA,hs-CRP and IL-6 were （2.8±0.4） μmol/L,（3.4±0.7） mg/L and （39.3±6.9） ng/L,significantly lower than （3.0±0.4） μmol/L,（3.9±0.7） mg/L and （45.9±8.4） ng/L （P<0.05） in the control and serum level of IL-10 was （28.7±8.6） ng/L,significantly higher than （22.3±5.4） ng/L（P<0.05） in the control group. Conclusion s Ezetimibe combined with atorvastatin could significantly decrease the serum lipid levels and improve liver functions in patients with NAFLD complicated by CHD,which might be related to the regulation of lipid metabolism and reduced levels of ADMA and serum inflammatory factors.

Objective To investigate the clinical efficacy of puerarin combined with metformin in the treatment of patients with non-alcoholic fatty liver disease （NAFLD） and prediabetes. Methods 84 patients with NAFLD and prediabetes were recruited in our hospital between April 2014 and June 2017,and they were randomly divided into the control group（n=42） and the observation grou （n=42）,receiving metformin hydrochloride or combination of metformin and puerarin,a herbal medicine,respectively. Fasting blood glucose （FBG）,postprandial 2h blood glucose（2hPG）,glycosylated hemoglobin （HbA1c）,fasting insulin （FINS）,insulin resistance index（HOMA-IR）],and C reactive protein（CRP）,malondialdehyde（MDA）,superoxide dismutase （SOD）,interleukin-6（IL-6）,and tumor necrosis factor α（TNF- α）] were assayed. Results At the end of 3 month observation,blood levels of FBG, 2hPG, FINS and HOMA-IR in the observation group were lower than those in the control group[（5.92±0.51） mmol/L,（6.01±0.81） mmol/L,（5.90±0.62）mmol/L,（1.52±0.42） vs. （6.32±0.35） mmol/L,（6.39±0.71） mmol/L,（6.72±0.83） mmol/L,（1.71±0.39）,respectively,P<0.05];plasma levels of TC,TG and LDL-C in the observation group were lower than those in the control group[（4.15±0.14）mmol/L,（1.12±0.22） mmol/L,（1.91±0.12） mmol/L vs.（4.56±0.21） mmol/L,（1.31±0.13） mmol/L,（2.14±0.11） mmol/L],while HDL-C level was higher than that in the control group [（1.31±0.22） mmol/L vs. （1.11±0.09） mmol/L,P<0.05];serum AST and ALT levels in the observation group were much lower than those in the control group [（49.71±4.75） U/L and（52.16±4.93） U/L vs. （59.13± 4.30） U/L and （77.52 ±7.15） U/L,P<0.05];serum inflammationary cytokine levels were also lower than those in the control （P<0.05）. Conclusion Puerarin combined with metformin is effective in the treatment of patients with NAFLD and prediabetes, which might be related to the regulation of blood glucose and lipid metabolism, and improvement of the liver function.

Objective To analyze blood glucose and total cholesterol （TC） in the prognosis of patients with liver failure （LF）. Methods A retrospective analysis was performed on 106 LF patients who were admitted to in our hospital. The patients were divided into blood TC≤1.0 mmol/L group（n=8）,1.0 mmol/L<TC≤2.0 mmol/L group（n=49） and TC>2.0 mmol/L group（n=49） according to the TC level at admission. After excluding 10 patients with diabetes,96 patients were divided into normal blood glucose group （n=60）,hyperglycemia group （n=12） and hypoglycemia group（n=24） according to the blood glucose levels at admission. The correlation between blood glucose or TC and survival rate was compared respectively. TC was dynamically monitored in 81 patients with TC>1.0 mmol/L at admission to explore the relationship between the dynamic changes of TC and the prognosis of patients with LF. Results Hepatitis B virus（HBV） infection was the main cause of LF in the 106 patients, accounting for 66.0% and the proportion of chronic liver failure（CLF） accounted for 46.2%;the survival rate in patients with hypoglycemia at admission was 41.7%,significantly lower than that in patients with normal blood glucose （71.7%,P<0.01）;there were significant differences in survival rates between patients with blood TC≤1.0 mmol/L group,1.0 mmol/L<TC≤2.0 mmol/L group and TC>2.0 mmol/L group and the lower the baseline TC levels,the lower the survival rates（12.5% vs. 51.0% vs. 75.5%,respectively,P<0.05 for all）;the survival rate in patients with a declining levels of TC during hospitalization was 28.6%,significantly lower than that in patients with an increasing trend （93.5%,P<0.05）. Conclusion Hypoglycemia and blood TC≤2.0 mmol/L at admission or decreased TC level trend are associated with poor prognosis of patients with LF,especially in patients with blood TC≤1.0 mmol/L at admission.

Objective To validate the prediction of short-term survival by four scoring systems based on models for end-stage liver disease（MELD） in patients with acute-on-chronic hepatitis B-induced liver failure （HBV-ACLF）. Methods 67 patients with HBV-ACLF were enrolled in this study between April 2015 and October 2017. The clinical parameters were collected for calculation of MELD,iMELD,MELD-Na and MESO scores,respectively. The predictive efficacy on forecasting survival of patients with HBV-ACLF by the four scoring systems was analyzed by receiver operating characteristic curve（ROC） supported by MedCalc15.8 software. Results 45（67.2%） out of 67 patients with HBV-ACLF died within 12 weeks;the scores of MELD,iMELD,MELD-Na and MESO models at presentation in survival group were （22.12±3.24）,（41.59±5.30）,（22.55±4.07） and （1.64±0.24）,much lower than 【（30.47±9.01）,（51.88±11.09）,（32.35±11.58） and （2.28±0.70）,respectively,P<0.01】 in the dead group;the area under the ROC curve （AUC） in forecasting the survival of patients with HBV-ACLF by the four models were 0.814,0.802,0.806 and 0.817 respectively,the cut-off-values were 22.70,47.76,22.16 and 1.69,and the Jordan index were 0.5040,0.5535,0.4808 and 0.4818,respectively,suggesting no significant differences between them（P>0.05）. Conclusion The four scoring systems base on MELD have good predictive efficacy on forecasting 12 weeks’ survival in patients with HBV-ACLF,which hints they might be applied in clinical practice.

Objective To investigate the polymorphism of programmed death-ligand 1（PD-L1） gene in susceptibility and prognosis of patients with hepatocellular carcinoma（HCC）. Methods 100 patients with HCC and 100 healthy persons were recruited in our hospital between January 2010 and June 2015. The peripheral blood were collected to assay the single nucleotide polymorphisms（SNP）,including rs4143185,rs17718883 and rs28906583,of PD-L1 gene by direct sequencing and polymerase chain reaction-single strand conformation polymorphism（PCR-SSCP）. Results The AC heterozygous mutation gene of rs2890658 reduced the risk of liver cancer susceptibility （OR=0.391,P<0.05）,and the CG heterozygous mutation of rs17718883 also reduced the risk of liver cancer susceptibility （OR=0.009,P<0.05）;the median survival times of 3 genotypes （AA,AC and CC） of rs2890658 were 18（15,21） m,20（16,22） m and 19（15,21） m,no significant differences among（P>0.05）;the median survival time in combination of genotype AC and CC was 20（16,23） m,much longer than carrying genotype AA（P<0.05）;there were significantly differences among survival times in individuals carrying CC,GC and GC of rs4143185 gene [16（13,19） m,20（15,23） m and 17（15,21） m,respectively,P<0.05],and the survival time in persons carrying combination of CG and GG was 21（17,24） m,much longer than those carrying CC（P<0.05）;COX regression analysis showed that patients carrying mutant genes of rs4143185 had a good prognosis （HR<1,P<0.05）. Conclusion The detection of blood PD-L1 gene polymorphism might be useful in clinical practice in screening individuals with high risk of HCC susceptibility and in forecasting the prognosis of patients with HCC.

Objective To investigate the factors influencing long-term survival in patients with hepatocellular carcinoma （HCC） with underlying hepatitis B virus （HBV） infection after hepatectomy. Methods 600 patients with hepatitis B virus related single large HCC were recruited in our hospital between January 2011 and January 2012, all patients received hepatectomy and followed-up for 5 years. Out of them,130 cases had tumors with diamiters greater than 5 cm,and 470 had tumors with less than 5 cm. The survival curve was drawn by the Kaplan-Meier method,the survival analysis was estimated by Log-rank test, and the Logistic regression analysis was applied to analyze the prognostic factors. Results There was no significant differences as respect to the clinical features （P>0.05） except the diameter of the tumors in the two groups;in 470 patients with small liver cancer,the survival time was 55.0±4.8 months,the tumor free survival time was 38.6±2.4 months,1 a,3 a and 5 a overall survival rates were 90.1%,71.5% and 57.1%,and the 1 a,3 a and 5 a tumor free survival rate was 57.1%,71.5% and 57.1%,while in 130 patients with large liver cancer,the survival time was 50.0±3.6 months （x2=12.175,P=0.001）,the tumor free survival time was 30.6±2.7 months （x2=0.669,P=0.102）,1 a,3 a and 5 a overall survival rates were 87.5%,58.4% and 47.1%,and the tumor free survival rates were 47.1%,58.4% and 47.1%;there were no significant differences as respect to overall survival rates and disease-free survival rates between patients with large liver cancer （5~10 cm） and those with small liver cancer （x2=0.489,P=0.202;x2=1.257,P=0.098）;the overall survival rates and disease-free survival rates in patients with tumor greater than 10 cm were shorter than in with small liver cancer（x2=15.271,P<0.001;x2=8.124,P=0.013）;multivariate analysis showed that serum HBV DNA loads（≥1×104 U/ml） and tumor size（>10 cm） were the independent risk factor for 5 a overall survival rate （OR=1.679,95% confidence interval:0.987~2.341;OR=2.348,P=0.025,95% CI:1.024~4.357,P=0.013） and 5 a disease-free survival rate（OR=2.365,95% CI:2.542~4.368,P=0.013;OR=2.674,95% CI:0.874~1.934,P=0.049）. Conclusion The overall survival and disease-free survival in patients with large liver cancer（5~10 cm） are similar with those in with small liver cancer,while the overall survival and disease-free survival in patients with tumors greater than 10 cm are poor. Measures should be taken to improve the prognosis of patients with large liver cancer.

Objective To investigate the application of neutrophil/lymphocyte ratio（NLR） and platelet/ lymphocyte ratio （PLR） in forecasting prognosis of patients with primary liver cancer （PLC） underwent transcatheter arterial chemoembolization（TACE）. Methods A retrospective analysis of 98 patients with PLC was made, and the patients were recruited in our hospital between August 2012 and August 2014. All of them received TACE,and followed-up for three years. The factors influencing 3-year survival rate was estimated by multivariate Logistic analysis, and the receiver operating characteristic curve（ROC） was calculated to determine the efficacy of NLR and PLR in forecasting the patients’ prognosis. Results The 1,2 and 3 year survival rates in the 98 patients with PLC after TACE treatment were 53.1%,42.9% and 39.8%;the 1,2 and 3 year survival rates in 23 patients with NLR≤1.82 were 73.9%,56.5% and 52.2%,while they were 46.7%,38.7% and 36.0%,respectively,（P<0.05） in 75 patients with NLR>1.82;the 1,2 and 3 year survival rates in 30 patients with PLR≤95.65 were 70.0%,60.0% and 53.3%,while they were 45.6%,35.3% and 33.8%,respectively,（P<0.05） in 68 patients with PLR>95.65; multivariate Logistic analysis showed that tumor number≥2,tumor diameter >50 mm and NLR>1.82 were the independent factors that would influence the patients’ prognosis. Conclusion The NLR should be assessed before TACE in patients with PLC,which is a easy marker to obtain and might be useful in clinical practice.

Objective To investigate serum and hepatic tissue microRNAlet-7 （let-7a and let-7b） levels and its clinical implication in patients with hepatocellular carcinoma （HCC）. Methods 54 patients with HCC and 52 healthy persons were recruited in our hospital between April 2015 and June 2016,and all the patients were confirmed by histopathological examination. Real-time fluorescence quantitative reverse transcriptase polymerase chain reaction（qRT-PCR） was applied to detect let-7a and let-7b in sera,cancerous tissues and its adjacent liver tissues. Results The results of qRT-PCR detection showed that serum let-7a level in patients with HCC was （0.6±0.4）,much lower than [（1.1±0.4）,P<0.05],and serum let-7b level was （0.3±0.1）,also significant lower than [（0.7±0.2）,P<0.05] in healthy persons;hepatic cancerous tissue let-7a level in patients with HCC was（0.3±0.1）,much lower than [（0.6±0.1）,P<0.05] in its adjacent liver tissues,and the cancerous let-7a level decreased by 2.17 times lower than in the adjacent liver tissues;hepatic cancerous let-7b level in patients with HCC was （0.4±0.2）,also much lower than[（1.3±0.4）,P<0.05] in its adjacent liver tissues,and the cancerous let-7b level decreased by 3.33 lower than in its adjacent liver tissues;serum let-7a level in 20 HCC patients with portal tumor thrombus formation was（0.4±0.2）,much lower than[（0.8±0.5）,P<0.05] in 34 HCC patients without, and serum let-7b level was（0.1±0.1）,also significantly lower than [（0.5±0.1）,P<0.05] in patients without,while serum let-7a and let-7b levels in patients with different age,gender,serum AFP levels,sizes of tumor, tumor differentiations,TNM stages and with or without tumor invasion were not significantly different（P>0.05）;cancerous tissue let-7a and let-7b levels in patients with different age,gender,serum AFP levels,sizes of tumor,tumor differentiations,TNM stages,with or without tumor invasion and portal tumor thrombus formation were not significantly different（P>0.05）. Conclusion sSerum and tumor tissue let-7a and let-7b levels decrease,and tumor tissue let-7a and let-7b levels are even lower than in its adjacent liver tissues,which hints what is still a problem and warrants further investigations in the future.

Objective To investigate the protective effect of combination of ulinastatin with magnesium isoglycyrrhizinate and reduced glutathione on hepatic functions in patients with primary liver cancer after partial hepatectomy. Methods 78 patients with primary liver cancer were included in our hospital between February 2013 and October 2016,and they received partial hepatectomy. After operation,the patients were randomly divided into group B,receiving combination of ulinastatin,magnesium isoglycyrrhizinate and reduced glutathione,and group A,receiving magnesium isoglycyrrhizinate and reduced glutathione. Serum tumor necrosis factor （TNF）-α,interleukin （IL）-6 and C reactive protein（CRP） levels were detected by ELISA. Results There was no significant differences between the two groups as respect to the indexes of liver functions and serum inflammatory factors before operation（P>0.05）;serum alanine aminotransferase （ALT） level in group B seven days after operation were significantly lower than in group A （P<0.05）;at the end of seven days,serum CRP,TNF-α and IL-6 levels in group B were （17.2±2.7） mg/L,（2.7±0.6） pg/ml and （28.4±5.7） pg/ml,much lower than [（19.8±3.2） mg/L,（3.5±0.7） pg/ml and （33.4±6.2） pg/ml in group A,P<0.05],and at the end of 14 d,serum CRP,TNF-α and IL-6 levels in group B were（13.6±3.0） mg/L,（2.0±0.4） pg/ml and （20.5±4.7） pg/ml,much lower than[（16.3±3.5） mg/L,（2.8±0.6） pg/ml and（24.6±4.9）pg/ml in group A,P<0.05];there was no significant differences of the incidences of postoperative septal effusion,bile leakage and death between the two groups （P>0.05）,while the incidence of hepatic failure in group B was significantly lower than that in group A （2.5% vs. 21.1%,P<0.05）. Conclusion Combination of ulinastatin,magnesium isoglycyrrhizinate and reduced glutathionecan might enhance the protective effects on hepatic function in patients with primary liver cancer after partial hepatectomy.

Objective To investigate the impact of laparoscopic cholecystectomy（LC） on blood immunoglobulin levels and on intestinal mucosa in patients with cholelithiasis,Methods 110 patients with cholelithiasis were recruited in our hospital between December 2015 and December 2016,and 55 received open cholecystectomy （OC） and another 55 received LC. Blood cortisol and immunoglobulin were detected,The specimen of intestinal mucosa was obtained under enteroscopy and was examined pathologically by Chiu's criteria. Results At the end of one week after operation,serum C-reactive protein,blood glucose and cortisol levels in LC group were （4.2±0.4） mg/L,（5.5±1.0） mmol/L and（249.4±43.1） ng/ml,much lower than [（5.3±1.0） mg/L,（6.1±1.1） mmol/L and （267.4±46.8） ng/mL in OC group （P<0.05）;serum IgA,IgG and IgM were （1.8±0.3） g/L,（1.0±0.2） g/L and （1.0±0.2） g/L,much higher than （1.4±0.2） g/L,（0.9±0.1） g/L and （0.8±0.1） g/L in the OC group （P<0.05）;at the end of three months after operation, the Chiu's injury of intestinal mucosa was much milder in the LC group than that in the OC group（U value=11.008,P<0.05）;the complication rate in the LC group was 5.4%,much lower than 18.2% in the OC group（P<0.05）. Conclusion s LC might induce little stress and immune reaction,and lead to mild intestinal mucosa injury.

Objective To analyze the efficacy of different Calot triangle anatomical approaches during laparoscopic cholecystectomy（LC） in the treatment of patients with gallbladder stones with chronic cholecystitis. Methods 200 patients with gallbladder stones with chronic cholecystitis were divided into two groups according to different Calot triangle anatomical approaches during LC,and 100 patients received LC by posterior gallbladder triangle anatomical approach（observation group） and another 100 by gallbladder triangle approach （control group）. The operation indexes were compared,and serum cytokines were detected by ELISA. Results We found 53 patients in observation group and 50 in control having adhesion around gallbladder during LC. There was no significant differences between the two groups without adhesion as respect to operational indexes,complications and the rates of conversion to laparotomy（P>0.05）;The operation time,intraoperative bleeding,time for intestinal function recovery after operation,hospital stay and postoperative visual analogue scale （VAS） score of pain in patients with adhesion in the observation group were（29.4±4.3） min,（33.9±4.6） ml,（26.0±4.2） h,（6.0±1.0） d,and（4.0±1.5）,significantly shorter,lesser or lower than those in patients with adhesion in the control group [（59.1±5.5） min,（45.6±4.1） ml,（30.3±4.5） h,（8.4±1.0） d,and （4.8±1.3）,P<0.05];There was not incidence of complications or conversion to laparotomy in patients with adhesion around gallbladder in the observation group, while they were 8.0% and 8.0% in patients with adhesion around gallbladder in the control group （P<0.05）;Serum levels of C reactive protein, interleukin-6,interleukin -8 and tumor necrosis factor α after operation in the observation group were significantly lower than those in the control group（P<0.05）. Conclusion Posterior gallbladder triangle anatomical approach can significantly reduce bleeding in patients with gallbladder adhesion, significantly decrease the incidence of complications and the rate of conversion to open operation. In laparoscopic cholecystectomy,the gallbladder adhesion needs to be observed closely and dealt with properly.

Tolvaptan is a new type of non-peptide selective arginine vasopressin V2-receptor antagonist,which has the function of increasing renal solute-free water excretion and increasing serum sodium concentration. Due to the disorder of solute-free water excretion,decompensated cirrhotic patients are prone to hyponatremia. Application of tolvaptan in treatment of hyponatremia can effectively increase the concentration of sodium,reduce the risk of complications such as hepatic encephalopathy,hepatorenal syndrome,and refractory ascites. In this paper,we briefly summarized the mechanism of tolvaptan’s effects,the efficacy and safety in treatment of patients with hyponatremia.

Ascites is the most common complications and is mainly arisen from portal hypertension. The diagnosis of cirrhotic ascites can be determined by the history,physical examination and ascitic uid analysis. Effective treatment of cirrhotic ascites improves the quality of life and survival rate. Although the prognosis of ascites can be improved by some treatment options,once complications occur,the prognosis is poor. Liver transplantation remains the ultimate option of treatment. So,the earlier treatment begins,the better the patient’s prognosis. Western medicine treatment include daily sodium intake limitasiton,diuretics,vaptans and serum albumin infusion. Refractory ascites can be dealt with large-volume paracenteses,a cell-free and concentrated ascites reinfusion therapy,a transjugular intrahepatic portosystemic shunt,and a peritoneo-venous shunt. More and more literatures at home and abroad report that Chinese medicine combined with diuretics in the treatment of ascites has better efficacy. However,the theory of TCM treatment and evaluation system are yet not validated up to now. It is of great practical importance to establish a standardized comprehensive treatment program for improving the clinical efficacy of ascites. The present review puts emphasis on the diagnosis and therapeutic management of cirrhotic ascites.