Objective To investigate the clinical efficacy of entecavir combined with live bifidobacterium and lactobacillus tablets in the treatment of B patients with decompensated liver cirrhosis. Methods 120 patients with hepatitis B induced decompensated liver cirrhosis in the Affiliated Hospital of the Southwest Medical University between Jan. 2015 and Aug. 2017 were randomly divided into control and observation groups. The patients in the control group were administrated entecavir and patients in the observation group were administrated entecavir and live bifidobacterium and lactobacillus tablets. The index of liver function,hepatic fibrosis,HBV DNA and the rate of spontaneous bacterial peritonitis were compared between the two groups. Results At the end of 12 weeks,serum levels of ALT and TBIL in combination treatment group were（70.2±6.2） U/L and（16.3±4.2） μmol/L,both significantly lower than （76.2±9.6） U/L and （26.3±5.2） μmol/L in the control group（P<0.05）;serum level of ALB in the treatment group was （32.5±4.2） g/L,significantly higher than（30.2±5.3）g/L in the control group（P<0.05）;at the end of 24 weeks,serum levels of ALT and TBIL in the treatment group were （12.2±3.2） U/L and（6.2±1.3） μmol/L,both significantly lower than （26.4±3.2）U/L and （11.2±3.2） μmol/L in the control group （P<0.05）;serum level of ALB in the treatment group was （37.8±2.3） g/L,significantly higher than （34.4±4.2） g/L in the control group （P<0.05）;serum LN and C- IV were （65.2±15.1）ng/ml and （85.5±8.5）ng/ml,much lower than【（75.3±10.3）ng/ml and （96.2±10.3）ng/ml in the control,respectively,P<0.05】;serum HBV DNA level was （1.0±0.1）lg copies/ml,no significantly different as compared to （1.7±0.3） lg copies/ml in the control （P>0.05）,and serum HBV DNA negativity rate was 100.0%,also no significantly different as compared to 90.0% in the control（P>0.05）;at the end of 12 w and 24 w,the SBP occurred in 5（8.3%） and in 2（3.3%）,significantly lower than in 10（16.7%） and in 8（13.3% in the control （P<0.05）;at the end of 24 w,3（5%） died in the combination group,much lower than 10（16.7%） in the control（P<0.05）. Conclusion Entecavir combined with live bifidobacterium and lactobacillus tablets has a good clinical efficacy in treatment of hepatitis B patients with decompensated liver cirrhosis,which is worth further investigation.

Objective To assess the prophylactic effect of carvedilol and propranolol for first esophageal and gastric variceal bleeding in cirrhotic patients. Methods A total of 125 patients with liver cirrhosis and esophageal and gastric varices were randomly divided into carvedilol-intervened group（n=61） and propranolol-intervened group（n=64）,receiving carvedilol and propranolol respectively for prophylaxis of gastrointestinal bleeding. The first variceal bleeding,biochemical index,hepatic vein pressure gradient（HVPG） and side effect were compared between the two groups. Results The clinical data such as gender,age,Child-Pugh class and complications of ascites at presentation were not significantly different between the two group （P>0.05）;there were 18 patients （29.5%） having first esophageal and gastric variceal bleeding in carvedilol-intervened group, and there were 20 patients（31.3%） having first esophageal and gastric variceal bleeding in propranolol-treated group during the follow-up period,which showed no significant differences between the two groups（P>0.05）;the HVPG level in carvedilol-intervened group decreased significantly from （14.1±3.7） mmHg at presentation to （10.3±2.1） mmHg after treatment（P<0.05）,and the HVPG level in propranolol-treated group also decreased significantly from （14.6±4.3） mmHg to （12.0±2.3） mmHg （P<0.05） without significant difference between the two group（P>0.05）;the changes of serum ALT, bilirubin and creatinine levels between the two groups showed no significant differences（P>0.05）;there were 10 cases having dizziness,3 cases having syncope,4 cases having chest distress and 1 case having anhelation in carvedilol-intervened group,while there were 8,2,6 and 1 case,respectively,in the propranolol-treated group,suggesting no significant difference between the two groups as respect to the incidence of side effects （P>0.05）. Conclusions Both carvedilol and propranolol have good prophylactic effects for the first esophageal and gastric variceal bleeding in cirrhotic patients,which needs further investigation.

Objective To investigate the efficacy of entecavir in the treatment of patients with hepatitis B virus （HBV）-related cirrhosis complicated by hepatogenous diabetes （HD） and its influence on indexes of glucose metabolism. Methods 84 patients with HBV-related cirrhosis complicated by HD were divided into control （n=42） and observation group（n=42） by randomized number table generated by computer. The patients in control group were given antidiabetic,hepatoprotective and other conventional treatment,and at this basis,the patients in observation group were additionally treated with entecavir,and the observation was 48 weeks. After treatment,the virological response rates,serum liver function tests,glucose metabolism indexes and blood liver fibrosis indexes were compared between the two groups. Results The negative conversion rate of serum HBV DNA in the observation group at the end of 48 week treatment was higher than that in the control group （78.6% vs. 16.7%,P<0.05）;at the end 48 weeks,serum total bilirubin （TBIL）,alanine transaminase （ALT） and aspartate transaminase （AST） levels in the observation group were （21.2±4.2） μmol/L,（43.3±12.7） IU/L, （39.4±1.8） g/L, significantly different as compared to those in the control group [（36.1±5.3） μmol/L,（77.1±15.2） IU/L,（33.9±3.4）g/L,respectively,P<0.05];the fasting blood glucose （FBG）,2h postprandial blood glucose （2h PBG）,hemoglobin A1c （HbA1c）,fasting insulin （FINS）,insulin resistance index（HOMA-IR） in the observation group were （5.3±0.7） mmol/L,（7.1±1.5） mmol/L,（6.1±0.6） %,（10.5±2.6） mU/L and（2.1±0.7）,much lower than those in the control group [（6.8±0.8） mmol/L,（10.3±1.6） mmol/L,（7.8±0.7） %,（15.6±4.0） mU/L,（3.1±0.6）,P<0.05];serum laminin （LN）,serum hyaluronic acid （HA）,procollagen III （PC III） and type IV collagen （IV-C） levels in the observation group were （144.3±54.2） μg/L,（81.7±38.7） μg/L,（116.3±31.4） μg/L and（71.2±42.9） μg/L,also much lower than those in the control group [（177.3±63.5） μg/L,（123.1±41.9） μg/L,（165.7±28.6） μg/L and（124.7±39.1） μg/L,P<0.05]. Conclusion Entecavir can inhibit replication of HBV,improve liver function and stabilize HD in patients with HBV-related cirrhosis complicated by HD.

Objective To investigate the efficacy of tenofovir disoproxil（TDF） in the rescue treatment of hepatitis B liver cirrhotics with multiple drug resistant infection. Methods 80 patients with multiple drug resistant hepatitis B-induced liver cirrhosis were recruited in our hospital between October 2014 and June 2016, and they were randomly divided into two groups receiving TDF or entecavir （ETV） for rescue therapy in each 40 patients. All the patients were followed-up for 48 weeks. Results At the end of 24 weeks,serum ALT normalization and HBV DNA negativity rates in TDF-treated group were 70.0% and 82.5%,much higher than 50.0% and 65.0%,respectivley（P<0.05） in ETV-treated gruop;at the end of 48 weeks,they were 92.5% and 95.0%,much higher than 70.0% and 75.0%,respectively（P<0.05） in ETV-treated group;at the end of 48 w regimen,serum ALT, ALB, Child-Pugh score and liver stiffness measurement were （45.6±10.4）IU/L,（35.2±1.9）g/L,（6.3±1.1） and （14.5±2.5） kPa,significantly different as compared to 【（58.7±11.4）IU/L,（33.5±2.0）g/L, （7.9±1.2） and （17.5±2.8） kPa,P<0.05】,respectively,in patients receiving ETV treatment;serum renal function index and phosphorus had no significant changes in the two groups,and viral breakthrough occurred in one （2.5%） and in two （5.0%） patients in the two groups（P>0.05）. Conclusions TDF has the ability to effectively inhibit HBV replication,and could improve the liver functions of patients with hepatitis B-induced liver cirrhosis. It is safe and reliable and might be used as an effective alternative agent for rescue therapy for patients with multi-drug resistance infection.

Objective To investigate the clinical application of serum neutrophil gelatinase associated apolipoproteins（NGAL） and serum creatinine（sCr） in the early diagnosis of hepatorenal syndrome（HRS） in patients with liver cirrhosis. Methods The clinical data of 108 patients with hepatitis B-induced liver cirrhosis in our hospital between March 2014 and March 2017 were retrospectively analyzed. Out of them,45 patients had HRS,and 63 had not. 66 persons for physical examination at the same time in our hospital were selected for the control. Serum NGAL and Cr in three groups were determined routinely. The early diagnostic value of serum NGAL and Cr in patients with hepatitis B cirrhosis complicated by HRS was analyzed by area under ROC. Results Serum NGAL and Cr levels in HRS group were （64.1±18.4） ng/ml and（109.6±24.5） μmol/L,which were significantly higher than [（10.6±3.1） ng/ml and（88.2±15.7） μmol/L,P<0.05] in patients without HRS or [（8.3±2.2） ng/ml and（82.6±14.3） μmol/L,P<0.05] in the control,and serum NGAL and Cr levels were not significant different between the control group and non-HRS group（P>0.05）;The Spearman correlation analysis showed that serum NGAL and Cr were negatively correlated with 24-Ccr（r=-0.768,P<0.01;r=-0.721,P<0.01）;The AUC of combination of NGAL and sCr in the diagnosis of HRS was 0.895（0.860-0.912） with a sensitivity of 82.5%,the specificity of 83.4% and the accuracy of 75.8%,which were significantly higher than those by any of the single parameters[the AUC of ROC_NGAL was 0.751（0.708-0.794） with a sensitivity of 75.3%,specificity of 84.5% and the accuracy of 63.84%; and the AUC of the ROC_sCr was 0.743（0.714-0.772） with a sensitivity of 73.2%,a specificity of 66.8% and the accuracy of 56.38%]. Conclusion The application of serum NGAL in the early diagnosis of hepatorenal syndrome in patients with liver cirrhosis is helpful,and the sensitivity and specificity of combination of serum NGAL and Cr is more practical,which can improve the early diagnosis of hepatorenal syndrome in patients with liver cirrhosis.

Objective To investigate the changes of peripheral blood Th17 and Treg cells and their related serum cytokines in patients with chronic hepatitis C（CHC） and liver cirrhosis（LC）. Methods 33 patients with CHC, 27 with CHC-induced LC patients and 30 healthy persons were recruited in this study between October 2014 and October 2016. The patients with CHC received PR therapy for 12 months. The percentages of peripheral blood Th17 and CD4⁺CD25⁺Foxp3⁺Treg cells and serum interleukin-6（IL-6）,IL-10,IL-17 and transforming growth factor-β （TGF-β） were detected by FCM and ELISA respectively. Results The percentages of Th17 and Treg cells and the Th17/Treg ratio in patients with LC were （4.6±0.7）%,（2.7±0.5）% and （1.6±0.4）,and in patients with CHC were （5.8±0.9）%,（3.1±0.6）% and （1.9±0.5）, both significantly higher than（2.3±0.4）%,（1.7±0.4）% and（1.4±0.2） in healthy control （P<0.05）,and the percentages of Th17 and Treg cells and the Th17/Treg ratio in patients with LC were significantly higher than those in patients with CHC （P<0.05）;serum levels of IL-6, IL-10,IL-17 and TGF-beta in patients with LC were（9.9±2.5） ng/L,（18.0±3.2） ng/L,（15.3±2.8） ng/L and （5.5±0.8） ng/L and in patients with CHC were （14.1±3.0） ng/L,（21.4±4.0） ng/L,（23.3±3.9） ng/L and （7.2±1.2） ng/L,both significantly higher than （6.7±1.1） ng/L,（14.2±2.9） ng/L,（5.3±0.6） ng/L and （4.3±1.0） ng/L in healthy persons（P<0.05）,and serum IL-6,IL-10,IL-17 and TGF-β levels in patients with LC were significantly higher than those in patients with CHC（P<0.05）;the percentages of Th17 and Treg cells,and serum TGF-β,IL-10 and IL-17 levels in patients with CHC at the end of the treatment weere （3.4±0.6）% and （1.9±0.4）%,and （4.7±0.6） ng/L,（15.1±2.5） ng/L and（11.5±2.1） ng/L,all significantly lower than those before treatment（t=7.477,t=7.177,t=4.596,t=4.102,t=6.237,P<0.05）. Conclusion The blood Th17 and Treg cell numbers and their related serum cytokines in patients with CHC and LC increase,which might be closely related to the pathogenesis of hepatitis C viral infection. The surveillance of the regulatory T lymphocytes and cytokines might be helpful in evaluating antiviral therapy.

Objective To evaluate the efficacy of intrahepatic human umbilical cord mesenchymal stem cell （HUC-MSCs） transplantation in the treatment of patients with hepatitis B-induced decompensated liver cirrhosis （LC）. Methods60 patients with decompensated hepatitis B LC were recruited in this study,and 20 received intrahepatic HUC-MSCs transplantation for once,20 for two to three times,and another 20 received conventional therapy for control. All patients were followed-up for 36 months. Results During the follow-up period,2 patients in multiple cell transplantation group,3 patients in the single cell transplantation group and 5 patients in the control group died;at the end of 36 month follow-up,serum bilirubin,albumin,international ratio of prothrombin time levels and Child-Pugh score in multiple cell transplantation group were（19.8±5.6） μmol/L,（40.6±2.2） g/L,（1.1±1.6） and （5.5±0.48）,much superior as compared with （50.2±4.3） μmol/L,（32.4±4.3） g/l,（1.6±1.3） and （8.9±0.5） in the control group（P<0.05）,or with （30.4±8.6）μmol/L,（35.6±4.8） g/L,（1.4±0.9） and（7.0±0.6） in patients receiving single cell transplantation（P<0.05）;the maximum liver cross-sectional area was（140.2±14.5） cm²,the spleen length was（145.2±19.3） mm and the spleen thickness was （45.8±9.2） mm in the patients receiving multiple cell transplantation,much superior as compared with （134.3±15.6） cm²,（154.7±20.1） mm and （49.9±8.7） mm in the control（P<0.05）. Conclusion Multiple intrahepatic HUC-MSC transplantation in treatment of patients with decompensated hepatitis B-induced liver cirrhosis might improve liver functions,and the approach is safe and reliable, which worth further investigation.

Objective To investigate the impact of UGCG siRNA on 7702 hepatocyte proliferation in vitro. Methods The 7702 hepatocytes were cultured in vitro and UDP-glucose ceramide glucosyltransferase（UGCG） siRNA was transfected into the hepatocytes. MTT was performed to detect the cell proliferation,the Bcl-2,Bax,Caspase 3 gene were detected by real-time quantitative PCR,and the expression of Caspase 3 protein in hepatocytes was detected by Western blot. Results UGCG siRNA successfully down-regulated glucosylceramide synthase mRNA levels as compared to that in the control（P<; 0.05）;the proliferation of hepatocytes was inhibited（P<; 0.05） after transfection of the glycosylated ceramide synthase gene,Bcl-2 mRNA decreased（P<; 0.05）,Bax mRNA increased （P<; 0.05）,and the expression of Caspase 3 protein was significantly upregulated（P<; 0.05）. Conclusion The changes of sphingolipid metabolism caused by the lack of glucosylceramide synthase is involved in hepatocyte proliferation, which might be related to the regulation of BCL2/BAX signal pathway.

Objective To investigate the effect of let-7a on proliferation of HCCLM3 cells under hypoxia by regulating autophagy in vitro. Methods The HCCLM3 cells from human hepatocellular carcinoma were divided into three groups,e.g. the normoxia group:5×10⁶/mL HCCLM3 cells in 10% fetal bovine DMEM medium were cultured in 37 ℃,5% CO₂,20% O₂,hypoxia group:in 37 ℃,5% CO₂,2% O₂,93%N₂ and hypoxia let-7a group:in 37 ℃,5% CO₂,2% O₂,93%N₂. Six parallel samples were prepared in each group and cultured for 72 h. After incubation,the autophagy of HCCLM3 cells was detected by acridine orange staining,the activity of HCCLM3 cells was detected by MTT,the HCCLM3 cell cycle analysis G1 was detected by flow cytometry,and the let-7a,cyc D1 and vascular endothelial growth factor （VEGF） levels in supernatant were determined by ELISA. Results The cell survival rate in oxygen let -7 group was（49.7±9.5） %,significantly lower than in normal oxygen or hypoxia group [（100.0±0.0） % or （119.1±13.1） %,P<0.05],the cell survival rate in hypoxia group was significantly higher than that in the normal oxygen group （P<0.05）;the cell cycle G1 phase and the rate of autophagy in oxygen let -7a group were （89.6±16.1） % and （49.3±7.4） %,significantly higher than those in normal oxygen or hypoxia group [（56.3±11.0）% and（13.2±8.1）% or（69.7±14.1）% and（23.5±5.5）%（P<0.05）;the let-7a level in the supernatant in the oxygen let -7a group was（96.1±9.3） μmol/L,much higher than in the normal oxygen or hypoxia group [（33.4±7.1）μmol/L or （65.3±5.2）μmol/L,P<0.05],cyc D1 and VEGF levels were（72.3±8.8）μmol/L and（56.3±6.3）μmol/L,much lower than in the normal oxygen or hypoxia group [（124.1±7.2）μmol/L and（114.1±5.2） μmol/L or （98.2±6.7） μmol/L and （85.2±8.1）μmol/L,P<0.05]. Conclusion The upregulation of let-7a expression in hepatocellular carcinoma HCCLM3 cells in vitro can induce cell autophagy,make the transformation disorder of the cells in G1 phase to S phase,inhibit the proliferation of cells in hypoxia,and the mechanism might be the decreased CYC D1 and VEGF expression.

Objective To explore the inhibitory effect on hepatocellular carcinoma growth by microRNA194 overexpression in Balb/c nude mice,and the possible mechanism by which the microRNA194 works. Methods We constructed the hepatoma cell Hep3B with microRNA194 overexpression by cell transfection and the cells were subcutaneously inoculated into Balb/c nude mice. Then,the microRNA194 overexpression was verified in Hep3B cells and in the tumor tissues by real-time fluorescent quantitative PCR. Thirty Balb/c nude mice were randomly assigned to the microRNA194 overexpression group （n=15） and the control group （n=15）. The tumor volume was measured every 5 days and the tumor weight was measured at 21 days post-inoculation. Finally,real-time fluorescent quantitative PCR and Western bolt were performed to detect insulin-like growth factor 1 receptor （IGF1R） mRNA levels and its protein expression respectively. Results The microRNA194 levels in Hep3B cells and in tumor tissues with microRNA194 overexpression were （2.68±0.33） and （2.33±0.38）,much higher than in the control group【（1.00±0.12） and（1.00±0.16）,respectively,P<0.01】;At day 11,day 16 and day 21 post-inoculation,the tumor volume in the microRNA194 overexpression group were （0.25±0.08）,（0.31±0.11） and （0.46±0.10） mm³,much lower than in the control group 【（0.56±0.13）,（0.73±0.20） and （0.95±0.22） mm³,P<0.01】;At day 21 post-inoculation,the tumor weight in the microRNA194 overexpression group was （0.85±0.19） g,much lower than in the control group【（1.43±0.27） g,P<0.01】;the mRNA level and its protein expression of IGF1R in the microRNA194 overexpression group were（0.78±0.12） and （0.81±0.17）, much lower than in the control group 【（1.0±0.16） and （1.0±0.11）,P<0.01】. Conclusion The overexpression of microRNA194 might inhibit tumor growth by suppressing the expression of IGF1R, which needs further investigation.

Objective To investigate the pathological and clinical features and factors affecting significant liver fibrosis in patients with chronic hepatitis B（CHB）. Methods The clinical data and liver biopsies in 250 patients with CHB were analyzed retrospectively,and serum HBV DNA loads and 1iver stiffness measurements were obtained. The factors affecting liver fibrosis was analyzed by Logistic analysis. Results The rate of patients with high serum HBV DNA loads was lower in 160 patients with serum HBeAg negative（66.9% vs. 99.4%, P<0.05） as compared to that in 60 with serum HBeAg positive;serum levels of ALT and AST in patients with serum HbeAg negative were siginificantly lower than in serum HBeAg positive group （P<0.05）;the hepatic activity grading and fibrosis staging in the two groups had no statistically significant differences（P>0.05）;multivariate Logistic regression analysis showed that age ≥40 yr,higher serum HBV DNA loads,lower PTA and high liver stiffness were the independent risk factors for significant liver fibrosis in patients with CHB. Conclusion There are many obvious clinical and histopathological differences in patients with serum HBeAg negative and positive, and the clinicians might take more attention to patients with serum HBeAg negative.

Objective To forecast hepatic activity index and liver fibrosis staging by serum golgiprotein-73（GP73） levels in individuals with chronic hepatitis B viral carriers. Methods 150 individuals with chronic HBV carriers,150 patients with chronic hepatitis B,150 patients with hepatitis B liver cirrhosis and 50 healthy persons were recruited in this study between January 2014 and December 2016,and serum GP73 levels were detected by ELISA. Liver biopsies were performed in 150 individuals with chronic HBV carriers,and liver inflammation grading and fibrosis staging were evaluated by Metavir score. Results Serum GP73 level in patients with liver cirrhosis was （231.6±20.1） ng/ml,much higher than （46.5±7.8） ng/ml in chronic HBV carrier or （90.2±10.9） ng/ml in patients with chronic hepatitis B,and all of them were higher than（36.7±6.6） ng/ml in healthy persons （P<0.05）;the liver biopsies in individuals with HBV carrier showed that G₀~G₁ were found in 105,G₂ in 30 and G₃~G₄ in 15,and serum GP73 levels were（45.2±12.8）ng/ml,（63.8±15.0）ng/ml and（83.7±20.1）ng/ml,respectively,and S0~S1 in 98,S2 in 30 and S₃~S₄ in 22,and serum GP73 levels were（45.1±16.8）ng/ml,（67.3±16.4）ng/ml and（72.0±18.4）ng/ml,respectively,suggesting obviously increased serum GP73 levels in those with significant liver histopathologic inflammation grading and significant fibrosis staging（F=16.8,F=19.2,P<0.05）;Logistic regression analysis showed that increased serum GP73 level was an independent factor for significant hepatic inflammation （OR=1.1,95% confidence interval:1.0~1.1,P<0.05） and for significant liver fibrosis （OR=2.1,95% CI:0.8~1.2,P<0.05）. Conclusion Serum GP73 level is associated with liver inflammation grade and fibrosis stage in chronic HBV carriers,which warrants further study to determine whether or not it might be acted as an potential marker for predicting liver inflammation and fibrosis.

Objective To investigate hepatic activity grading and fibrosis staging in hepatitis B patients with low serum hepatitis B surface antigen levels. Methods Seventy patients with low serum HBsAg levels were recruited in our hospital between March 2016 and March 2018. The liver biopsies were performed in all patients,and the Scheuer’s hepatic activity index was applied to determine the hepatic inflammation grade and fibrosis stage. Univariate and multivariate regression analysis was used to analyze the influencing factors. Results There were 26 patients （37.1%） without or with mild hepatic inflammatory grading （G₀-G₁）,and 44 patients （62.9%） with moderate to severe inflammatory grading （G₂-G₃）,and there were 37 patients （52.8%） without or with mild hepatic fibrosis （S₀-S₁） and 33 patients （47.2%） with moderate to severe hepatic fibrosis （S₂-S₃）;univariate and multivariate regression analysis showed that the duration of infection[OR=3.245,95 % confidence interval （CI）:1.210-2.012,P=0.035] and splenic vein diameter（OR=4.011,95% CI:1.248-6.514,P=0.025） were the independent risk factors affecting hepatic activity grading,and serum aspartate aminotransferase level（OR=2.225,95% CI:0.895-1.211,P=0.048） and platelet counts（OR=3.014,95% CI:0.964-1.010,P=0.021） were the independent risk factors affecting liver fibrosis. Conclusion The hepatic activity index might be increased in CHB patients with low serum HBsAg levels,suggesting that they should be given much more medical attention for appropriate management in time.

Objective To evaluate the clinical efficacy and safety of large dose of domestic interferon-α2b and ribavirin in the treatment of patients with chronic hepatitis C（CHC）. Methods In this study,we recruited 178 patients with CHC between January 2012 and January 2016,and 148 patients were treated with domestic interferon-α2b at dose of 6 MU qod in combination with ribavirin,and 30 patients were treated with pegylated interferon-α in combination with ribavirin. The regimen lasted for 48 weeks and all patients were followed-up for 24 weeks. Results At presentation,serum ALT level was （80.9±22.6）U/L,serum AST level was （74.3±18.2）U/L,and serum HCV RNA load was （2.9±0.5）×10⁵copies/mL in patients receiving domestic interferon-α,no significant differences as compared to 【（82.32± 20.5） U/L,（72.9±16.7）u/L and （2.8±0.5）×10⁵copies/ml】 in patients receiving pegylated interferon-α（P>0.05）;at the end of 4 w,12 w,24 w and 48 w treatment and at the end of 24 w followed-up,serum ALT normalization rats in domestic interferon-treated patients were 79.7%,87.2%,90.5%,92.6% and 86.5%,without significant differences as compared to 76.7%,83.3%,90.0%,93.3% and 90.0% in pegylated interferon-α-treated patients（P>0.05）;serum HCV RNA loss were 66.2%,71.0%,84.5%,90.5%and 69.5%,without significant differences as compared to 66.7%,73.3%,80.0%,90.0% and 70.0% in pegylated interferon-α-treated patients（P>0.05）;the hypocytosis,hair loss and anorexia were more common and severe in pegylated interferon-α-treated patients（P<0.05）. Conclusion The application of large -dose interferon α2b in combination with ribavirin in the treatment of patients with CHC might get the same clinical efficacy of pegylated interferon-α treatment,with less side effects, which needs further investigation and long-term observation.

Objective To investigate the efficacy of polyene phosphatidylcholine（PPC） in patients with moderate -to-severe nonalcoholic fatty liver disease （NAFLD）. Methods A total of 90 patients with moderate -to-severe NAFLD were recruited in our hospital between January 2013 and December 2016,and were randomly divided into three groups by computer-generated randomized numbers. The patients in control received routine treatment, and those in observation group one received PPC orally,and in observation group two received PPC intravenously for eight weeks. Results At the end of the observation,the ultrasound scores in observation group one and two were （3.2±0.7） and（3.3±0.6）,much lower than （4.5±0.6） in the control,and the liver/spleen CT ratios were（0.9±0.2） and （0.9±0.1）,much higher than （0.7±0.2） in the control （P<0.05）;serum levels of total cholesterol （TC）,triglyceride（TG） and low density lipoprotein （LDL-C） in observation group one were（4.8±0.6）mmol/L,（2.0±0.2）mmol/L and（3.0±0.2）mmol/L,and in observation group two were （4.7±0.6）mmol/L,（1.9±0.3）mmol/L and （2.9±0.3）mmol/L,much lower than（5.1±0.5）mmol/L,（2.2±0.2）mmol/L and（3.3±0.3） mmol/L,while high density lipoprotein （HDL-C） were （1.4±0.4）mmol/L and （1.4±0.3）mmol/L,respectively,much higher than （1.3±0.3）mmol/L in the control（P<0.05）;serum tumor necrosis factor-α（TNF-α）,monocyte chemotactic protein-1（MCP-1） and nuclear factor-κB （NF-κB） levels in observation group one were （10.3±2.6）ng/ml,（4.6±0.7） ng/mL and （9.4±1.1）ng/ml,and in group two were （9.8±2.3）ng/mL,（4.4±0.6）ng/ml and （9.6±1.4）ng/ml,much lower than（22.5±3.6）ng/ml,（9.3±1.1）ng/ml and（16.3±2.5）ng/ml in the control,while serum heme oxygenase-1 （HO-1）,glutathione peroxidase （GSH-Px） and superoxide dismutase （SOD） levels were much higher than those in the control（P<0.05）. Conclusion There is no significant difference in the efficacy and safety of PPC orally and intravenously in the treatment of patients with NAFLD. The therapy might promote blood lipid metabolism, and the possible mechanism might be related to the inhibition of inflammatory reaction and oxidative stress response.

Objectivee To analyze the severity of coronary artery lesions and risk factors in patients with nonalcoholic fatty liver disease （NAFLD） complicated by coronary heart disease （CHD）. Methods 154 patients with NAFLD were recruited in our hospital between January 2015 and January 2017,and 71 were found with CHD by coronary angiogram. The degree of fatty liver was determined by altrasonography and/or CT scan. Logistic analysis was applied to screen the risk factors for CHD occurrence. Results There were statistically significant differences between the two groups as respect to the percentages of diabetes and smoking,and serum levels of FPG,TC,TG,ALT,AST,GGT,hs-CRP and HOMA-IR （t/x²=7.62,5.38,3.82,5.80,3.72,8.79,3.10,5.75,5.25,5.93, P<0.05 or P<0.01）;multivariate Logistic regression analysis showed that diabetes,FPG,TC,ALT,hs-CRP and HOMA-IR were the independent risk factors of CHD in patients with NAFLD （P<0.05 or P<0.01）;among 71 patients with CHD,there were 37 cases with mild,23 with moderate and 11 with severe NAFLD,and there were statistically significant differences among the three groups as to the percentages of single,double and three branches coronary artery lesions （x²=14.8,P<0.01）. Conclusion The incidence of CHD in patients with NAFLD is relatively higher,and clinicians must take the risk factors into consideration in clinical practice in order to decrease the morbidity and mortality of heart diseases.

Objective To investigate the clinical application of ultrasonography in the early diagnosis of patients with small primary liver cancer （PLC）. Methods 156 individuals with high risk of PLC were monitored by ultrasonography in the Department of Oncology between January 2016 and December 2016 in this study. Computed tomography（CT）,and magnetic resonance imaging（MRI） were performed within 15 days after contrast-enhanced sonography. The pathologic diagnosis was made by surgical histopathological examination or fine needle biopsy. Results Out of the 156 persons with high risk of PLC,29 malignant and 14 suspected malignant foci were found by routine sonography,while 32 malignant and 9 suspected malignant foci were detected by contrast-enhanced sonography;32 hepatocellular caicinoma （HCC） and 9 suspected malignant foci were confirmed by pathology;out of the 32 patients with HCC,17 were men,and 15 women with a average age of 48.56±2.05 （20~69） yr,the diameter of foci was 0.8~2（1.62±0.12） cm,and the foci was arterial enhancement and hypoechogenicity in portal and delayed phase in 13,and keeping enhancement in three phase in 19. Conclusions Regular monitoring of ultrasonography is necessary in individuals with high risk of PLC for early diagnosis of malignant foci.

Objective To investigate the effectsof propofol on peripheral blood lymphocyte subsets and serum tumor related markers in patients with primary liver cancer（PLC） receiving partial hepatectomy（PH）. Methods A total of 92 patients with PLC were recruited in our hospital between February 2010 and April 2014,and were divided into propofol and isoflurane group,with 46 in each when PH was done. The percentages of peripheral blood lymphocyte subsets were detected by FCM,and serum E-cadherin（EC）,vascular endothelial growth factor（VEGF） and matrix metalloproteinase（MMP） levels were detected by ELISA. Results The percentages of peripheral blood CD3⁺,CD4⁺ and CD8⁺ cells,and the ratio of CD4⁺/CD8⁺ showed no significant differences between the two groups before anesthesia（P>0.05）,while 1 day after operation,the percentage of CD3⁺ and CD4⁺ cells were （56.3±4.8）% and （36.8±5.7）% in the propofol group,significantly higher than （52.5±4.5）% and （34.2±4.2）% in the isoflurane group （P<0.05）;before anesthesia,there was no significant difference as recpect to serum EC,VEGF and MMP levels between the two group（P>0.05）,while 14 days after operation,serum levels of these three cytokines were （1763±112.7） ng/ml,（201.9±36.9） pg/ml and（32.4±4.2） ng/L in the propofol group,significantly lower than （2318±153.9） ng/ml,（369.9±56.8） pg/mL and（72.5±7.2） ng/L in the isoflurane group （P<0.05）;the incidence rate of leukopenia in the propofol group was significantly lower than that in the isoflurane group（47.8% vs. 69.6%,P<0.05）;there were no significant differences between the two groups as respect to the postoperative 3-year survival rates（P>0.05）. Conclusion Propofol can effectively relieve the postoperative immunosuppression in patients with PLC,which might inhibit tumor cell metastasis and improve the recovery.

Objective To investigate the diagnostic value of 3.0T multi-phase dynamic magnetic resonance （MR） enhanced scan and multi-slice spiral CT three-phase augmentation in patients with hepatocellular carcinoma（HCC）. Methods Ninety-eight patients with suspected primary liver cancer were admitted to our hospital between September 2015 and September 2017,and all of them received MR imaging （MRI） and CT scan. Their efficacy of diagnosis was evaluated by histopathological examination. Kappa test was used to analyze the consistency between diagnostic scores by three doctors' determination. The receiver operating characteristic curve （ROC） was used and the area under the curve （AUC） was calculated to determine the diagnostic efficacy of the imaging findings. Results 86 case out of 98 patients were diagnosed with HCC by pathological confirmation. 97 cancerous foci were found in the 86 patients with HCC by imaging check-up, and 32 were less than 1.0 cm;MRI found 31（96.9%）,while CT found 26（81.3%,P<0.05） out of the 32 foci <1.0 cm;both MRI and CT found other 65 foci >1.0 cm;kappa test analysis showed that the HCC diagnostic scores by three physicians were consistent with the k=0.77,0.82,0.74（P>0.05）;ROC analysis demonstrated that the AUC were 0.962 and 0.824,respectively,（t=3.106,P<0.05） by MRI and CT,with the sensitivity,specificity and accuracy being 99.0%,91.0% and 96.2% by MRI,significantly superior to 93.8%,72.0% and 85.3% by CT scan（x²=19.587,P<0.05）. Conclusion The multi-phase dynamic contrast-enhanced 3.0T MR scan could show the fine morphology and enhancement features of HCC lesions,which might has a better diagnostic efficacy in finding small hepatic cancer.

Objective To investigate the effect of 1aparoscopic hepatectomy on peripheral blood T lymphocyte subsets and serum cytokines in patients with primary liver cancer（PLC）. Methods 68 patients with PLC were recruited in our hospital between February 2014 and February 2015,and were randomly divided into two groups with 34 in each. 34 patients received laparoscopic hepatectomy and another 34 received open hepatectomy. The peripheral blood T lymphocyte subsets and serum cytokines,immunoglobulin levels were assayed and compared between the two groups. Results The percentages of peripheral blood CD3⁺,CD4⁺ and CD8⁺T cells in the two groups at presentation were not significantly different（P>0.05）,while the CD3⁺,CD4⁺ and CD8⁺T cells in patients receiving laparoscopic hepatectomy seven days after operation were（57.2±5.6）%,（46.9±7.2）% and （28.4±5.3） %,significantly different as compared to[（51.9±3.2）%,（41.2±6.4）% and（33.6±2.3）%] in open hepatectomy,respectively,（P<0.05）;serum vascular endothelial growth factor（VEGF）,fibroblast growth factors-a （aFGF） and bFGF levels were （18.4±5.1） ng/ml,（5.3±4.2） pg/ml and （6.5±4.3） pg/ml,much lower than [（31.9±5.7） ng/ml,（8.7±5.2） pg/ml and（8.4±6.9） pg/ml,respectivley,in open hepatectomy,P<0.05];the changes of blood liver function index and immumoglobulin levels in the two groups were not significantly different（P>0.05）. Conclusion The impact of laparoscopic hepatectomy on immune functions is milder than open operation, might be related to its mild injuries in the process.

Objective To investigate the efficacy of radiofrequency ablation （RFA） combined with DC-CIK in the treatment of patients with advanced hepatocellular carcinoma（HCC） and its effect on the quality of life. Methods 144 patients with HCC at ⅢB~Ⅳ stage were recruited in our hospital between September 2013 and September 2016,and were randomly divided into combination and and control group with 72 patients in each group. The patients in both groups were treated with RFA,and 72 out of them received DC-CIK therapy and RFA combination. The quality of life was evaluated by QLQ-C30 questionnaire. Results The objective response rate （ORR） was 70.8%,and the disease control rate （DCR） was 90.3% in the combination group,much higher than 40.3% and 72.2% in the control,and progress-free survival（PFS） was（13.2±3.1） m,much longer than 【（10.5±3.3）m,P<0.05】 in the control;serum AFP,CEA and CA-199 levels were （240.5±28.7） ng/ml,（100.8±20.4） ng/ml and （210.8±52.4） U/ml,much lower than 【（320.4±70.1） ng/ml,（129.4±30.7） ng/ml and （320.7±40.9） U/ml,P<0.05】,respectively in the control;the physical,role’s,emotional,cognitive and social functions in the combination were much higher than those in the control（P<0.05）. Conclusions RFA combined with DC-CIK therapy in the treatment of patients with advanced HCC is in short and long term efficient,which improve the quality of life of the patients.

Objective Lymph node（LN） metastasis is a major negative predictive factor for hilar cholangiocarcinom （HC）. Whether clearance of abdominal aortic LN can influence progression free survival （PFS） and overall survival （OS） in Bismuth type I and II HC has not been well evaluated. Methods We retrospectively reviewed the data of 72 patients with Bismuth type I and II HC admitted to our hospital undergoing surgical resection with curative intent between 2005 and 2009. Results Compared to 37 HC patients without clearance of abdominal aortic LN,35 patients with clearance of abdominal aortic LN demonstrated a significantly lower 1,2 and 3 a tumor recurrence rate（22.9%,40.1% and 65.7% vs. 45.9%,62.2% and 91.9%,respectively,P<0.05）;PFS were 65.7%,40.0% and 17.1,and OS were 74.3%,60.0% and 31.4%,both much higher than in patients without clearance of abdominal aortic LN（35.1%,16.2% and 2.7%,and 59.5%,40.5% and 13.5%,respectively,all P<0.05）. Conclusions Clearance of abdominal aortic LN could reduce the recurrence of tumor and improve PFS and OS in patients with type I and II HC after surgical operation.

Objective To investigate the efficacy of ultrasound（US）-guided percutaneous aspiration in treatment of patients with purulent liver abscess（PLA） and its effects on blood cytokine levels. Methods 78 patients with PLA were recruited in our hospital between March 2014 and March 2017,and they were randomly divided into two groups by computer-generated numbers. The patients in observation group were treated by direct aspiration under US guidance,and those in the control were treated by percutaneous transhepatic catheter drainage under US guidance. Serum interleukin（IL）-6）,IL-8 and tumor necrosis factor-α（TNF-α） were detected by ELISA,and blood procalcitonin level was routinely assayed. Results The time of abscess disappearance in the observation was （9.0±0.9） d,much shorter than（13.0±1.3） d in the control （P<0.05）,while there were no significant differences between the two groups as respect to pain disappearance,temperature returned to normal,hospital stay and medical costs [（1.3±0.1） d,（2.2±0.2） d,（12.3±1.3） d and （14000±100） yuan vs. （1.4±0.1） d,（2.3±0.3） d,（12.7±1.4） d and （14000±100） yuan, respectively,P>0.05];there were no significant differences between the two groups as respect to blood biochemical parameters before and after the treatment （P>0.05）;in the observation group at the end of the treatment,peripheral blood white blood cell counts was（7.2±1.3）×10⁹/L,neutrophil ratio was（0.7±0.1） and serum procalcitonin level was（0.3±0.1） ng/ml,without significant difference as compared to （8.7±1.5）×10⁹/L,（0.7±0.1） and （0.4±0.1） ng/ml（P>0.05） in the control;serum IL-6 level was （0.1±0.1） ng/mL,IL-8 level was（0.1±0.0） ng/ml and TNF-α level was （0.2±0.0） μmol/L,without significant difference as compared to （0.1±0.0） ng/ml,（0.1±0.0） ng/ml and （0.2±0.1） μmol/L in the control （P>0.05）;the local infection occurred in one,bleeding in one and the drainage tube fell off in one in the control. Conclusion Ultrasound-guided percutaneous puncture aspiration in the treatment of patients with PLA have good clinical efficacy and safety.

Objective To investigate the effect of Xueshuantong,a herbal compound,on hepatic arterial blood flow and resistance index in patients after orthotopic liver transplantation （OLT）. Methods 40 patients with benign end-stage liver disease received OLT,and 20 was administered with Xueshuantong injection intravenously,and another 20 without after OLT. The hepatic artery blood flow and resistance index were measured by color Doppler sonography. Results The hepatic artery blood flow in patients receiving Xueshuantong at the end of 1 month,6 months and 18 months were 51.22±12.11 cm/s,61.32±11.87 cm/s and 65.38±12.76 cm/s,significantly higher than 47.181±4.25 cm/s,51.33±13.24 cm/s and 53.45±11.43 cm/s in the control（P<0.05）,and the hepatic artery resistance index were 0.66±0.13,0.62±0.12 and 0.68±0.11,significantly lower than 0.72±0.14,0.71±0.11 and 0.75±0.14 in the control（P<0.05）;serum bilirubin and ALT levels were significantly lower than those in the control group（P<0.05）. Conclusion Application of Xueshuantong injection can improve the hepatic artery blood flow,decrease resistance index and improve the liver function in patients after OLT.

Objective To investigate the effects of sub-dose ketamine combined with total intravenous anesthesia on cognitive function and serum pro-inflammatory cytokine levels in elderly patients undergoing laparoscopic cholecystectomy（LC）. Methods 75 elderly with cholecystolithiasis were recruited in our hospital between June 2015 and June 2016,and all of them underwent LC. During the operation,the patients were randomly divided into observation group（n=40） receiving ketamine and intravenous anesthesia,and control group receiving intravenous anesthesia alone. The satisfaction of anesthesia was assessed by Ramsay’s score,and the cognition was assessed by mini mental state scale （MMSE） score. Serum tumor necrosis factor alpha （TNF-alpha）,interleukin-1 beta（IL-1 beta） and interleukin-6（IL-6） were detected by ELISA. Results At the end of anesthesia,10 min,30 min and 1 hour after the discontinuation of anesthesia,the Ramsay’s scores in the observation group were （4.3±0.3）,（3.1±0.5）,（2.5±0.3） and （2.3±0.3）,much lower than[（4.5±0.4）,（3.4±0.5）,（3.1±0.4） and （2.7±0.5）,P<0.05] in the control;1 h, 3 h,1 d and 3 d after extubation, the MMSE scores were （17.5±0.7）,（20.6±0.7）,（26.1±1.3） and（27.3±0.9）,much higher than [（14.6±0.7）（15.7±0.8）,（20.3±1.4） and（25.1±1.1）,P<0.05] in the control;at the end of the operation and 30 min after extubation,serum TNF-α,IL-1β and IL-6 levels were significantly higher than those in the control（P<0.05）;the awakening time,the time of extubation and orientation recovery were （13.5±1.8） min,（18.2±1.7） min and （20.4±1.8）min,much earlier than[（15.7±1.5） min,（20.6±2.1） min and（23.8±2.9）min,respectively,P<0.05] in the control. Conclusion The combination of total intravenous anesthesia and subdose ketamine can effectively improve the cognitive function in elderly patients undergoing LC operation. It has good anesthetic effect, and the mechanism might be related to the suppression of inflammatory reactions.

Objective To explore the application of multimodal analgesia under the idea of enhanced recovery after surgery in laparoscopic cholecystectomy（LC）. Methods 120 patients with gall stone（n=82） or gallbladder polyp（n=38） were recruited and divided randomly into routine analgesia （control group） and multimodal analgesia under the fast track surgery（study group）,with 60 cases in each group. The perioperative related indicators（postoperative duration of initial exhaust,duration of initial defecation, time of resumed eating,time of off-bed activities,total length of hospital stay） were compared between the two groups,and the pain scores was evaluated by Houston pain outcome instrument（HPOI） and the quality of life score by Pittsburgh sleep quality index（PSQI）. The incidence of postoperative complications was analyzed. Results The initial exhaust time,the initial defecation time,the time for feeding recovery,the ambulation time and the total hospital stay in the study group were（15.3±2.9） h,（30.6±4.3） h,（6.8±2.1） h,（4.8±1.4） h,（3.3±1.2） d,significantly shorter than [（19.2±3.1） h,（45.2±5.3） h,（9.2±2.4） h,（7.2±1.6） h,（4.8±1.4） d] in the control（P<0.05）;at 12 h,24 h and 72 h after operation,the scores of pain in study group were （6.3±1.6）,（7.6±2.1） and （8.3±2.4）,significantly higher than [（4.4±1.3）,（5.2±2.0） and （6.5±2.1）] in the control （P<0.05）,while the PSQI scores were （15.8±3.2）,（13.4±2.8）,（10.6±1.9）,significantly lower than [（18.6±3.5）,（17.5±3.2）,（15.8±2.8）] in the control （P<0.05）;there was no significant difference between the two groups as respect to the incidence rates of postoperative urinary retention,incision infection and deep venous thrombosis（3.3%,1.7%,6.7% vs. 5.0%,1.7%,10.0%,respectively,P>0.05）. Conclusion The application of multimodal analgesia under the idea of enhanced recovery after surgery in the treatment of patients with gall stone or gallbladder polyp after LC is of importance in relieving postoperative pain,improving sleep quality,and promoting the recovery.

Objective To investigate the reasons and prognosis of repeated operations in patients with intra- and extrahepatic cholangiolithiasis. Methods 100 patients with cholangiolithiasis between January 2010 and January 2015 were recruited in this study. The causes of reoperation,options of operations and the quality of life were analyzed. Results 100 patients received reoperation for residual and/or recurrent stones,and 9 were found with concurrent primary biliary enteric anastomotic stenosis,7 with cholangiocarcinoma,and 3 with gastrointestinal stromal tumor and invasion of intrahepatic bile duct;the operation mainly included hepatectomy in 29（29%）,hepatectomy and choledocholithotomy in 24（24%）,choledochoscopic exploratoin and cholangiojejunostomy in 14（14%）;the immediate stone clearance rate was 63%,and the final stone clearance rate was 88%;postoperative incision infection occurred in 19 patients,biliary fistula in 10 patients,pleural effusion in 9 patients,and postoperative biliary tract hemorrhage in 7 patients;75 patients were bile culture positive,and the bacteria were Escherichia Coli（35%）,Pseudomonas aeruginosa （28%）,Klebsiella pneumoniae （19%） and Enterobacter cloacae（18%）;the postoperative hospital stay was （22.7±6.1） d;at 3 and 4 months after operation,2 patients died of secondary tumor and 19 lost;at the end of six months after operation,the physiological function,body pain,general health,role emotional and mental health scores in 79 patients were 92.8±11.6,30.1±9, 87.1±9,98±6.3,81.2±6.7,much improved as compared to those before operation（P<0.05）. Conclusions The main causes of repeated operations were residual stones and recurrence of stones,and surgeons should find more practical and scientific approaches for the radical clearance of stones.

Objective To investigate the diagnostic efficacy of abdominal CT and endoscopic ultrasonography （EUS） examination in patients with chronic pancreatitis （CP）. Methods 78 patients with CP were recruited in this study between May 2012 and March 2017,and all of them were examined by EUS and abdominal CT. The diagnostic efficacy was analyzed by ROC curve. Results The histopathological examination showed that there were 28 patients with CP stage 1, 24 with CP stage 2,and 26 with CP stage 3; the AUC by EUS in diagnosing patients with CP stage 1 was 0.85（95%CI：0.75-0.92）,with the sensitivity （Se） of 85.7%,specificity （Sp） of 84.0%,and accuracy （Ac） of 84.6%,while the AUC by CT examination was 0.72（95%CI：0.61-0.82）,with the Se of 60.7%,Sp of 88.0%,and Ac of 78.2%; the AUC by EUS in diagnosing patients with CP stage 2 was 0.81（95%CI：0.70-0.89）,with Se of 79.2%,Sp of 81.5%,and Ac of 80.8%,while the AUC by CT was 0.73（95%CI：0.62~0.82）,with Se of 62.5%,Sp of 85.2%,and Ac of 78.2%; the AUC by EUS in diagnosing CP stage 3 was 0.75（95%CI：0.64-0.84）,with Se of 84.6%,Sp of 85.2%,and Ac of 85.0%,while the AUC by CT was 0.69（95%CI：0.57-0.79）,with Se of 69.2%,Sp of 88.9%,and Ac of 82.5%. ConclusionThe application of EUS and CT in the diagnosis of patients with CP is both highly efficient,and we recommend the EUS examination especially in patients with early CP in clinical practice.

Objective To investigate the application of CT scan in diagnosis of patients with acute ischemic bowel disease（AIBD）. Methods 20 patients with acute ischemic bowel disease were recruited in our hospital between June 2014 and June 2017,and all of them were checked-up by German SIEMENS Emotion 64 layer spiral CT scan. The data of spiral CT scan was analyzed retrospectively. All patient received fiber colonoscopy. Results Out of the 20 patients with AIBD,the site of ischemic enteropathy was at small intestine in 9 patients（jejunum in 5 patients,ileum in 4）,at ileocecal area in 3 patients（at terminal ileum and ascending colon segments）,at colon in 8 patients（at transverse colon in 3 patientss,at hepatic flexure of colon in 2 patients,at splenic flexure of colon in 1 patients,at descending colon in 1 patient,and at sigmoid colon in 1 patient）;all patients had portal gas accumulation,and 13 of them showed extensive gas accumulation in the portal vein and the hepatic vein,presenting the shadow of the dendritic gas,and in other 7 cases,CT showed a gas shadow at the distal hepatic vein;all patients showed intestinal wall gas accumulation,and there were bubble like low density shadows in the lesion area,a single gas bubbles in 10 patientss,multiple gas bubbles in 7 patients,and band shaped bubbles in 3 patients;CT showed that there was a low density shadow in the intestinal wall;CT showed the thickening and edema of the intestinal wall in 14,bowel dilation in 6,and abdominal effusion in 4;10 patients were scanned by enhanced CT examination and the intensification of the intestinal wall and mesentery in the intestinal segment of the enhanced lesion was weakened,and the lamination was characterized by a ring target and a halo sign;all patients received second CT scan,and they showed different degree of absorption in the portal vein and intestinal walls,e.g. completely absorbed in portal vein in 4 patients,obvious absorption in 9,a small amount of absorption in 4 patients,and no significant change in 3 patients,and pneumatosis was completely absorbed in intestinal segment in 5 patients,obvious absorption in 7 patients,absorption in 6 patients,and no significant change in 2 patients. Conclusion The manifestation of CT examination in patients with AIBD is characteristic,mainly by portal vein and intestinal wall gas accumulation, which might help the diagnosis in clinical practice.

Objective To investigate the application of CT scan in diagnosis of patients with acute ischemic bowel disease（AIBD）. Methods 20 patients with acute ischemic bowel disease were recruited in our hospital between June 2014 and June 2017,and all of them were checked-up by German SIEMENS Emotion 64 layer spiral CT scan. The data of spiral CT scan was analyzed retrospectively. All patient received fiber colonoscopy. Results Out of the 20 patients with AIBD,the site of ischemic enteropathy was at small intestine in 9 patients（jejunum in 5 patients,ileum in 4）,at ileocecal area in 3 patients（at terminal ileum and ascending colon segments）,at colon in 8 patients（at transverse colon in 3 patientss,at hepatic flexure of colon in 2 patients,at splenic flexure of colon in 1 patients,at descending colon in 1 patient,and at sigmoid colon in 1 patient）;all patients had portal gas accumulation,and 13 of them showed extensive gas accumulation in the portal vein and the hepatic vein,presenting the shadow of the dendritic gas,and in other 7 cases,CT showed a gas shadow at the distal hepatic vein;all patients showed intestinal wall gas accumulation,and there were bubble like low density shadows in the lesion area,a single gas bubbles in 10 patientss,multiple gas bubbles in 7 patients,and band shaped bubbles in 3 patients;CT showed that there was a low density shadow in the intestinal wall;CT showed the thickening and edema of the intestinal wall in 14,bowel dilation in 6,and abdominal effusion in 4;10 patients were scanned by enhanced CT examination and the intensification of the intestinal wall and mesentery in the intestinal segment of the enhanced lesion was weakened,and the lamination was characterized by a ring target and a halo sign;all patients received second CT scan,and they showed different degree of absorption in the portal vein and intestinal walls,e.g. completely absorbed in portal vein in 4 patients,obvious absorption in 9,a small amount of absorption in 4 patients,and no significant change in 3 patients,and pneumatosis was completely absorbed in intestinal segment in 5 patients,obvious absorption in 7 patients,absorption in 6 patients,and no significant change in 2 patients. Conclusion The manifestation of CT examination in patients with AIBD is characteristic,mainly by portal vein and intestinal wall gas accumulation, which might help the diagnosis in clinical practice.

Myeloid derived suppressor cells （MDSC） are the kind of immature myeloid cells and progenitor cells from bone marrow. Recent studies found that MDSC were involved in the regulation of pathological changes of various liver diseases. This article systematically summarized the history,clustering and mechanism of MDSC,and the immunoregulatory effects of these cells in the pathogenesis and progression of various liver diseases.

Serum non-organ-specific autoantibodies（NOSA） and anti-thyroid autoantibodies（ATAB） were often found positive in patients with chronic hepatitis C and hepatitis C viral carriers. The patients were characterized by loss of autoimmune tolerance, which might cause a set of autoimmune diseases in this setting. The progress in this field will be discussed in this article.

Non-alcoholic fatty liver disease （NAFLD）,involvement of metabolic syndrome,is being the most common liver disease worldwide. The spectrum of NAFLD ranges from simple steatosis to NASH,finally leading to liver cirrhosis and hepatocellular carcinoma（HCC）. As the obesity is becoming global problem,the incidence of NAFLD,NASH and NAFLD/NASH-associated cirrhosis and NAFLD/NASH-associated HCC is increasing gradually. In recent years,many scholars believe that HCC might arise in the absence of overt cirrhosis in patients with NASH,and the mechanism for the switch remains elusive. The review will focus on the relationship between NAFLD and HCC.