Objective To investigate the influence of miR-363 on the proliferation and apoptosis of HepG2 cells by targeting E2F3 in vitro. Methods The HepG2 cells was cultured and transfected with miR-373 inhibitors or negative control（NC） by Lipofectamine liposome method. At 48 h,MTT method and flow cytometry were used to detect the cell proliferation and apoptosis respectively. The miR-363 mRNA in HepG2 cells was detected by RT-PCR and the E2F3,BAX and caspase-3 proteins in HepG2 cells were detected by Western blot. Results The proliferation rate of HepG2 cells in the control group was（96.4±9.7）%,significantly higher than [（72.3±6.5）%,P<0.05] in the inhibitor-intervened group,while the apoptosis rate was （8.2±1.4）%,significantly lower than[（9.7±0.8）%,P<0.05] in the inhibitor-intervened group;the relative miR-363 mRNA level was（1.0±0.1）,significantly higher than [（0.6±0.2）,P<0.05] in the inhibitor-intervened group;the expression of E2F3 protein was （1.0±0.1）,significantly higher than[（0.6±0.1）,P<0.05],while the expression of Bax and caspase-3 protein were（0.4±0.0） and（0.5±0.1）,significantly lower than [（0.6±0.1） and（0.7±0.0）,respectively,P<0.05] in the inhibitor-intervened group. Conclusion The miR-363 can inhibit the proliferation,and induce the apoptosis of HepG2 cells by targeting E2F3,which provides a theoretical basis for targeted therapy of liver cancer.

Objective To observe the effect of MiR-384 on sirt3/FOXO1 signaling pathway in HFFA-induced Hepa1-6 cells in vitro. Methods Hepa1-6 cells were cultured in DMEM complete medium containing 10% fetal bovine serum. When the cell fusion was up to 80%,DMEM medium containing 1% fetal bovine serum was given and the final concentrations of OA and PA were added with the final concentrations of the two being 1 mmol/L and 0.5 mmol/L,respectively. The incubation at 37°C lasted for 24 h,and the establishment of nonalcoholic steatohepatitis in vitro was determined. The reactive oxygen species（ROS） in the hepatocytes was assayed for successful model. The cells were transfected with miR-384 mimetic,miR-ctrl,miR-384 inhibitor,miR-384 inhibitor ctrl,si-sirt3 or si-ctrl for 48 h. The levels of ROS in the cells were measured by FCM,and the expression of sirt3,FOXO1 and antioxidant proteins（MnSOD and CAT） in the cells were measured by Western blot. Results Compared with in the normal group （0.66±0.01）,the levels of ROS in miR-384 mimetic group and si-sirt3 group were significantly increased [（37.3±1.13） and （10.4±0.36）,respectively,P<0.01];Compared with in the HFFA group（29.4±0.98）,the levels of ROS in HFFA/miR-384 inhibitor group was significantly decreased [（12.8±0.41）,P<0.01];Compared with the expression of sirt3 protein in Hepa1-6 cells in normal group（0.75±0.04）,the sirt3 in HFFA group was decreased[（0.23±0.01）,P<0.01];Compared with in the HFFA group,that in the HFFA/sirt3 group significantly increased[（0.83±0.03）,P<0.01];Compared with the HFFA/sirt3 group,that in the HFFA/sirt3/miR-384 group significantly decreased[（0.46±0.02）,P<0.01];Compared with in the control group,the expression of sirt3 protein and FOXO1 protein in miR-384 mimetic group significantly reduced in Hepa1-6 cells [（0.2±0.01） and（0.3±0.01）,respectively,P<0.01] and the level of CAT and manganese superoxide dismutase（MnSOD） significantly increased [（2.3±0.05） and（2.4±0.06）,P<0.01],while compared in with HFFA group,the expression of sirt3 protein and FOXO1 protein in Hepa1-6 cells in HFFA/miR-384 inhibitor group increased [（0.5±0.02） and （0.7±0.01）,P<0.01],and the expression of MnSOD and CAT decreased[（1.6±0.04）（2.0±0.03）,P<0.01];Compared with the activities of SOD（327±3.45） and CAT（386±4.03） in NAFLD group the levels of SOD and CAT in the normal group[（425±5.49） and（512±6.04）,P<0.01] and SOD and CAT in the miR-384 inhibitor group [（406±4.79） and（447±5.38）,P<0.01] were significantly increased. Conclusion The expression of miR-384 could lead to the increase of oxidative damage induced by HFFA in Hepa1-6 cells,which might partly be contributed to the inhibition of sirt3/FOXO1 pathway.

Objective To construct a eukaryotic vector for recombinant interferon-λ4（IFNL4） protein expression in 293-T cells in vitro. Methods The target fragment of IFNL4 was amplified by PCR from plasmid pFC14A-p179 which contained human IFNL4 gene sequence. The amplified fragment was ligated into pcDNA3.1-His-tag vector and identified by restriction enzyme digestion and sequencing. The vector was then transfected into 293-T cells. After culture for 72 hours,the cells were lysed and the recombinant protein was purified and identified by Western blot. Results The eukaryotic expression vector pcDNA3.1-p179-His was successfully constructed and the recombinant protein was expressed in 293-T cells and successfully purified. Western blot analysis showed that the target protein band was about 20 kDa. Conclusion The eukaryotic expression vector fused with IFNL4 and His-tag is successfully constructed,which might be used as a noval candidate for immune therapy.

Objective To investigate the effects of splenectomy on hepatic fibrosis in mice with poly I:C-induced primary biliary cholangitis（PBC）. Methods Forty C57BL/6 female mice were randomly divided into the splenectomy group （n=10）,sham-operation group （n=10）,model control group （n=10） and normal control group （n=10）. Mice in the first three groups were injected with poly I:C to establish PBC models,while animals in the control were injected with equal volume of saline. At the end 20 weeks,splenectomy was performed in ten mice, and sham operations were performed in another ten mice. Liver index,liver function index and liver histology were performed at each group at the end of 32w. The mRNA levels of TGF-β1,TβRI and TβRII in liver tissues were assayed by RT-PCR,and TNF-α levels in terminal ileum were detected by ELISA. Results At the end of 32 weeks,the liver index were （41.5±5.2）,（39.6±7.5）,（39.1±1.0） and （53.2±2.1）,in splenectomy,sham-operation,model and control group,respectively （P<0.05）;serum ALT,AST and ALP levels in splenectomy group were （43.5±6.4）U/L,（157.7±20.9） U/L and（178.1±38.0） U/L,significantly lower than those in model group[（52.0±9.0） U/L,（183.4±12.4） U/L and（195.3±62.6） U/L,P<0.05 for all];liver fibrosis staging in splenectomy group were significantly milder than those in sham-operation and model control group;hepatic TGF-β1,TβRI,TβRII mRNA levels were （0.5±0.09）,（0.5±0.05） and （0.5±0.09） in splenectomy group,significantly lower than those in model group [（1.0±0.10）,（1.0±0.08） and（1.0±0.09）,P<0.05];the TNF-α level in terminal ileum homogenate was （50.0±8.6）ng/L in splenectomy group,obviously lower than[（106.8±19.8） ng/L,P<0.05] in model group. Conclusion Splenectomy could relieve the progression of liver fibrosis in PBC mice,which might be related to the inhibition of hepatic TGF-β1 and ileal TNF-α expression.

Objective To investigate the protective effect of astaxanthin on hepatic fibrosis and the mechanism by which the TGF-β1/Smad/ERK pathway involved. Methods 50 male SD rats were randomly divided into control,model,colchicine （0.1 mg·kg^-1）,astaxanthin group I （2 mg·kg^-1） and astaxanthin groupⅡ（4 mg·kg^-1）-intervened groups with 10 rats in each group. A rat model of hepatic fibrosis was established by subcutaneous injection of carbon tetrachloride. At 10th week of modeling,rats in each group were respectively given intragastric administration of colchicines or astaxanthin except in control and model with normal salt,for 6 weeks. The expression of type I collagen,Smad2,transforming growth factor-β1（TGF-β1） and p-ERK protein in liver tissues was detected by immunohistochemistry and Western blot,and the collagen I,Smad2,TGF- beta 1 and p-ERK mRNA in liver tissues was detected by RT-PCR. Results The collagen I protein in the liver tissues of control,astaxanthin group I and astaxanthin group II were （0.4±0.1）,（1.4±0.3） and （1.2±0.3）,respectively,significantly lower than [（1.7±0.4）,P<0.05] in the model,Smad2 protein was（0.5±0.1）,（1.3±0.4） and（0.8±0.4）,much lower than [（1.6±0.3）,P<0.05] in the model,TGF-β1 protein was（0.5±0.1）,（1.4±0.4） and （1.4±0.4）,significantly lower than[（1.7±0.4）,P<0.05] in the model,and the p-ERK protein was（0.4 ± 0.1）,（1.3±0.4） and（0.9±0.3）,respectively,also significantly lower than[（1.6±0.5）,P<0.05] in the model;the hepatic collagen I mRNA levels in the control,astaxanthin group I and astaxanthin group II were （1.0±0.1）,（2.0±0.4） and （1.8±0.5）,significantly lower than[（2.4±0.4）,P<0.05] in the model,the Smad2 mRNA were（1.0 ± 0.1）,（2.0±0.5） and （1.8±0.4）,significantly lower than[（2.5±0.6）,P<0.05] in the model,the TGF-β1 mRNA were（1.0±0.1）,（2.1±0.4） and （1.6±0.3）,much lower than [（2.5±0.5）,P<0.05] in the model,and the p-ERK mRNA levels were （1.1±0.1）,（2.1±0.4） and（1.8±0.3）,respectively,also significantly lower than[（2.6±0.5）,P<0.05] in the model. Conclusion Astaxanthin can inhibit the progression of hepatic fibrosis,which might be related to the down-regulation of TGF-β1/Smad/ERK pathway activation.

Objective To observe the efficacy and safety of tenofovir（TDF） in the treatment of patients with chronic hepatitis B（CHB）. Methods Sixty naive patients with CHB were enrolled in our hospital between January 2015 and December 2016,and were randomly divided into two groups,with 30 patients in each group. 30 patients with CHB were given TDF and the other 30 patients with CHB were given entecavir （ETV） treatment for 96 weeks. Serum alanine aminotransferase （ALT） and HBV DNA levels,as well as virological and biochemical response rates were compared between the two groups. Results Before treatment and at the end of 12 w,24 w,48 w,72 w and 96 w of treatment,serum HBV DNA levels in TDF-treated group were（7.5±0.9） lg IU/mL,（1.7±1.4）lg IU/mL,（1.1±1.0） lg IU/mL,（1.0±0.8） lg IU/mL,（0.7±0.6） lg IU/mL and（0.6±0.5） lg IU/mL,and in ETV-treated group were （6.8±1.5） lg IU/mL,（2.1±1.1） lg IU/mL,（1.8±1.1） lg IU/mL,（1.0±0.7） lgIU/mL,（0.8±0.8） lg IU/mL and （0.9±0.8） lg IU/mL,suggesting that at the first 24 w treatment,serum HBV DNA levels in TDF-treated group were significantly lower than in ETV-treated group （P<0.05）;serum ALT levels in TDF-treated group were （205.8±23.8） U/L,（80.7±8.6） U/L,（49.7±12.5） U/L,（46.2±6.7） U/L,（42.5±6.5） U/L and（41.8±2.4） U/L,and in ETV-treated group were （199.0±25.9） U/L,（99.8±11.0） U/L,（59.3±9.4） U/L,（53.9±8.8） U/L,（44.62±7.4） U/L and （42.7±4.5） U/L,respectively,showing than at the first 24 w,serum ALT levels in TDF-treated group decreased more obviously than in ETV-treated group （P<0.05）;at the end of 12 w,24 w,48 w,72 w and 96 w,the virologic response rates in TDF-treated group were 50.0%,70.0%,73.3%,80.0% and 96.7%,while in ETV-treated group were 23.3%（P<0.05）,56.7%,60.0%,70.0% and 93.3%,respectively;serum ALT normalization rates in TDF-treated group were 63.3%,96.7%,96.7%,100.0% and 100.0%,while in ETV-treated group were 50.0%,86.7%,96.7%,96.7% and 100.0%,showing no significantly different between the two groups （P>0.05）. Conclusion Both TDF and ETV might be the optimal option for treatment of naive patients with CHB at present, showing promising efficacy and good safety,which worth further and long-term investigation.

Objective To investigate the efficacy of combination inoculation of hepatitis B vaccine and hepatitis B immunoglobulin（HBIG） on blocking mother-to-child transmission of hepatitis B virus infection in newborn with serum HBsAg/HBeAg-positive mothers. Methods 712 newborns with serum HBsAg（n=304） or HBsAg/HBeAg-positive （n=408） mothers were inoculated with hepatitis B vaccine （n=356） or hepatitis B vaccine and HBIG combination（n=356）. The children were followed-up for ten years. Results Serum anti-HBs positive rates were 89.3%,87.6%,81.1%,83.7% and 76.3% in 56 children at age of 1-2 yr,234 at of 3-4 yr,249 at of 5-6 yr,135 at of 7-8 yr and 38 at of 9-10 yr,and serum HBsAg positive rates were 0.0%,0.4%,0.4%,1.5% and 2.6%,respectively,without significant differences among the five groups（P>0.05）;serum anti-HBs positive rate in combination inoculation group was 84.3%,much higher,while serum HBsAg positive rate was 3.1%,much lower than in hepatitis B vaccine inoculation group（64.3% and 15.2%,respectively,P<0.05）;in children with serum double HBsAg/HBeAg positive mothers,serum HBsAg positive rate in 246 children with combination inoculation was 1.6%,much lower than 11.7% （P<0.05） in 162 children with hepatitis B vaccine inoculation alone,while in children with serum HBsAg positive mothers,there was no significant difference as respect to their serum HBsAg positive rates（2.7% vs. 6.2%,P>0.05） in 110 children with combination and 194 with hepatitis B vaccine inoculation. Conclusions The hepatitis B vaccine combined with HBIG inoculation in newborns with serum double HBsAg/HBeAg positive mothers might block HBV mother to child transmission,which is worthy of clinical observation.

Objective To investigate serum IL-17 and its gene polymorphism in clinical outcomes of individuals with chronic hepatitis B viral infection. Methods 40 patients with hepatitis B liver cirrhosis, 120 patients with chronic hepatitis B,60 patients with asymptomatic HBV carriers and 80 individuals with self-limited HBV infection were rucruited in this study between March 2015 and August 2017. Serum IL-17 levels were detected by ELISA,serum alanine aminotransferase（ALT）,aspartate aminotransferase（AST） and total bilirubin （TBIL） levels were detected by automatic biochemical analyzer. Serum HBV DNA load was detected by polymerase chain reaction with fluorescent probe,and the single nucleotide detection kit was used for polymorphism detection. Results Serum level of IL-17 in patients with hepatitis B liver cirrhosis was higher than in patients with chronic hepatitis B,asymptomatic HBV carrier or self-limited HBV infection（F_3,296=102.8,P<0.05）; serum IL-17 level in patients with chronic hepatitis B was significantly higher than in asymptomatic HBV carrier or self-limited HBV infection（P<0.05）;in patients with hepatitis B liver cirrhosis,serum IL-17 level increased in those with higher serum HBV DNA load（t=5.1,P<0.05） and high ALT level（t=10.7,P<0.05）;in both patients with hepatitis B liver cirrhosis and chronic hepatitis B,serum IL-17 levels increased in those with higher serum ALT levels（t=24.5,P<0.05;t=22.4,P<0.05）and with higher serum bilirubin levels（t=7.3,P<0.05;t=12.8,P<0.05）;the frequency of IL-17-197 AA,AG and GG distribution in patients with liver cirrhosis were 75.0%,10.0% and 15.0%,and allele A distribution frequency was 57.5%,G distribution frequency was 42.5%,while in patients with chronic hepatitis B were 25.8%,16.7%,57.5% and 34.2%,65.8%,respectively,significantly different between the two groups （P<0.05）;the priority frequencies in patients with liver cirrhosis were IL-17-197 AA genotype and A allele,the priority frequencies in patients with chronic hepatitis B were GG genotype and G allele,the priority frequencies in asymptomatic HBV carrier were AA genotype and A allele,and the priority frequencies in self-limited individuals were GG genotype and G allele. Conclusion The host immunity and genetic background determine the outcomes of HBV infection and serum IL-17 plays an important role in the process of chronic hepatitis B virus infection. The AA genotypes and A alleles of IL-17-197A/G might be the HBV susceptible host genes,which increase the adverse outcome of HBV infection.

Objective To investigate the predictive of liver fibrosis by gamma-glutamyl-transpeptidase-to-platelet ratio （GPR） in patients with chronic hepatitis B viral infection with normal serum transaminase levels. Methods 202 patients with chronic HBV infection with normal serum transaminase levels were recruited in our hospital between 2010 and 2016,and all of them underwent liver biopsy. The GPR,AST/PLT ratio index （APRI） and fibrosis index based on the factor（FIB-4） were determined. The area under ROC（AUC） was used for diagnostic efficacy in predicting liver fibrosis. Results F1,F2,F3 and F4 were found in 82,60,39 and 21 cases by the liver biopsies as the gold standard;the GPR,APRI and FIB-4 in patients with F4 were 0.4（0.2,1.0）,（0.6±; 0.2） and 1.6（0.9,1.8）,respectively,while they were 0.2（0.2,0.4）,（0.6±; 0.2） and 0.9（0.9,1.2） in patients with F3,and 0.2（0.1,0.3）,0.4±; 0.2 and 0.9（0.7,1.3） in patients with F2,respectively,differences significant （P<; 0.05）;the AUC of GPR for significant fibrosis（≥F2）,for advanced fibrosis（≥F3） and liver cirrhosis（F4） were 0.739,0.790 and 0.824,respectively,significant higher than（0.547,0.731 and 0.736） by APRI （P<; 0.05）;the AUC of GPR for liver fibrosis≥F3 was 0.790,significant higher than FIB-4（0.748,P<; 0.05）,while the AUC of FIB-4 for liver fibrosis≥F2 was 0.777,significant higher than GPR （0.739,P<; 0.05）;there was no significant difference as respect to the efficacy to predict liver cirrhosis（F4） between FIB-4 and GPR （AUC=0.824 and 0.792,P>; 0.05）. Conclusion GPR might be used to predict the liver fibrosis stages in patients with chronic HBV infection with normal serum aminotransferase levels,which is better than APRI and might be used as a noninvasive biochemical prediction index in this settings.

Objective To investigate the impact of entecavir therapy on hepatic steatosis in patients with chronic hepatitis B （CHB） and nonalcoholic fatty liver disease （NAFLD）. Methods A total of 25 patients with histological-proved chronic hepatitis B（CHB） were enrolled in this prospective study. The patients were treated with entecavir for 96 weeks. The hydrogen proton spectroscopy（¹H-MRS） was performed and the life style was investigated by a questionnaire in all patients. Results 16 patients（64.0%） with CHB were found having liver steatosis≥F1 by liver biopsies. 21 patients （84.0%） obtained complete viralogic response at the end of 96 weeks;serum HBsAg and HBV DNA levels at baseline and at the end of observation were significantly different（P<0.05）,while there were no significant differences as respect to serum bilirubin,ALT,body mass index,waist-hip ratio and low-density lipoprotein cholesterol （P>0.05）;at the end of 96 weeks,8 were found having liver steatosis deteriorated,13 unchanged and 4 improved by the lipid-water ratio（LWR） of ¹H-MRS out of 16 patients with NAFLD and the waist-hip ratio decreased in those with improved steatosis（P<0.05）;the analysis of life habit showed that the staple food was the independent factor which influenced the outcome of hepatic steatosis （P<0.05）. Conclusion Entecavir treatment could not improve hepatic steatosis in patients with CHB and NAFLD,and the decreased waist-to-hip ratio might be associated the improvement of liver steatosis in those patients.

Objective To investigate the application of controlled attenuation parameter （CAP） in screening individuals with risk of metabolic syndrome（MetS）. Methods 662 persons with MetS and 1577 healthy individuals were recruited,and screened by Fibroscan for liver stiffness measure（LSM） and CAP. The clinical parameters were obtained routinely. Results The body mass index （BMI） were [（22.0±2.9） kg/m² and（25.5± 1.4） kg/m²],the waist circumference（WC） were [（78.9±6.7） cm and （85.3±7.1） cm],the systolic blood pressure （SBP） were [（128.0±17.0） mmHg and（139.0±16.0） mmHg] and the diastolic blood pressure （DBP） were [（76.0±9.0） mmHg and（87.0±5.0） mmHg] in healthy persons and in patients with MetS （P<0.001）;the fasting plasma glucose （FPG） levels were [（5.3±0.5） mmol/L and （6.3±0.4） mmol/L],serum triglyceride （TG） levels were [（1.3±0.5） mmol/L and （2.1±0.6） mmol/L],serum total cholesterol （TC） were [（4.7±0.5） mmol/L and （5.0±0.6） mmol/L],HDL-C were [（1.6±0.1） mmol/L and （1.3±0.2） mmol/L],LDL-C were [（2.1±0.3） mmol/L and （2.7±0.5） mmol/L],alanine aminotransferase（ALT） were[（36.5±3.1） U/L and（102.3±4.7） U/L],aspartate aminotransferase （AST） were [（33.4±5.8） U/L and （125.3±7.6） U/L],LSM were[（4.8±0.2） kPa and（6.6±0.3） kPa] and CAP were [（213.1±24.3） dB/m and（269.4±30.2） dB/m] in the two groups （P<0.001）;Logistic analysis showed that BMI,WC,blood pressure,FPG,serum lipid and CAP were the independent risk factors for the development of MetS. Conclusions The screening of individuals with MetS by CAP measure is practical and noninvasive,which warrants further investigation.

Objective To analyze of differentially expressed genes （DEGs） between diabetic and normal liver tissues and to screen proteins in liver tissues that may be associated with insulin resistance. Methods After download the gene expression profile GSE23343 （including gene expression value from 10 cases of type 2 diabetes mellitus and 7 cases of normal liver） from the GEO Database,and the protein-protein interaction network of DEGs was constructed by DEGs expression profiling and functional pathway enrichment analysis. Results After analysis of the microarray data,928 DEGs were found to be significantly up-regulated（P<; 0.01）. Functional pathway enrichment analysis showed that most of the differential genes were enriched in cellular and metabolic processes,and KEGG pathway enrichment showed that DEGs were mainly focused on signal transduction and tumor-associated pathways. Five key protein molecules,e.g. MDM2,PCNA,CAV1,PIK3R1,and NR3C1,were identified by protein-protein interaction network. Conclusion The protein molecules related to the formation of insulin resistance in human liver tissues are systematically selected,which might provide us the basis for the further study of the mechanism of hepatic insulin resistance and for finding new targets of hypoglycemic medicine.

Objective To investigate the clinical features of alcoholic liver disease and alcohol withdrawal syndrome（AWS）. Methods 79 patients were enrolled according to the guideline for management of alcoholic liver disease at our Department of Gastroenterology between 2009 and 2015,including 56 patients with liver cirrhosis,and 20 out of 44 patients showed alcohol withdrawal syndrome after abstinence. Results There were statistical differences as respect to age （54.3±7.1 years vs. 45.1±10.1 years） and total drinking consumption （5607.3±3667.0 g/year vs. 3884.5±2509.4 g/year） in patients with liver cirrhosis and those without （P<0.05）;there were statistical difference as respect to daily drinking consumption（222.1±121.5 g vs. 139.5±92.2 g） and total drinking consumption（5520.4±4400.1 g/year vs. 4274.3±3136.8 g/year） in patients with AWS and non-AWS （P<0.05）. Conclusions Long and huge alcohol consumption might lead to alcoholic liver cirrhosis,and inappropriate abstinence might induce alcohol withdrawal syndrome,which must be take into consideration in clinical practice.

Objective To summarize the diagnostic value of two diagnostic criteria in diagnosis of patients with drug-induced liver injury（DILI） in Chinese population. Methods We searched publications about Chinese patients in journal full-text database,Wanfang database and pubmed database with keywords of drug-induced liver injury,diagnostic criteria,diagnostic scoring system,RUCAM and Maria scale. Literature review,case reports,and duplication data were excluded. Age,gender and diagnostic criteria were summarized. Results A total of 7 papers including 1352 patients with DILI were included in this analysis. The age range of the patients in this series was 2 to 91 years old. Six papers having 997 cases （97.1%） were diagnosed as DILI,and 30 cases （2.9%） were not diagnosed as DILI by RUCAM scale. Four papers having 736 cases（58.8%） were diagnosed as DILI,and 303 cases（41.2%） were not diagnosed as DILI by Maria scale. Conclusion The diagnostic results of DILI by RUCAM scale and Maria scale were not the same sometimes,which warrants further study.

Objective The aim of this prospective study is to verify four bleeding criteria in patients with acute-on-chronic liver failure（ACLF）. Method We prospectively enrolled 56 patients with non-ACLF,26 with Asian Pacific Association for the Study of the Liver （APASL）-ACLF and 12 with European Association for the Study of the Liver（EASL）-ACLF）,and evaluated their bleeding events by using four bleeding criteria,e.g. Bleeding Academic Research Consortium（BARC）,Thrombolysis in myocardial infarction（TIMI）,Global Use of Strategies To Open Coronary Arteries（GUSTO） and International Society on Thrombosis and Haemostasis （ISTH）. Result Out of the 94 patients,bleeding events occurred in 57.6%,and lethal bleeding events was 1.1%;the bleeding incidence in patients with non-ACLF was 41.1%,significant lower than 76.9% in patients with APASL-ACLF or 100.0% in patients with EASL-ACLF（both P<0.05）;patients with bleeding had higher 28 day and 90 day mortality rate than those without bleeding （13.0% vs. 0.0% and 24.5% vs. 0.0%,respectively,P<0.05）;the area under curve of receiver operating characteristic（AUC） in predicting 28 day mortality by ISTH was 0.95 （95%CI:0.861-1.000）,significant wider than by BARC[0.880（95%CI:0.747-1.000,P<0.05）] or by TIMI [0.801（95%CI:0.653-0.948,P<0.05）]. Conclusion Bleeding events are common in patients with ACLF and the incidence increases in accordance with the severity of the diseases,though the fatal bleeding events are rare. ISTH bleeding criteria is recommended for assessment of hemorrhagic events in patients with ACLF.

Objective To investigate blood IFN-γ gene polymorphism in patients with hepatitis B-induced acute-on-chronic liver failure （ACLF）. Method Single nucleotide polymorphism （SNP） technique was applied to detect blood single nucleotide polymorphism of IFN-γ gene +874T/A and +2109 A/G in 51 patients with ACLF and 50 healthy controls. Results The frequency of +874 locus TA+AA genotype in patients with ACLF was 54.9%,much higher than 24.0% in the control（P<0.05）,and A allel was 38.2%,also much higher than 22.0% in the control（P<0.05）;the frequency of +2109 locus AG+GG genotype in patients with ACLF was 51.0%,much higher than 26.0% in the control（P<0.05）,and G allel was 32.4%,much higher than 16.0% in the control（P<0.05）;there was no significant difference as respect to the frequencies of +874 and +2109 allele and genotype between 28 survivals and 23 dead（P>0.05） at the end of 3 month follow-up. Conclusion IFN-γ gene +874 locus A allel and its genotype and +2109 locus G allel and its genotype might be the genetic susceptibility genes for the occurrence of ACLF.

Objective To investigate the quantitative diagnosis of liver functions in patients with liver cirrhosis by multi-slice spiral CT-calculated liver volume. Methods 70 patients with liver cirrhosis were recruited in this study between April 2015 and April 2017，and all the patients received multi-slice spiral CT examination. The theoretical and practical liver volumes were calculated according to the reported methods. Results The CT-determined practical liver volumes in 28 patients with Child-Pugh class C，25 with class B and 17 with class A were（712.07±65.89） cm3，（832.17±80.46） cm3 and（992.51±299.02） cm3，much lower than the theoretical liver volumes [（1415.74±126.81） cm3，（1458.29±164.17） cm3 and （1498.93±114.39） cm3，respectively，P<0.05]；the CT liver volumes in 22 patients with MELD score≥20，in 30 with 20>MELD score ≥10 and 18 with MELD score<10 were（757.83±39.04） cm3，（813.84±80.97） cm3 and（982.09±281.75） cm3，significantly lower than the theoretical liver volumes[（1461.57±65.23） cm3，（1481.19±155.85） cm3 and（1482.12±87.26） cm3，respectively，P<0.05]. Conclusions Multi-slice spiral CT-calculated liver volume might be used as a quantitative diagnosis of liver functions in patients with hepatitis B cirrhosis.

Objective To explore the characteristic of intestinal flora changes in patients with chronic hepatitis B （CHB）,liver cirrhosis （LC） and liver failure （LF）. Methods 23 patients with CHB,20 with LC,6 with LF and 9 healthy persons were recruited in this study. The morning excrements in the 58 cases were collected to test the intestinal flora,and the fecal intestinal flora DNA was obtained by fecal bacterial genome DNA extraction kits. The 16SrDNA of metagenomics sequencing technology was applied to analyze the intestinal flora. The biology and SPSS statistical software were applied to analyze the sequencing results to compare the differences of the intestinal flora in patients with CHB,LC and LF. Results In the phylum level of intestinal flora,all samples showed priority to Bacteroidetes,and secondly was Proteobacteria. Bacteroidetesa bundance in patients with CHB （617.83） was much greater than in with LC （343.16） or with LF （182.15） or in healthy persons （236.66,P<0.05）;Proteobacteria in patients with LC（183.16） was much greater than in with CHB （35.86）,with LF（18.87） or in healthy group（53.40,P<0.05）;in the genus,all samples showed the priority to Bacteroides,and secondly were Prevotella and Fusobacterium. Prevotellaa bundance in patients with CHB （345.28） was much greater than in with LC（46.75）,in with LF（5.63） or in healthy group（20.14）;Bacteroides was the least flora in patients with LC（150.28,P<0.05）. Conclusions Bacteroidetes is the dominant bacteria in all samples and the main difference of flora is the abundance in patients with HBV infection. The Proteobacteria is the most flora in patients with CHB,but is the least in patients with LC and Veillonella increases in patients with LF.

Objective To investigate the efficacy of entecavir（ETV） and Fufang Biejiaruanganpian,a Chinese herbal medicine compound,combination therapy in patients with hepatitis B-induced liver cirrhosis. Methods 76 patients with hepatitis B liver cirrhosis were recruited in our hospital between January 2014 and December 2016. The patients with liver cirrhosis were randomly divided into control group （n=36） and observation group（n=40）,receiving ETV or ETV and Fufang Biejiaruangan combination therapy,and all patients were followed-up for 12 months. Serum HBV DNA loads were detected by PCR,and serum HA,PⅢP,LN and CⅣ levels were assayed routinely. All patients received Fibroscan check-up. Results At the end of 12 month observation,serum bilirubin and ALT levels in the observation group were （19.7±13.4） μmol/L and （28.3±9.4） U/L,much lower than [（23.2±13.8） μmol/L and （53.6±10.2）U/L,P<0.05] in the control,and serum albumin level was （37.2±5.6） g/L,prothrombin time activity （PTA） was （91.1±11.2）%,much higher than [（34.7±6.1）g/L and （81.4±10.5）%,P<0.05] in the control;the CTP score was （6.3±1.2）,much lower than [（8.1±1.4）,P<0.05] in the control,and liver stiffness measurement （LSM） was（16.5±12.2） kPa,also much lower than [（22.7±14.4）kPa,P<0.05] in the control;serum HA level was （89.2±43.1） μg/L,PⅢP level was （119.7±60.8） μg/L,LN level was （98.7±30.2） μg/L,and CⅣ level was （102.6±29.7） μg/L,significantly lower than [（184.3±58.2） μg/L,（254.5±74.7） μg/L,（140.8±39.7） μg/L,and （165.7±41.2） μg/L,respectively,P<0.05] in the control;serum HBV DNA loss was 97.5%（39/40）,and it was 94.4% （34/36） in the control,without significant difference between the two groups（P>0.05）,and serum HBV DNA load was（3.2±0.3） log10 copies/ml,no significant difference as compared to（3.5±0.4） log10 copies/ml in the control（P>0.05）;the incidences of ascites,hepatic encephalopathy,gastrointestinal bleeding and hepatocellular carcinoma in the observation group were 17.5%,5.0%,10.0% and 2.5%,much lower than 52.7%,13.8%,16.7% and 11.1% （P<0.05） in the control;no one in the observation group but three patients（8.3%） in the control died within the 12 month observation. Conclusion The combination of ETV and Fufang Biejiaruangan compound therapy in patients with hepatitis B-induced liver cirrhosis might improve liver functions,alleviate liver cirrhosis,and improve the prognosis,which needs further and long-term investigation.

Objective To investigate the changes of peripheral blood 25-（OH）2-D3 levels and peripheral T lymphocyte subsets in patients with primary biliary cirrhosis（PBC） receiving vitamin D supplementation and ursodeoxycholic acid（UDCA） treatment. Methods 70 patients with PBC were recruited in our hospital between April 2013 and April 2016,and they were randomly divided into the observation group and the control group with 35 cases in each group by the random number generated by computer. The patients in control group was treated with UDCA,and those in the observation group was additionally treated with calcitriol soft capsules （vitamin D） at the base of UDCA. The response rate to UDCA were statistically analyzed. Results At the end of one year treatment,serum levels of 25-（OH）2-D3 and blood CD8⁺ cells in the observation group were （24.5±4.2） ng/ml and （29.0±5.2） %,respectively,significantly higher than （20.2±3.6） ng/ml and （26.3±4.8） %,while the percentage of CD4⁺ cells and the ratio of CD4⁺/CD8⁺ cells were （31.8±5.9） % and （1.1±0.2）,significantly lower than [（36.2±6.4） % and（1.4±0.3） in the control,all P<0.05];the response rate to UDCA by Barcelona criteria in the observation group was 85.7%,significantly higher than 62.9% in the control group （P<0.05）;serum diamine oxidase（DAO）,D-lactic acid,aspartate aminotransferase （AST） and alkaline phosphatase （ALP） levels in the observation group were （3.5±0.6） U/ml,（8.2±1.5） g/ml,（62.3±11.2） U/L and（317.5±57.3） U/L,significantly lower than [（3.9±0.7）U/ml,（9.4±1.7） g/ml,（76.9±13.9） U/L and（355.4±64.2） U/L in the control（P<0.05）. Conclusion Vitamin D supplementation can increase the response to UDCA,regulate the abnormal immune functions,protect intestinal barrier functions and promote liver function recovery in patients with PBC.

Objective To investigate the efficacy of somatostatin（SS）,octreotide（OC） and pitressin plus nitroglycerin（PN） in the treatment of patients with acute variceal bleeding. Methods 224 patients with acute esophageal and gastric variceal hemorrhage were randomly divided into three groups,receiving SS （group,n=68）,OC（group B,n=73） and pitressin plus PN（group C,n=83） treatment,respectively. The Doppler ultrasound parameters in the three groups were measured before,during and after the treatment. Results The bleeding control rates at 24 h,48 h and 72 h in group A were 67.7%,73.5% and 91.2%,and in group B were 68.5%,72.6% and 91.8%,significantly higher than 50.6%,54.2% and 80.0% in group C,respectively（P<0.05）;the bleeding-controlled time in group A was （32.7±6.8） h,and in group B was （33.8±8.0） h,significantly shorter than （44.6±15.4） h in group C （P<0.05）;the portal vein diameters （PVD）,portal vein velocities （PVV）,blood flow （PVF）,and hepatic artery pulsatility index（HA-PI） in the three groups 12 h after treatment were significantly reduced as compared with those before treatment;the results of systematic hemodynamic parameters showed that the heart rates （HR） and cardiac outputs （CO） were significantly decreased,while the mean arterial pressure（MAP） did not change significantly in group A and in group B,but the HR and MAP significantly increased in group C 12 h after treatment. Conclusions SS and OC were more effective with less side effects than PN for treatment of patients with acute variceal hemorrhage,and the mechanism might be the reduction of cardiac output and contraction of visceral blood vessels,which reduce the portal vein blood flow and portal pressure.

Objective To explore the risk factors of portal vein thrombosis（PVT） occurrence in patients with liver cirrhosis. Method The clinical data of 444 patients with liver cirrhosis recruited in our hospital between March and December 2016 were retrospectively analyzed. Out ot them,44 had PVT,and 400 without. The clinical data in the two groups were collected and compared. The t-test or Chi-square test was used to analyze the risk factors for PVT,and univariate and multivariate Logistic regression model were applied to analyze the independent risk factors. Results Univariate analysis showed that there were significant differences as respect to Child-Pugh score,hemoglobin （HB）,platelet（PLT）,D-dimer,fibrinogen degradation product （FDP）,albumin （ALB）,portal vein diameter,spleen length,spleen thickness,portal vein flow rate and the incidence of diabetes between the two groups （P<0.05）;multivariate Logistic regression analysis showed that portal vein diameter （OR=1.258,95%CI 1.035~1.616,P=0.009）,D-dimer（OR=3.915,95%CI 2.243~5.796,P=0.000）,and diabetes （OR=4.189,95%CI 2.067~6.231,P=0.000） were the independent risk factors for the formation of PVT. Conclusion There are many factors influencing the occurrence of PVT,whereas increased blood D-dimer levels,widened portal vein diameter and diabetes are the independent risk factors in patients with liver cirrhosis. which should be taken into consideration in clinical practice.

Objectives To investigate the connection changes between bilateral paleness and whole brain network in patients with hepatic encephalopathy（HE）. Methods 28 patients with overt HE（OHE）,30 with minimal HE（MHE） and 30 healthy volunteers were recruited in our hospital between February 2015 and June 2017,and all of them received resting blood oxygenation level-dependent functional MRI（BOLD-fMRI） scan,and the bilateral globus pallidus was selected as the seed point and the whole brain function was connected. The functional MR data were analyzed to observe the differences among the brain functional network connections in the bilateral globus pallidus regions. Results The differences among the globus pallidus and the whole brain network in most patients with HE were located in the frontal,parietal and temporal lobes（P<0.05）;the connection of the right side occipital gyrus,the right frontal gyrus and the left orbital frontal gyrus to the brain network in patients with OHE decreased,while the connection of the left central gyrus,the bilateral tail nucleus and the left triangle part increased as compared with in healthy persons;the connection of right wedge anterior lobe,right temporal gyrus,right fusiform gyrus,and right angle decreased,while the connection of bilateral tail nucleus and right temporal gyrus enhanced as compared with the patients with MHE（P<0.05）. Conclusion The functional connections among the bilateral globus pallidus and multiple brain regions were impaired in the patients with HE and it is assumed that the cognitive dysfunctions in these patients might be related to the functional connection disorders.

Objective To investigate the prognosis of patients with hepatocellular carcinoma（HCC） and underlying chronic hepatitis B（CHB）. Methods 469 patients with CHB-related HCC were recruited in our hospital between January 2008 and November 2015,and 243（51.8 %） of them had low serum HBV loads （HBV DNA<1×10⁴ copies/ml） and 226 （48.2%） had high （HBV DNA≥1×10⁴ copies/ml）. The baseline characteristics,nucleoside analogues（NAs） treatment,serum HBV DNA loads and liver function index was recorded. The prognosis of patients in the two groups was analyzed by Logistic analysis. Result The average age in patients with low and in with high serum HBV load were （54±10） yr and （52±10） yr,no significant difference （P>0.05）;the men in patients with low serum HBV DNA were 213 （87.7%）,while the percentage of men was 90.7 %,no significant difference between them （P>0.05）;serum ALT and AST levels in patients with low serum HBV DNA were （80±105） u/L and （55±72） u/L,respectively,much lower than （114±130） u/L and （80±107） u/L in patients with high serum HBV load （P<0.05）;the survival time in patients with low serum HBV load was（1144±732） d,much longer than [（496±278） d,P<0.05] in patients with high serum HBV load;univariate analysis showed that anti-rival therapy,serum AFP level≥40 μg/L,serum ALT level ≥64 IU/L,serum AST level≥40 IU/L,serum bilirubin level≥24 μmol/L and serum HBV DNA load≥1×10⁴ copies/ml were the factors affecting the survival of patients with HCC（P<0.001）;multivariate analysis showed than the BCLC stage（HR=1.84,CI 为1.57-2.15,P<0.001）,without anti-viral therapy （P<0.01）, serum AST≥40 IU/L （P<0.05） and serum HBV DNA ≥1×10⁴ copies/ml （P<0.001） were the independent factors for poor prognosis of patients with hepatitis B-related HCC. Conclusions Many factors impact the survival of patients with CHB-related HCC,and serum HBV loads and anti-viral therapy might be taken into consideration in clinical practice.

Objective To investigate the single nucleotide polymorphisms （SNP） of blood IL-18 gene-137G/C and -607A/C in patients with hepatocellular carcinoma（HCC）. Methods A total of 178 patients with HBV-related HCC and 251 healthy persons were recruited in this study,and peripheral blood were obtained for SNP detection of IL-18 gene-137G/C and -607A/C site by polymerase chain reaction-ligase detection reaction （PCR-LDR）. Results The frequencies of IL-18-37 G/C gene GG,GC and CC genotypes in patients with HCC and healthy persons were 75.3% vs. 47.0% （P<0.05）,20.8% vs. 51.4% （P<0.05） and 3.9% vs. 1.6% （P>0.05）,and the frequencies of G and C alleles were 93.6% vs. 72.7% （P<0.05） and 6.4% vs. 27.3% （P<0.05）,respectively;the frequencies of IL-18-607A/C gene AA, AC and CC genotypes in the two groups were 37.6% vs. 13.5% （P<0.05）,43.3 % vs. 66.9% （P<0.05） and 19.1% vs. 19.5% （P>0.05）,and the frequencies of A and C alleles were 59.3% vs. 47.0% （P<0.05） and 40.7% vs. 53.0% （P<0.05）;the frequency distributions of IL-18-137G/C site GG genotype and G allele in patients with HCC were significantly higher than in healthy persons （P<0.05）,and the frequencies of IL-18-607A/C site AA genotype and A allele in patients with HCC were also significantly higher than in the control（P<0.05）. Conclusion Individuals carrying IL-18-137G/C and IL-18-607A/C gene might be at the risk of HCC susceptible,especially in those with underlying HBV infection, and screening the specific gene might help find out the patients with HCC early in clinical practice.

Objective To investigate the protective effect of aspartate ornithine on hepatic ischemic reperfusion injury in patients with primary liver cancer （PLC）. Methods 101 patients with PLC were recruited in our hospital between August 2015 and March 2017,and all patients with PLC received partial resection of hepatectomy. After operation,the patients were divided into control （n=50） and observation （n=51） group,receiving conventional supporting treatment and those in the observation was treated with intravenous ornithine aspartate injection. Serum malondialdehyde （MDA）,superoxide dismutase （SOD）,nitric oxide （NO） and endothelin-1（ET-1） levels were assayed. Results At the end of 7 day treatment,serum MDA level was significantly lower than in the control [（5.4±0.6） μmol/L vs.（7.3±0.9） μmol/L],serum ET-1 level was also significantly lower than in the control [（115.2±14.3） pg/L vs.（216.6±26.8） pg/L],while serum SOD level in the observation was much higher than in the control[（18.6±2.3） U/mL vs.（13.3±1.6） U/mL],and serum NO level was also significantly higher than in the control [（37.9±5.7） μmol/L vs. （22.5±3.1）μmol/L,P<0.05];serum bilirubin level in the observation group was （23.4±7.7）μmol/L,much lower than in the control[（31.3±7.8） μmol/L,P<0.05];there was no significant difference as respect to the routine blood parameters in the two groups（P>0.05）. Conclusion The application of ornithine aspartate might reduce hepatic ischemia-reperfusion injury after surgical tumor resection in patients with PLC, attributed to the protection of liver function by relieving oxygen free radical and peroxidation injury.

Objective To investigate the efficacy and safety of sorafenib in the treatment of patients with advanced primary liver cancer （aPLC）. Methods 82 patients with aPLC were recruited in our hospital between April 2013 and December 2016,and were divided randomly into two groups with 41 in each by computer-generated numbers. All patients received radiofrequency ablation （RFA）,patients in the observation group received oral sorafenib daily,and all patients were followed-up for 12 weeks. Serum basic fibroblast growth factor （bFGF） and vascular endothelial growth factor（VEGF） levels were detected by ELISA,and the efficacy was evaluated by the response evaluation criteria in solid tumors（RECIST）. Results Two patients in the observation group were kicked off because of bad obedience,and three in the control failed to revisit. At the end of 12 week follow-up,the disease control rate in the observation group was 61.5%,without significant difference as compared with 52.6% in control group （P>0.05）,while the Objective effective rate in the observation group was 48.7%,much higher than 26.3% in the control group,the difference was statistically significant（P<0.05）;serum levels of AFP,bFGF and VEGF were （184.7±10.5） μg/L,（3.8±1.3） pg/mL and （172.3±25.4） pg/mL in the observation group,much lower than（213.6±11.6）μg/L,（6.4±2.0） pg/mL and（210.5±28.3） pg/mL,respectively in the control（P<0.05）;the progression-free survival （PFS） in the observation group was 10.2 months（95%CI:7.4-11.5）,while it was 7.9 months （95%CI: 6.0-10.1） in the control,which was significantly different by Log-rank test （P<0.05）;the incidence rates of hand-foot skin syndrome,skin rash,leukopenia,oral mucositis,hair loss and abnormal liver function tests in the observation group were 43.6%,25.6%,17.9%,20.5%,25.6% and 23.1%,much higher than 0.0%,2.6%,0.0%,0.0%,0.0% and 5.3% in the control （P<0.05）. Conclusion Sorafenib might inhibit the growth of solid tumors in patients with aPLC, and might thereby prolong the progression-free survival. However,the application of sorafenib can cause a variety of adverse reactions,which should be taken into consideration and the clinicians should take measures in time to deal with them.

Objective To analyze the correlation of HLA-A,-B,-C,-DRB1,-DQB1 allele polymorphisms to the development of hepatocellular carcinoma （HCC） in patients with hepatitis B. Methods 56 patients with HCC and underlying hepatitis B viral infection and 97 healthy persons were recruited in this study. Blood HLA-A,-B,-C,-DRB1,-DQB1 genes were detected by polymerase chain reaction sequence-based typing. Results The frequencies of HLA-A*02:03,A*02:07,HLA-B*46:01,HLA-DRB1*14:54,DRB1*12:02,HLA-DQB1*05:03 were significantly higher in patients with HCC than in the control,and they might be the risk factors for chronic hepatitis B patients developing HCC. While the frequencies of HLA-A*30:01 and HLA-B*13:02 were significantly lower in HCC group than in the control group. Conclusion In GuangDong province population,blood HLA-A*02:03,A*02:07,HLA-B*46:01,HL-DRB1*14:54,DRB1*12:02,HLA-DQB1*05:03 are positively correlated with the development of HCC.

Objective To investigate the application of CT three dimensional reconstruction in patients with hilar cholangiocarcinoma （HCCA） underwent hepatectomy. Methods 33 patients with HCCA were recruited in our hospital between January 2013 and January 2017,and CT three dimensional reconstruction was performed in 19 patients and conventional CT check-up was done in 14 before operation. Results The tumor R0 resection in patients receiving CT three dimensional reconstruction before operation was completed in 12 patients with HCCA （63.2%）,while it was done in 6 （42.9%） in the control group （P<0.05）;the intraoperative blood loss were （425.3±124.5） ml and （539.4±234.7） ml （P<0.05）;the operation time were （3.2±1.3） h and （4.1±2.5） h（P<0.05）;the postoperative hospital stay were（11.7±4.8） d and（13.9±5.4） d（<0.05）,and the postoperative complications were 10% and 12%（P>0.05）,respectively,in the two groups. Conclusion CT three-dimensional reconstruction before operation might be helpful in evaluation of tumor invasion and hepatic blood vessels involvement,and in rehearsing the hepatectomy.

Objective To investigate the efficacy of gadolinium disodium enhanced MR in the diagnosis of patients with focal liver lesions（FLL）. Methods 47 consecutive patients with FLL were selected in our hospital between June 2015 and June 2017. The liver biopsies were performed and the diagnoses were confirmed by histopathology. All patients underwent disodium gadoxate enhanced MR with or without hepatobiliary phase,and enhanced CT scan. The independent blind analysis was performed by radiologists based on the five-point scale. Results The lesion size was 0.7~6.2 cm（2.1±0.8） cm in the 47 patients with FLL,and the pathological examination demonstrated cholangiocarcinoma in 15,biliary cystadenocarcinoma in 1,metastases from colorectal cancer in 11,and hepatic hemagioma in 5,hepatic focal nodular hyperplasia in 8,nodule with underlying liver cirrhosis in 4,lipoma in 2 and adenoma in 1;the sensitivity,specificity and accuracy by MRI with hepatobiliary phase scan were 88.9%,80.0%and 85.1%,much higher than 60.0%,61.7% and 63.0% by MRI without hepatobiliary phase scan or 45.0%,48.9% and 51.9% by CT scan,respectively（P<0.05）. Conclusion The application of gadolinium-disulfonate-enhanced MR scan is beneficial for the qualitative diagnosis of patients with FLL,which warrants further investigation.

Objective To investigate the efficacy of microwave ablation combined with transcatheter arterial chemoembolization（TACE） in treatment of patients with hepatic metastasis from colorectal cancer. Methods 90 patients with liver metastasis who had colorectal cancer removed were recruited in our hospital between June 2012 and June 2015,and were divided into control group receiving systemic chemotherapy （n=45） and observation group receiving microwave ablation combined with TACE （n=45）. Comparison of the therapeutic efficacy,prognosis and changes of peripheral blood lymphocyte subsets between the two groups was made. Results At the end of 6 month followed-up,the complete response,partial response,stable disease and progress of disease in the combination group were 28.9%,40.0%,20.0% and 11.1%,significantly superior to 11.1%,28.9%,26.7% and 33.3% （x²=7.571,P=0.006） in the control group;at presentation,the percentages of peripheral blood CD8⁺ cells,CD4⁺ cells and CD3⁺ cells as well as the ratio of CD4⁺/CD8⁺ cells in two groups were not significantly different（P>0.05）,while at the end of three month treatment,the percentages of peripheral blood CD8⁺ cells,CD4⁺ cells and CD3⁺ cells as well as the ratio of CD4⁺/CD8⁺ cells in the combination group improved obviously as compared to those in the control（t=7.256,t=5.916,t=7.701,t=7.013,P<0.01）;the follow-up demonstrated that the survival time in the control group was （16.0±5.2） m,significantly shorter than （29.1±8.4） m（t=8.895,P<0.001） in the combination group. Conclusion The application of microwave ablation and interventional embolization chemotherapy in the treatment of patients with liver metastasis from colorectal cancer has to some intent clinical good efficacy,which might effectively improve the immune function of patients and prolong the patient's survival.

Objective To investigate the clinical efficacy of hepatectomy and extravascular exfoliation in treatment of patients with giant hepatic hemangioma. Methods The clinical data of 82 patients with giant hepatic hemangioma admitted to our hospital between May 2014 and April 2016 were retrospectively analyzed，and 41 patients received hepatectomy and another 41 received extravascular exfoliation. All patients were followed-up for one year. Results The operative time，intraoperative blood loss，intraoperative blood transfusion，hepatic blood flow blocking time and hospital stay were （2.3±1.1） h，（885.2±387.5） ml，（928.7±412.4） ml，（21.4±9.6） min and （14.2±3.2） d in patients receiving exfoliation and（3.3±1.1） h，（1567.5±751.4） ml，（1896.4±852.4） ml，（27.5±8.2） min and（16.5±3.5） d in patients receiving hepatectomy（all P<0.05）；the incidence rate of postoperative complications was 14.6% in patients receiving exfoliation and 34.2% in patients receiving hepatectomy （P<0.05）；at the end of 1 year follow-up，one patient had recurrent hepatic hemagioma，11 lost and 29 had hepatic hemagioma disappeared in patients receiving hepatectomy，and one had recurrent hemagioma，8 lost and 32 had hemagioma disappeared in patients receiving tumor exfoliation. Conclusions Hepatectomy and extravascular exfoliation can be applied to the removal of giant hepatic hemangioma，while the latter has the advantages of relatively simple operation，small surgical trauma，little blood loss，short liver blood flow blocking time，rapid postoperative recovery and few postoperative complications.

Objective To evaluate the clinical application of real-time ultrasound elastography in the evaluation of ischemic biliary lesions （IBL） in patients with orthotopic liver transplantation （OLT）. Methods 52 patients received OLT in our hospital between January 2013 and January 2017, and all of them were checked-up by ultrasonography and real-time ultrasound elasticity imaging to measure portal vein diameter （PVD）,hepatic artery resistance index （HARI）,portal vein velocity （PVV）,hepatic artery pulsatility index （HAPI）,hepatic artery peak systolic velocity （HAV） and shear wave velocity （SWV）. Results There were 10 patients （19.2%） out of the 52 recipients having IBL at 6th month check-up postoperatively;there were no significant differences as respect to PVV,HAV,HARI and HAPI in the two groups（P>0.05）,while the PVD in patients with IBL was higher than that in those without [（1.1±0.2） cm/s vs. （0.8±0.3） cm/s,P<0.05];there was no significant difference in serum AST level between the two groups （P>0.05）,while serum ALP and GGT levels in patients with IBL were much higher than those in the control group （P<0.05）;the SWVs in patients with IBL detected at 4 cm and 5 cm depth were much higher than those in the control group （P<0.05）. Conclusion The real-time ultrasonic elastography is an economical, convenient,noninvasive and repeatable approach for the evaluation of IBL in patients after OLT, which might be of great importance in monitoring the biliary lesions.

Objective To investigate the prevalence of Helicobacter pylori （Hp） infection and gastric mucosa inflammation in patients with bile reflux gastritis（BRG）. Methods 618 patients with BRG and 1486 patients with chronic superficial gastritis（CSG） without bile reflux were recruited in our hospital between March 2015 and February 2017. Gastroscopy was carried out in all patients,and the Hp infection was determined by ¹⁴C-urea breath test,serum anti-Hp antibody detection and gastric mucosa histopathological examination. Results The prevalence of Hp infection was 32.7%（202/618） in patients with BRG,no significant difference as compared to 40.6% （603/1486） in patients with CSG （P>0.05）;the mild,moderate and severe inflammatory reaction of gastric mucosa in 202 BRG patients with Hp positive were 10.9%,61.4% and 27.7%,much severer than 40.4%,51.7% and 7.9% （P<0.05） in 416 patients with Hp negative,and the incidences of lymphoid follicle formation,intestinal metaplasia and active inflammation were 15.4%,5.4% and 16.8%,respectively,also much severer than 2.7%,10.8% and 0.7%（P<0.05） in patients with Hp negative;the mild,moderate and severe inflammatory reaction of gastric mucosa in 603 CSG patients with Hp positive were 29.2,59.4% and 11.5%,no significant difference as compared to 34.1%,54.0% and 11.9%,respectively （P>0.05） in 883 patients with Hp negative,and the incidences of lymphoid follicle formation,intestinal metaplasia and active inflammation were 10.4%,1.8% and 8.5%,also no significant difference as compared to 7.8%,1.0% and 5.0%,respectively（P>0.05） in patients with Hp negative;the pathological examination of gastric mucosa showed that the severity of inflammation in 117 BRG patients with III degree of gastric mucosal lesions under gastroscopy were more severe than in 200 patients with I degree or 301 patients with II degree （P<0.05）. Conclusion The gastric lesions under gastroscopy and histopathological inflammation of gastric mucosa are obvious in patients with BRG and bile reflux and Hp infection are the important factors in the pathogenesis of gastric mucosa inflammation. The endoscopic classification has a significant implication in early judgment of the disease.

Objective To investigate the short-term efficacy of laparoscopic functional retention operation in patients with pancreatic neuroendocrineneoplasm（PNENs）. Methods A total of 67 patients with PNENs were recruited in our hospital between March 2014 and February 2017,and 33 patients received laparoscopic pancreatic functional retention surgery serving as observation group,and out of them,local tumor resection was conducted in 8,middle segment pancreatectomy （MSP） in 11 and pylorus preserving pancreaticoduode nectomy （PPPD in 14 patients,and 34 patients were operated by traditional surgery serving as the control group. Serum glucagon,gastrin,somatostatin and insulin levels were detected by ELISA. Results In the observation group, the operative time was significantly shorter than that in the control group [（163.7±21.3） min vs. （179.4±20.8） min,P<0.01], the amount of intraoperative blood loss was significantly less than in the control group [（267.8±36.1） ml vs. （315.2±35.6） ml,P<0.01],the anal venting time was significantly shorter than that in the control group [（22.4±6.2） h vs.（29.1±6.5） h,P<0.01] and the post-operational stay was significantly shorter than that in the control group [（6.9±1.4） d vs. （7.5±1.2） days,P<0.05];at the end of 1 week post-operation,serum glucagon levels was （134.9±44.8） ng/L,much lower than [（175.3±44.2）ng/L,P<0.01],serum gastrin level was （354.6±62.7） pg/L,muchi lower than [（435.9±63.3） pg/L,P<0.01],while serum somatostatin level was（59.0±5.4） ng/L,significantly higher [（42.1±5.8） ng/L,P<0.01],and serum insulin level was （9.8±1.5） μU/ml,significantly higher [（7.6±1.4） μU/ml,P<0.01] in the control;the incidences of complications, such as new diabetes, gastrointestinal anastomotic fistula, gastric emptying dysfunction, infection, and portal thrombosis was 12.1%,much lower than 26.5% （P<0.05） in the control and at the end of one year followed-up, the tumor recurrence was not significantly different between the two groups （9.1% vs. 17.6%,P>0.05）. Conclusion Laparoscopic functional retention pancreatic surgery might be preserve the pancreatic functions in patients with PNENs with less post-operational complications and improve early recovery of the patients.

Autoimmune hepatitis is a parenchymal inflammation of liver that is mediated by autoimmune response to hepatocytes. There are various factors which can induce autoimmune hepatitis such as drugs,infection,environment,age,gender and genetic factors. However,the mechanism of induction is still not yet very clear,and the illumination of these factors might help prevent and manage the disease. In this review,we will do a brief overview of each of the above mentioned induction factors.

The prevention and treatment of hepatic fibrosis（HF） is a major medical challenge worldwide.The activation of hepaticstellate cells （HSCs） and the excess deposition of extracellular matrix （ECM） are believed to play an important role in the development of HF.More and more researches have verified that endoplasmic reticulum stress （ERS） is involved in the development and reversion of HF. This review will discuss the effects of ERS on HF and explore new insights for the prevention and treatment of HF.

Non-coding RNAs （ncRNAs） refer to the RNAs that don't encode proteins,while play an important role in the life activities of organisms. Methylation is the significant part of RNA transcription based on genome. The abnormal methylation of microRNA and lncRNA may be the key signals to influence the occurrence and development of hepatocellular carcinoma （HCC）. In this paper,the implication of non-coding RNA（microRNA and lncRNA） methylation in the development of HCC in recent years is reviewed.

Hepatitis C virus（HCV） infection is of concern in elderly patients because the proportion of patients with prolonged duration of infection increases gradually,which might be associated with an increased risk of HCV infection-associated liver diseases,includingcirrhosis and hepatocellular carcinoma. The patients with chronic hepatitis C（CHC） at this ages tends to be accompanied with underlying diseases,such as malignancy,kidney disease,diabetes,cardiovascular disease,and neurocognitive impairment. The efficacy of new direct-acting antiviral agents （DAA） for the treatment of elderly patients with CHC is still under investigation,and the safety needs further observations.