Objective To establish a simple approach for isolating hepatocytes（HCs） from neonatal rats. Methods Multi-step enzymatic digestion and tissue adhering method were used to isolate primary HCs from neonatal rats,and after low-speed centrifugation and selective adherence culture,the HCs were identified by PAS and anti-CK-18 immunocytochemical staining. Results The numbers of separated HCs were about 1-2×10⁶ cells per rat. After 0.4% trypan blue staining,the transient cell activity was >80%,and after cell suspension or tissue block were cultured for 3 to 5 days,the cells spread 70% to 80% of the bottom of each bottle. The purity of the HCs was greater than 95%,and the cell growth were in good condition. Conclusion The primary parenchymal cells of liver obtained were pure and in good activity,which might be used in laboratory for further experiments.

Objective To investigate the impact of miR-21 on proliferation and apoptosis in HepG2 cells in vitro. Methods HepG2 cells were divided into three groups,intervened respectively by Lipofectamine 2000/Hsa-miR-21 mimics（enhancement）,Lipofectamine 2000/Has-miR-21 inhibitor（inhibition） and Lipofectamine 2000（control）. The expression of B-cell translocation gene 2（BTG2） protein was detected by Western blot,cell proliferation by CCK-8,and cell cycle and apoptosis by flow cytometry（FCM）. Results The expression of BTG2 in enhancement group decreased obviously and it increased in inhibition group,which were significantly different as compared to that in the control（P<0.05）;the proliferation of HepG2 cells in inhibition group decreased significantly as compared to those in enhancement or control cell（P<0.05）,while it increased obviously as compared to that in the control（P<0.05）;the proportion of S phase cells in inhibition group decreased markedly as compared to those in the enhancement or control （P<0.05）,while G2 phase cells obviously increased （P<0.05）,and S phase cells in enhancement increased and G2 cells decreased as compared to that in the control（P<0.05）;the apoptosis in inhibition obviously increased as compared to those in the enhancement or control（P<0.05）,while it in enhancement significantly decreased as compared to that in the control（P<0.05）. Conclusion MiR-21 might play an important role in hepatocarcinogenesis by intervention of BTG2 expression,which might be a new approach to deal with hepatocellular carcinoma.

Objective To observe the inhibition of miR-144 liposomes on proliferation,migration and invasion of liver cancer cells in vitro and in vivo. Methods DOTMA cationic liposomes were prepared by thin film dispersion method,and miR-144 liposomes were prepared by incubating liposome with miR-144. The volume to mass ratio of DOTMP liposomes and miR-144 were determined by uptake and transfection experiments. The cytotoxicity of liposome on HepG2 and SMMC-7721 cells,impacts on cell migration and invasiveness and the inhibitory effect on implanted tumor sizes in nude mice were observed. Results When the volume mass ratio of DOTMP liposomes and miR-144 was 3:1,the particle size of miR-144 liposome complex was about 200 nm with the PDI of less than 0.3;the transfection efficiency of DOTMP liposomes was the highest when the volume/mass ratio of plasmids and miR-144（mu l/g） was 3:1（P<0.05）;the HepG2 and SMMC-7721 cells intook much more miR-144 liposome complex as incubation prolonged（P<0.05）;the migration distance of HepG2 and SMMC-7721 cells were both significantly shorten by miR-144 liposome complex as compared with in the control group（P<0.05）;the volumes of implanted miR-144 liposome complex intervened HepG2 and SMMC-7721 cell tumors were significantly smaller than in the control group （P<0.05）. Conclusion MiR-144 liposomes might inhibit the activity of hepatocellular carcinoma cells in vitro and in vivo,which worth further investigation.

Objective To investigate the expression of glycosyltransferase Colgalt2 in liver tissues of mice with acetaminophen （APAP）-induced acute liver injury （ALI）. Methods One hundred of C57BL/6 mice were included,and the model of ALI was established by intraperitoneal injection of APAP at 0 mg·kg^-1 APAP（control）,100 mg·kg^-1,250 mg·kg^-1,500mg·kg^-1 and 1000mg·kg^-1 group （APAP concentration model,10 in each） or by intraperitoneal injection of APAP at 500 mg·kg^-1 for 0 h（control）,2 h,4 h,8 h and 12 h group（time model）. Hepatic Colgalt2 mRNA and its protein were detected by real-time PCR and Western blot,respectively. Results Serum ALT levels were（1360.5±189.8） IU/L,（3191.2±118.6） IU/L and （5022.7±234.6） IU/L,and serum AST levels were （2147.1±133.4） IU/L,（3628.8±107.9） IU/L and（5854.5±295.1） IU/L in 250 mg.kg^-1,500 mg·kg^-1 and 1000 mg·kg^-1 APAP-intervened groups,significantly increased as compared to those in the control（P<0.05）;serum ALT levels were（694.1±63.5） IU/L,（1321.9±83.5） IU/L and（3151.1±162.7） IU/L,and serum AST levels were（857.5±69.2） IU/L,（1658.5±109.5） IU/L and（3395.2±620.6） IU/L,respectively,at 4 h,8 h and 12 h APAP group,significantly increased as compared to those in the control（P<0.05）;the hepatic Colgalt2 mRNA levels significantly increased at 500 mg·kg^-1 and 1000 mg·kg^-1 APAP groups,and they also gradually increased at 2 h,4 h,8 h and 12 h APAP group as compared to those in the control（P<0.05）,and the expression of Colgalt2 protein was similar gradually increased as its gene did. Conclusion Glycosyltransferase Colgalt2 plays an important role in the pathogenesis of mice with acetaminophen-induced ALI.

Objective To establish liver fibrosis model with low-dose diethylnitrosamine（DEN） in rats. Methods Thirty Wistar rats were randomly divided into model group and control group with 15 in each. The rats in the model group were treated with low-dose DEN（10 mg·kg^-1 body weight,orally,once daily） for 10 weeks. After sacrificing,the hematoxylin and eosin staining was performed to determine histopathological alterations and transmission electron microscopy（TEM） was used to observe the changes of ultrastructures in the hepatic cells. The automatic biochemical analyzer was used to measure ALT and AST levels,and biochemical methods was used to determine the content of serum SOD,MDA and GSH-Px. Results The levels of ALT and AST in the model group were（410.08±93.6） U/L and（399.7±90.9） U/L,respectively,significantly higher than those in the control group [（56.51±11.2） U/L and（63.26±10.0） U/L,P<0.001];serum contents of SOD,GSH-Px and MDA in the model group were（83.08±22.0） U/mg,（24.65±2.0） U/mg and （9.78±2.0） nmol/mg,respectively,significantly lower than those in the control group[（178.57±22.8） U/mg,（45.16±2.9） U/mg and（3.76±0.7） U/mg,P<0.01];the histological alterations of liver cells in the model group were mainly hepatic deforming,proliferation,necrosis and pseudolobule formation and the ultrastructural changes were mainly the increase of heterochromatin in the nucleus,decrease of organelle,matrix density and hepatin. Conclusion Low-dose DEN could successfully induce liver fibrosis and cirrhosis in rats with a high successful rates and stable pathological changes.

Objective To explore whether copy number variations （CNVs） of blood programmed cell death-l（PD-1） are associated with outcomes of hepatitis B virus（HBV） infection. Methods 300 convalescent individuals from HBV infection,437 patients with chronic hepatitis B（CHB）,249 patients with liver cirrhosis （LC） and 123 patients with hepatocellular carcinoma（HCC） were recruited in this study,and peripheral blood copy numbers of PD-1 gene were measured by using AccuCopy method. x² tests were used to evaluate the distribution differences of copy number variations（CNVs） of PD-1 in different clinical types of HBV infections. The Logistic regression analysis was used to analyze the independent risk factors for severe outcome of the disease. Results In 1109 samples,the variation range of PD-1 gene copy number was 1 to 3 copies. The haploid rates in convalescent individuals,patients with CHB,with LC and with HCC were 11.7%,9.6%,6.0% and 10.6%,respectively,and the polyploid rates in these four groups were 89.3%,90.4%,94% and 89.4%,demonstrating that there were significant differences between convalescent individuals and patient with LC,or between patient with HCC and with LC（P<0.05）;The Logistic analysis showed that the age and serum HBV DNA loads were the independent risk factors affecting the prognosis of the disease. Conclusions Our results indicate that the patient’s age and serum HBV DNA levels are the risk factors which might determine the prognosis of patients with HBV infection,while what roles the CNVs of PD-1 play in the pathogenesis of hepatitis B viral infection needs further observation.

Objective To investigate the distribution of HBV genotypes and drug-resistant mutations in patients with chronic hepatitis B（CHB）. Methods 240 patients with CHB receiving monotherapy or swift from one to another of nuleos（t）ide analogues（NAs） for at least three months were recruited in this study,and the drug resistance mutation was assayed by sequencing reverse transcription area and the HBV genotypes were detected by sequencing HBV S gene. Results The resistant mutation rate in 35 patients treated by lamivudine was 40.0% with the resistant mutation sites of rtL80I/V,rtVl73L,rtLl80M,rtM204V/I,and rtV207I;the resistant mutation rate in 23 patients receiving adefovir was 47.8% with the mutation sites of rtAl81T/V,rtS213T/N, rtV214A,rtQ215S/H/P,rtl233V,rtN236T,rtP237H,rtN/H238A/K/D/S;the mutation rate in 70 receiving entecavir was 14.3% with the mutation sites of rtM204I;the resistant mutation rate in 12 patients receiving telbivudine 41.7% with the mutation sites of rtI169T,rtL180M,rtT184G/S/A/I/L/F,rtS202I/G,rtM204V and rtM250V/I/L;the resistance mutation rate in 100 patients with combination or swift therapy was 51.0% with the mutation sites of rtA194T;out of 240 patients with CHB,21（8.8%） were with type B,216（90.0%） were with type C,and 3 （1.2%） were with type D hepatitis B viral infection;out of the 91 patients with drug resistance mutations,6 （6.6%） were with type B,83（91.2%） were with type C,and 2（2.2%） were with type D infection;multidrug resistance mutations occurred in 2 （33.3%） of 6 patients with type B and 15（18.1%） of 83 type C infection. Conclusion Surveillance of HBV genotypes and resistance mutations in patients with CHB receiving NAs therapy might help improve the clinical response.

Objective To build up a scientific and appropriate followed-up and management model for pregnant women with chronic hepatitis B viral infection to block mother to infant communication. Methods 1103 pregnant women with hepatitis B viral infection and 456 infants were followed-up in our Department of Infectious Diseases,First Affiliated Hospital,Xi'an JiaoTong University between September 2012 and September 2017,and a expert team was responsible for the management of them. We made up two questionnaire on hepatitis B-related knowledge and health demand knowledge and the corresponding intervention measures were taken for them. Results 32.28% of pregnant women accepted breastfeeding,44.33% of them considered natural labor, while most people thought that cesarean delivery might reduce mother to infant transmission of hepatitis B virus infection;41.89% of them accepted antiviral therapy during pregnancy and some worried about the nucleos（t）ide analogues might have a negative impact on the baby growth; out the 1103 pregnant women,the awareness rates of hepatitis B and mother-to-infant transmission knowledge before our intervention were 59.11% and 47.69%,the obedience was 77.61%,while they increased to 83.86%,79.69% and 93.20% （P<0.05） after our education with the satisfactory rate reaching to 89.66%;out of 456 infants who followed the entire the management,2（0.44%） got serum HBsAg positive at age of six months,suggesting the successful blockage of mother to infant transmission in our series was 99.56%（454/456）. Conclusion The establishment of standardized, scientific,reasonable and cultural followed-up and management scheme might increase the successful blockage of mother to child hepatitis B viral transmission, and achieve a “zero” transmission goal.

Objective To study the efficacy of telbivudine in blocking mother-to-child transmission of hepatitis B virus infection in pregnant women with serum HBsAg positive and its influence on infant’s response to hepatitis B vaccination. Methods 100 pregnant women with serum HBsAg positive and their 100 newborns were enrolled in our hospital between July 2013 and July 2015,41 out of the pregnant women took telbivudine at 28 week gestation,and 59 didn’t. All newborns were fully vaccinated with hepatitis B vaccine. They were followed-up for 12 months. Serum HBV markers and HBV DNA loads were measured by electrochemical luminescence and serum IFN-γ and IL-10 levels were detected by ELISA. Logistic multivariate regression analysis was used to analyze the facters affecting the response of infants to hepatitis B vaccination. Results Serum HBV DNA load in women receiving antiviral therapy after dilivery was（2.0±1.3） lg IU/ml,significantly lower than 【（7.1±1.6） lg IU/ml,P<0.05】 in women who didn’t receive antiviral therapy;the incidences of cesarean section,premature delivery,postpartum hemorrhage and neonatal asphyxia in women receiving antiviral treatment were 29.3%,12.2%,4.9% and 9.8%,all not significantly different compared with 30.5%,11.9%,5.1% and 8.5%,respectively,in women who didn’t receive antiviral therapy （P>0.05）;at the end of 12-month followed-up,no infant in 41 mothers receiving antiviral therapy was serum HbsAg positive,while six（10.2%） in 59 mothers without antiviral therapy were serum HbsAg positive（x²=4.436,P=0.035）;the strong response rates in 50 infants with high serum IFN-γ and IL-10 levels were much higher than those with lower serum cytokine levels（P<0.05）;Logistic regression analysis showed that high serum IFN-γ and IL-10 levels were the independent factors affecting infants’response to hepatitis B vaccination. Conclusion The application of telbivudine at late gestational stage might block the HBV mother-to-infant transmission in women with serum HbsAg positive,and the detection of serum IFN-γ and IL-10 levels might predict the response of infants’ response to hepatitis B vaccination.

Objective To investigate the clinical efficacy of peg-IFNα and ribavirin combination in treating patients with chronic hepatitis C（CHC） and genotype one and six infection. Methods A total of 246 patients with CHC were enrolled in this study,and the patients were randomly divided into observation group （n=123） and control group （n=123）,receiving peg-IFNα-2b 80 μg,or peg-IFNα-2a 180 μg subcutaneously once a week,respectively,and the patients with CHC in both groups received ribavirin orally for 48 weeks. All patients were followed-up for 24 weeks after discontinuation of the regimen. Serum HCV RNA and HCV genotypes were detected routinely by Abbott RealTime HCV Genotype II kits. Results At baseline, the genotype one of HCV infection in the observation and control groups were 84.6% and 87.8%,and genotype six infection were 15.4% and 12.2% （P>0.05）,serum HCV RNA levels were（7.17±0.89） lg copies/ml and （7.19±0.88） lg copies/ml,white blood cell counts were （6.6±1.3）×10⁹/L and （6.6±1.5）×10⁹/L,platelet counts were （154.1±21.1）×10⁹/L and （157.2±19.2）×10⁹/L,serum ALT levels were（83.4±26.3） U/L and （80.3±29.4） U/L,all without significant differences （P>0.05）;the rapid virologic response（RVR）,early virologic response（EVR）,end-treatment virologic response（ETVR） and sustained virologic response rates（SVR） in the observation group were 45.5%, 82.1%,83.7% and 85.4%,no significant differences as compared to 43.1%,78.9%,79.7% and 78.0%,respectively in the control （P>0.05）,and the relapse rates in the two groups were 14.6% and 22.0%（P>0.05）;during the injection of interferon-α,there were no significant differences as compared to the side effects such as the fever （58.5% vs. 61.0%）,muscle aches（48.8% vs. 51.2%）,fatigue （41.5% vs. 44.7%）,headaches （30.9% vs. 34.1%）,anorexia（25.2% vs. 30.1%）,hair loss （26.8% vs. 30.9%）,insomnia（20.3% vs. 25.2%）,leukopenia（27.6% vs. 31.7%）,declined erythrocyte counts（23.6% vs. 28.5%）,thrombocytopenia （13.8% vs. 17.9%） and serum T3/T4/TSH level abnormal （8.9% vs. 10.6%,all P>0.05）. Conclusions Application of peg-IFNα-2b and peg-IFNα-2a show similar efficacy and safety in the treatment of patients with CHC with genotype 1/6 infection,which is worthy of further clinical observation.

Objective To compare the therapeutic efficacy of pegylated interferon-α （peg-IFN-α） in treatment of patients with different hepatitis C viral genotype infection. Methods 108 patients with chronic hepatitis C（CHC）,including 58 with hepatitis C virus（HCV） genotype one,and 50 with non-genotype one infection,were recruited in our hospital between October 2013 and October 2016,and all patients were treated with combination of peg-IFN-α and ribavirin for 48 weeks. All patients were followed-up for 24 weeks. The virological and biochemical responses were compared between the two groups. Results At baseline,the age,gender,body mass index,serum ALT and HCV RNA levels in the two groups were not significantly different（P>0.05）;the rapid virological response（RVR）,early virological （EVR）,end treatment virological response （ETVR） and sustained virological response rates in patients with non-genotype one infection were 74.0%,82.0%,88.0% and 86.0%,all significantly higher than 51.7%,60.3%,63.8% and 58.6%,P<0.05） in patients with HCV genotype one infection;the SVR in 67 patients having RVR was 100.00%,much higher than 25.6% （P<0.05） in 41 patients without,and the SVR in 76 patients having EVR was 94.7%,also much higher than 15.6% （P<0.05） in 32 patients without;in patients with serum HCV RNA levels less than or equal to 4×10⁵ IU/ml,the virologic response rates in patients with HCV genotype I or non-genotype I infection were not significantly different（P>0.05）,while in those with serum HCV RNA greater than 4×10⁵ IU/ml, the RVR,EVR,ETVR and SVR in 39 patients with non-genotype I infection were 71.8%,79.5%,87.2% and 84.6%,significantly higher than 50.0%,59.1%,63.6% and 74.4% （P<0.05） in 44 patients with HCV genotype I infection;at the end of 24 week,48 week of the treatment and 24 week of follow-up,the biochemical responses rates in patients with non-genotype I infection were 70.0%,80.0% and 84.0%,all significantly higher than 50.0%,60.3% and 69.0%（P<0.05）. Conclusion The standard combination of peg-interferon-α and ribavirin is effective in the treatment of patient with non-HCV type I infection,and an alternative therapy should be considered in patients with HCV type I infection,not getting RVR and EVR,and with high serum HCV loads.

Objectives To investigate the implication of serum apolipoprotein B（ApoB） levels and its correlation with metabolic syndrome（MS） in checked-up individuals. Methods The physical examination was carried out in 1451 individuals between February 2015 and November 2017 in our hospital,and they were screened for nonalcoholic fatty liver disease （NAFLD） by ultrasonography and FibroTouch. Serum ApoB level was assayed routinely. The influencing factors of NAFLD occurrence was analyzed by Logistic regression analysis. Results Out of the 1451 individuals,the incidence of NAFLD was 24.8%;serum ApoB level in 360 patients with NAFLD was（1.07±0.24）g/L,significantly higher than【（0.88±0.27） g/L,P<0.01】 in 1091 individuals without NAFLD;serum ApoB levels were divided into Q1（<0.73 g/L） in 263,Q2（0.73~0.85 g/L） in 364,Q3（0.86~0.99 g/L） in 321,Q4（1.0~1.16 g/L） in 300 and Q5（≥1.17 g/L） in 203 persons,and their morbidity of NAFLD were 4.2%,9.9%,19.0%,25.0% and 34.5%,suggesting higher incidence rate of NAFLD in those with higher serum ApoB levels（P<0.05）;in the same way,the incidence rates of various clinical types of MS,such as visceral obesity,hypertension,hypertriglyceridemia and hyperglycemia,increased as serum ApoB levels increased;multivariate Logistic regression analysis showed that gender,diastolic blood pressure,body mass index,blood lipids,fasting blood glucose and serum ApoB levels were the independent risk factors for NAFLD occurrence. Conclusion Elevated serum ApoB level might hint the existence of NAFLD,which warrants further check-up in clinical practice.

Objective To investigate the implication of plasma thyroid stimulating hormone （TSH） levels in patients with nonalcoholic fatty liver disease（NAFLD） and type 2 diabetes mellitus （T2DM）. Methods 43 patients with NAFLD and T2DM and 40 with T2DM were admitted to our hospital,and the patient's age,gender,height,body mass,body mass index（BMI）,insulin resistance index（HOMA IR）,systolic blood pressure,diastolic blood pressure,blood biochemical parameters and free three iodine thyroid original glycine（FT3）,free thyroxine（FT4） and TSH were compared between the two groups. Results The BMI in patients with NAFLD and T2DM was （28.4±3.8） kg/m²,significantly higher than（23.8±3.1） kg/m² in patients with T2DM （P<0.05）;serum ALT,AST,gamma glutamyl transpeptidase,triglyceride,HOMA-IR and TSH levels in patients with NAFLD and T2DM were much higher than those in patients with T2DM（P<0.05）;serum TC,TG,LDL-C and FT3 levels in three groups of NAFLD patients with different serum TSH levels were significantly different （P<0.05） as the patients with NAFLD were divided into low（n=14）,middle（n=16） and high（n=13） serum TSH levels;the Logistic analysis showed that BMI（RR=1.720,95%CI:1.154-3.015）,HOMA-IR（RR=2.632,95%CI:1.010-3.654）,serum TSH（RR=2.577,95%CI:1.214-3.689） and TG levels（RR=1.538,95%CI:1.240-2.658） were the independent risk factors for the occurrence of T2DM in patients with NAFLD. Conclusion The clinicians should take the risk factors of T2DM occurrence in patients with NAFLD into consideration in clinical practice for early prevention and intervention,and the detection of serum TSH level might be helpful in dealing with patients in this settings.

Objective To investigate the changes of serum glycosylated hemoglobin（HbA1c） level and cardiac functions in patients with non-alcoholic fatty liver disease （NAFLD）. Methods A total of 118 patients with NAFLD and 60 healthy volunteers with matched age and gender were recruited in our hospital between May 2017 and May 2018,and the general data,including blood biochemistry,liver B-ultrasound and ultrasonic cardiogram parameters were collected in the two groups. The impacting factors of cardiac functions were evaluated by two-class Logistic regression analysis. Results The body mass index（BMI）,systolic blood pressure,diastolic blood pressure,fasting blood glucose,total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol （LDL-C）,uric acid,glutamyl transpeptidase （GGT） and HbA1c levels in patients with NAFLD were （26.8±5.6） kg/m²,（131.9±18.4） mmHg,（81.5±7.5） mmHg,（6.0±1.2） mmol/L,（5.4±0.7） mmol/L,（1.8±0.4） mmol/L,（3.2±0.6） mmol/L,（334.2±46.7） μmol/L,（39.4±9.0） U/L and （6.0±1.2）%,significantly higher than（23.4±5.0） kg/m²,（125.4±16.9） mmHg,（77.3±6.9） mmHg,（5.3±1.1） mmol/L,（4.9±0.6） mmol/L,（1.3±0.4） mmol/L,（2.9±0.6） mmol/L,（290.4±40.2） μmol/L,（22.2±5.7） U/L and（5.4±1.2）% （P<0.05） in healthy individuals,while serum high-density lipoprotein cholesterol （HDL-C） level was lower than that in the control group [（1.4±0.4） mmol/L vs. （1.6±0.4） mmol/L,P<0.05];the left ventricular end-diastolic volume（LVEDV） and incidence rate of diastolic cardiac dysfunction（DCD） in 43 patients with NAFLD and elevated blood HbA1c level were （48.3±5.3） mm and 27.91%,significantly higher than（45.2±4.7）mm and 9.33% （P<0.05） in 75 patients with normal HbA1c levels,and the left ventricular ejection fraction （LVEF） and E/A ratio were（53.0±11.3）% and （1.0±0.2）,significantly lower than （59.9±12.3）% and [（1.1±0.3）,P<0.05] in the latter;Logistic analysis showed that HbA1c,LVEDV and GGT were the independent risk factors for occurrence of DCD in patients with NAFLD,while the LVEF was a protective factor （P<0.05）. Conclusions Patients with NAFLD are often associated with elevated blood HbA1c levels,which might be the risk factor for DCD or coronary heart disease in patients with NAFLD.

Objective To investigate the implication of serum IL-10 and GP73 levels in patients with HBV-related acute-on-chronic liver failure（HBV-ACLF）. Methods Serum IL-10 and GP73 levels were measured by ELISA in fifty-six patients with HBV-ACLF,thirty-two patients with chronic hepatitis B （CHB）,and twenty healthy persons. All patients with HBV-ACLF were followed-up for 3 months. Results At presentation,serum IL-10 level in patients with HBV-ACLF were （32.4±14.8） pg/ml,significantly higher than （15.2±6.3） pg/ml in patients with CHB or（6.1±1.9） pg/ml in healthy control （P<0.05）,and serum GP73 level in patients with HBV-ACLF were （283.4±95.4） ng/ml,also significantly higher than （129.7±58.1） ng/ml in patients with CHB or （45.5±16.2） ng/ml in the control（P<0.05）;at baseline,serum IL-10 levels in 33 survivals with HBV-ACLF were （34.6±15.3） pg/ml,significantly higher than（30.1±14.3） pg/ml in 23 dead ones（P<0.05）,and there was no significant difference between the survival and the dead as respect to their serum GP73 levels [（279.7±94.5） ng/ml vs. （287.2±96.2） ng/ml,P=0.36];two weeks after treatment,serum IL-10 levels in survival group with HBV-ACLF were （30.1±14.0） pg/ml,still significantly higher than （24.9±11.2） pg/ml in dead group （P<0.05）,and there was a significant difference of serum GP73 levels in the survival and dead [（258.7±85.9） ng/ml vs.（331.2±107.5） ng/ml,P<0.05]. Conclusion The HBV-ACLF patients with high serum IL-10 level might have a relatively good prognosis,and the dynamic detection of serum GP73 level might be of certainly significance in assessing short-term prognosis of patients with HBV-ACLF.

Objective To investigate the prognostic efficacy of serum keratin 18 in patients with hepatitis B virus-related acute on chronic liver failure（HBV-ACLF）. Methods One hundred patients with HBV-ACLF,30 with chronic hepatitis B and 30 healthy persons were recruited in our hospital between January 2015 and January 2017,and serum K18 （M30 and M65） levels were measured by enzyme-linked immunosorbent assay. All patients were followed-up for 3 months. The prognostic efficacy of M30/M65 ratio and the end stage liver disease model（MELD） were assessed by AUC. Results Serum M30,M65 and M30/M65 ratio in patients with ACLF at presentation were（1.0±0.1） lg U/L,（3.4±0.3） lg U/L and （0.3±0.1）,significantly different as compared to 【（2.1±0.1） lg U/L,（3.3±0.2） lg U/L and （0.6±0.0）,respectively,P<0.05】 in patients with CHB or【（2.1±0.1） lg U/L,（2.1±0.1） lg U/L and（1.0±0.2）,respectively,P<0.05】 in control persons;MELD score in 68 survivals was（18.2±.0）,significantly lower than【（26.1±3.3）,P<0.05】 in 32 dead,serum M65 level was [（2.9±0.2） lg U/L,much lower than [（4.1±0.5） lg U/L,P<0.05] in the dead,and M30/M65 ratio was （0.4±0.1）,significantly higher than 【（0.2±0.1）,P<0.05】 in the dead group;the cut-off-value of MELD in forecasting the prognosis of patients with ACLF was 23.21,and its AUC was 0.650,with the sencitivity（Se） of 85.5%,specificity（Sp） of 65.0% and accuracy （Ac） of 72.0%,while the cut-off-value of M30/M65 ratio was 0.30,and its AUC was 0.875,with the Se of 94.5%,Sp of 85.0% and Ac of 85.0%,much superior to MELD score（P<0.05）. Conclusion Serum K18（M30 and M65） level is related to the severity of liver diseases,and early detection of serum M30/M65 might be helpful in predicting the prognosis of patients with HBV-ACLF.

Objective To investigate the efficacy of autologous bone marrow stem cell transplantation for treatment of patients with hepatitis B-induced acute-on-chronic liver failure（ACLF）. Methods 120 patients with hepatitis B-induced ACLF at early and middle stages were recruited in this study,all of them received plasma diafiltration（PDF） at the base of conventional supporting measures,and 58 cases out of them received autologous bone marrow stem cell transplantation via hepatic artery. The survival rates,activity status,MELD score,CTP grade,liver functions,clinical symptoms and adverse reactions were compared between the two groups. Results At the end of 24 w and 48 w after transplantation,the survival rates in patients with stem cell transplantation were 70.7%and 55.2%,respectively,much higher than 51.6% and 32.2% （P<0.05） in those without;the percentages of Eastern Cooperative Oncology Group（ECOG） score ≥2 were 27.5% and 12.5%,respectively,much lower than 56.3% and 40.0% （P<0.05）;at the end of 24 w,the MELD score and indocyanine green retention rate at 15 min （ICGR15） were （18.6±4.1） and （20.6±8.1）%,much lower than （20.4±5.2） and （28.7±10.3）% （P<0.05）;no severe untoward effect was found in patients underwent stem cell transplantation. Conclusion Autologous bone marrow stem cell transplantation at the base of artificial liver support is effective in the treatment of patients with ACLF at early and middle stage,which warrants further validation.

Objective The prognosis of patients with ACLF is extremely poor with mortality rates ranging from 30% to 70%. Hemoperfusion,plasma exchange（PE） and double plasma molecular absorb system （DPMAS） are the most popular non-biological artificial liver support system applied in China. The present study was to evaluate the effects of PE and sequential DPMAS therapy on short survival in patients with hepatitis B virus-induced acute-on-chronic liver failure （HBV-ACLF）. Method 83 patients at different stages of HBV-ACLF were recruited in Xijing hospital between January 2011 and December 2016. All the laboratory parameters were collected at admission,before and after artificial liver support system therapy,and at the end of 90 day follow up. Result There were 29 cases at early stage,34 cases at middle stage and 20 cases at advanced stage at admission in this series of 83 patients with HBV-ACLF. At the end of 90 days of treatment,the survival rate in patients at early stage was 65.5%,in patients at middle stage was 38.2%,and in patients at advanced stage was 15.0% （P<0.001）;The incidence rates of hepatic encephalopathy in patients at early,middle and advanced stage were 20.7%,52.9% and 60.0% （P<0.05）;Multivariate Logistic regression analysis showed that the advanced stage（P=0.01）,serum bilirubin level being ≥350 μmol/L（P=0.008）,hepatic encephalopathy being≥grade 2（P=0.001） and CLIF-SOFA being≥10（P=0.043） at presentation were the independent risk factors of mortality in patients with HBV ACLF. Conclusion Sequential PE and DPMAS therapy might remove toxin from blood,improve the overall survival rate,and the efficacy is obvious in patients at early and middle stage,which still needs further investigation. Patients at admission have serum bilirubin levels ≥350 μmol/L,with hepatic encephalopathy≥grade 2,CLIF-SOFA scores≥10 and at advanced stage might hint poor prognosis.

Objective To evaluate the impact of terbivudine （LdT） combined with adefovir dipivoxil （ADV） therapy on renal functions in patients with decompensated hepatitis B liver cirrhosis. Methods In this cohort study,76 patients with HBV-induced decompensated liver cirrhosis were divided into two groups,and 39 cases in observation group received combination of LdT and ADV,and 37 cases in control group received lamivudine（LAM） and ADV therapy. All the patients were followed-up for 52 weeks. The estimated glomerular filtration rate（eGFR） were calculated as reported in literature. Results At the end of 52th week,serum ALT, ALB and TBIL levels,Child-Pugh scores and HBV DNA negative rates in the two groups were significantly improved as compared with those before treatment （P<0.05） and no significant differences between the two groups （P>0.05）;the eGFR in observation group was（118.5±14.2） ml.min-1.1.73 m^-2,significantly higher than that in the control group[（94.2±18.5） ml·min^-1·1.73 m^-2,P<0.05],and serum creatinine level in observation group was （70.5±8.8） μmol/L,significantly lower than that in the control group[（109.1±15.8） μmol/L,P<0.05]. Conclusion The combination of LdT and ADV therapy in dealing with ADV-resistance has a good efficacy in patients with HBV-induced decompensated liver cirrhosis,which needs further observation.

Objective To evaluate the efficacy of entecavir and peg-IFNα-2a or thymosin α1 combination in the treatment of patient with compensated hepatitis B liver cirrhosis. Methods In this study,88 patients with compensated hepatitis B cirrhosis were selected,and 38 received entecavir, 17 received entecavir combined with PEG-IFNα-2a and 33 received entecavir and thymosin α1 combination for 104 weeks. Results Serum HBV DNA levels in the entecavir monotherapy group before treatment and at the end of 104 week were （5.6±1.7） IU/ml and （1.0±0.7） IU/ml,respectively （P<0.05）,in PEG-IFNα-2a combination group were （5.8±1.3） IU/ml and （1.0±0.7） IU/ml,respectively（P<0.05） and in combined with thymosin group were （6.1±2.0） IU/ml and（1.0±0.9） IU/ml, respectively（P<0.05）;serum albumin levels in the entecavir group before treatment and at the end of 104 week were （43.1±5.4） g/L and （46.9±4.9） g/L,respectively （P<0.05）,and in combined thymosin group were （43.0±4.0） g/L and（46.8±5.4）g/L,respectively（P<0.05）;there were no significant differences as respect to liver stiffness measures and INRs among the three groups （P>0.05）. Conclusion Entecavir monotherapy could effectively inhibit the replication of HBV DNA, and improve liver function tests and we don’t find any advantages of combination with PEG-IFNα-2a or thymosin-α1 from the results of this study.

Objective To investigate the clinical efficacy of autologous peripheral blood stem cell （PBSC） transplantation in patients with hepatitis B cirrhosis. Methods 95 patients with hepatitis B liver cirrhosis were recruited in our Department of Infectious Diseases between April 2014 and April 2017,and all the patients were randomly divided into transplantation （n=48） and control group （n=47）. The patients in the control group received entecavir and conventional supporting treatment,and the patients in the observation group were treated with intrahepatic transplantation of autologous PBSCs via hepatic artery at the base of supporting treatment. Peripheral blood T lymphocyte subgroups,liver stiffness,and serum tumor necrosis factor-α（TNF-α）,interleukin-6 （IL-6） and hypersensitive C reactive protein（hs-CRP） levels were assayed. Results At the end of 6 month treatment,total serum bilirubin level in patients receiving PBSCs transplantation was（16.4±1.2） μmol/L,significantly lower than （22.5±2.6） μmol/L （P<0.05） in the control,while serum albumin level was （35.2±4.0） g/L,much higher than （31.6±3.7） g/L（P<0.05） in the control;the percentage of peripheral blood CD3⁺ cells was （67.9±6.5）%,significantly higher than 【（60.3±5.5）%,P<0.05】,CD4⁺ cells was （42.7±3.8）%,significantly higher than 【（38.2±3.5）%,P<0.05】,and ratio of CD4⁺/ CD8⁺ cells was （1.5±0.2）,significantly higher than 【（1.4±0.1）,P<0.05】 in the control;the liver stiffness measurement was （7.1±0.1） kPa,much lower than [（7.9±0.1）kPa,P<0.05],and Child-Pugh score was （5.5±1.5）,much lower than [（7.4±2.3）,P<0.05] in the control;serum hs-CRP level was （18.9±5.6） pg/mL,much lower than [（25.2±7.9） pg/mL,P<0.05] in the control. Conclusion Autologous stem cell transplantation is short-term efficient in patients with hepatitis B liver cirrhosis,which might effectively improve the patient's immune functions,and decrease the blood cytokine levels.

Objective To analyze the risk factors of nosocomial infections in patients with hepatitis B liver cirrhosis. Methods 280 patients with hepatitis B liver cirrhosis were recruited in our hospital between January 2015 and January 2017,and the diagnosis of infections was carried out according to the clinical,blood,bacteria culture and imaging results. The independent risk factors of acquired infection were analyzed by Logistic regression analysis. Results Out of the 280 patients with liver cirrhosis, the nosocomial infections occurred in 57（20.4%）,including spontaneous bacteria peritonitis in 18（31.6%）,respiratory infection in 12（21.1%）,gut infection in 10（17.5%）,urological infection in 7（12.3%）and septicemia in 10（17.5%）;univariate analysis showed that age （x²=7.416,P=0.006）,hospital stay（t=28.247,P<0.001）,serum albumin （t=2.661,P=0.008）,ATP of peripheral blood CD4⁺T lymphocyte （t=8.122,P<0.001）,Child-Pugh score（x²=10.577,P=0.005）,invasive manipulation （x²=29.214,P<0.001）,ascites （x²=25.776,P<0.001） and gastrointestinal bleeding （x²=111.434,P<0.001） were,while the gender and hepatic encephalopathy were not（P>0.05）,the risk factors for acquired infections;multivariate Logistic analysis demonstrated that age,invasive manipulation,ascites,gastrointestinal bleeding,hospital stay and serum albumin level were the independent risk factors for the nosocomial infections in these patients. Conclusion Patients with liver cirrhosis are susceptible to nosocomial infections,especially in those with elderly age,lower serum albumin level and long hospital stay,and the clinicians should pay attention to them and eliminate the risk factors of nosocomial acquired infection.

Objective This study was designed to evaluate of reliability and validity of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） in patients with liver cirrhosis. Methods A total of 138 patients with liver cirrhosis were enrolled in this study. The reliability and validity of the two scales was evaluated by Cronbach’s α co-efficient,intraclass correlation co-efficient （ICC）,Kaiser-Meyer-Olkin （KMO） score and Bartlett’s test of sphericity（BTS）. Results The prevalence of anxiety and depression in this series were 38.2% and 63.1%,respectively;SAS scale’ Cronbach's α coefficient was 0.777 and SDS scale’ was 0.782, indicating better homogeneity reliability; Twenty items of SAS and SDS scales were analyzed by exploratory factors to construct validity and four main factors were extracted from the SAS scale that showed the variances ratio were 15.4%,14.9%,10.6% and 10.2%,respectively,and four factors accounted for 51.1% of the total variance of accumulated explanation;Five main factors were extracted from SDS scales that showed the variance ratio were 14.0%,12.6%,11.9%,10.3% and 8.4%,respectively,with 57.4% of the total variance;The re-measurement analysis of SAS and SDS scale’s items found that the two measurements were highly correlated with each other （P<0.001）. Conclusion SAS and SDS scales have a better reliability and validity in the investigation of psychological and mental impairment in patients with liver cirrhosis.

Objective To investigate the cancerous and noncancerous expression of epithelial cell adhesion molecule（Ep-CAM） and C-Kit in patients with hepatocellular carcinoma（HCC）. Methods Cancerous and its adjacent noncancerous tissues from ninety patients with HCC were obtained after hepatectomy in our hospital between March 2015 and January 2017. Immunohistochemical staining was applied to detect the expression of Ep-CAM and C-Kit protein,and the positivities of Ep-CAM and C-Kit protein between different histological grades, with or without envelope,different lesion sizes,high and low serum alpha-fetoprotein（AFP） levels and with or without vascular infiltration were compared. Results Out of the 90 patients with HCC,the positive expression rates of Ep-CAM and C-Kit protein in cancerou tissues were 65.6% and 74.4%,significantly higher than 11.1% and 4.4% in its adjacent noncancerous tissues（P<0.05）;the positive expression rates of Ep-CAM in 50 patients with Ⅲ/Ⅳ differentiation,in 49 with serum AFP>400 ng/ml and in 28 with vascular infiltration were 76.0%,79.6% and 82.1%,significantly higher than 52.5%,48.8% and 58.1% in 40 patients with Ⅰ/Ⅱ differentiation,in 41 with serum AFP≤400 ng/ml and in 62 without vascular tumor infiltration;the positive expression rates of C-Kit in patients with Ⅲ/Ⅳ differentiation,in with serum AFP>400 ng/ml and in with vascular infiltration were 86.0%,87.8% and 89.3%,much higher than 60.0%,58.5% and 67.7% in patients withⅠ/Ⅱ differentiation,in with serum AFP≤400 ng/ml and in without vascular tumor infiltration（P<0.05）. Conclusion The positive expression rate of Ep-CAM protein and C-Kit protein in cancerous tissues of patients with HCC increase,and they are related to tumor histological grades,preoperative serum AFP levels,and to vascular tumor infiltration. The implication needs further investigations.

Objective To investigate the clinical implications of serum Golgi protein 73（GP73）,lentil lectin-reactive alpha-fetoprotein-L3（AFP-L3）,AFP,and α-L- fucosidase（AFU） in patients with primary liver cancer（PLC）. Methods 261 patients with PLC,201 patients with hepatitis B liver cirrhosis （LC）,238 patients with chronic hepatitis B（CHB） and 200 healthy individuals were recruited in this study betweem January 2015 and March 2017,and serum levels of GP73,AFP-L3,AFP and AFU were detected. The efficacy of diagnosis was performed by Logistic fitting and the ROC curve were drawn to calculate their diagnostic efficacy. Results Serum GP73 level in patients with PLC was significantly lower than in patients with CHB or in patients with LC（P<0.05）,serum AFP-L3 level was much higher than those in patients with CHB,with LC or healthy persons（P<0.05）,and serum AFU level was much higher than in healthy persons or in patients with LC,but much lower than in patients with CHB（P<0.05）;the AUC of serum GP73,AFP-L3,AFP and AFU in diagnosing PLC based on comparison with non-PLC individuals were 0.564（95%CI：0.485-0.636）,0.724（95%CI：0.555-0.786）,0.745（95%CI：0.654-0.806） and 0.571（95%CI：0.385-0.536）,and the cut-off-value of serum AFP-L3 and serum AFP combination were 8.25% and 49.25 ng/mL,with the sensitivity（Se） of 55.5%,specificity（Sp） of 85.0% and accurracy （Ac） of 80.1%,significantly higher than 55.5%,85.0% and 76.4% by serum AFP-L3 or 57.1%,82.7% and 75.2% （P<0.05） by serum AFP alone;out of 261 patients with PLC,71 patients （27.2%） had serum AFP<9.6 ng/ml,and 30（42.3%） of them had serum PG73>106.5 ng/ml,suggesting the latter might be useful in diagnosing PLC patients with lower or negative serum AFP;out of 201 patients with LC,serum AFP levels were less than 9.6 ng/ml in 98（48.8%）,and 53.1% of them（52/98） had serum PG73 level being greater than 106.5 ng/ml,hinting that liver cirrhosis might impact serum GP73 level. Conclusion Serum GP73 level is associated with liver injury and fibrosis and serum AFU level is of little significance for the diagnosis of patients with PLC. The application serum AFP combined with AFP-L3 might improve the efficacy in diagnosing patients with PLC,while the Se and Sp are still not high. The clinicians should take this into consideration and make a relatively accurate diagnosis by detailed illness history,comprehensive physical examination and necessary imaging.

Objective To investigate the expression of interferon-induced transmembrane protein （IFITM3） in hepatocellular carcinoma（HCC） and its correlation with intrahepatic tumor recurence after hepatectomy. Methods A total of 43 patients with HCC were recruited in our hospital,and all of them received hepatectomy. The specimens of cancer and its adjacent liver tissues were taken,and the expression of IFITM3 was detected by Western blot and by immunohistochemistry. All the patients were followed-up for 1 years. Results The expression of IFITM3 protein in HCC tissues was （1.2386±0.1901）,significantly stronger than （0.9496±0.0995） in the adjacent tissues （t=8.832,P=0.000）；the results of immunohistochemical staining showed that the brownish yellow granular IFITM3 protein located in the cytoplasm of liver cancer tissues and adjacent tissues,and the positive rate of IFITM3 protein in hepatocellular carcinoma was 72.1%（31/43）,significantly higher than 14.0%（6/43） in adjacent tissues（x²=29.647,P=0.000）；the positive rate of IFITM protein in low and medium differentiated HCC tissues were 95.2%（20/21） and 90.9%（10/11）,significantly higher than 9.1%（1/11） in high differentiated group（x²=14.727,P=0.000；x²=23.748,P=0.000）；the positive rate of IFITM3 protein in patients with recurrent intrahepatic tumor was 81.0% （17/21）,much higher than 22.7% （5/22） in without tumor recurrence（x²=14.578,P=0.000）. Conclusion IFITM3 protein is highly expressed in HCC tissues,and the worse the differentiation of HCC,the stronger the degree of expression,which might closely be related to the recurrence of HCC after hepatectomy.

Objective To explore the efficacy of transcatheter arterial chemoembolization （TACE） and radion implantation in the treatment of patients with primary liver cancer（PLC） and its impact on hepatic expressions of telomeric repeat binding factor（TRF）1 and TRF2. Methods 108 patients with PLC between December 2013 and December 2015 were recruited in our hospital,and were randomly divided into two groups by tossing coins. 54 patients in the control group received TACE,and another 54 in the observation group received intrahepatic¹²⁵I radion impoantation at the base of TACE. Liver biopsies were conducted and the expressions of TRF1 and TRF2 were stained by SP. Results At the end of 3 months after treatment,the Objective remission rate（ORR） in the combination group was 79.6%,much higher than 61.1% in the TACE-treated group（P<0.05）；serum CEA and AFP levels were （273.7±38.1） ng/ml and （820.4±130.3） μg/L,much lower than （312.5±33.9） ng/ml and （1080.1±121.3） μg/L,respectively,in the TACE group（P<0.01）；the TRF1 expression in the adjacent liver tissue was（9.7±2.3）,much stronger than（4.2±1.8） in the tumorous tissues（P<0.01）,while TRF2 expression in the tumorous tissue was（9.2±2.2）,much stronger than （3.8±2.6） in the adjacent tissue（P<0.01）；the 1 yr-survival in the combination group was much higher than in the TACE group（96.3% vs. 85.2%,x²=3.967,P=0.046）. Conclusion The combination of TACE and hepatic radion implantation in the treatment of patients with PLC is effective,and the mechanism by which it works might be related to the regulation of expressions of TRF1 and TRF2.

Objective To compare the efficacy of ultrasound-guided percutaneous radiofrequency ablation and hepatectomy in treatment of patients with hepatocellular carcinoma （HCC） of less than 3 cm diameters and to analyze the impacting factors of prognosis. Methods A total of 107 patients with HCC were recruited in our hospital between January 2011 and April 2015,and 58 patients with HCC received US-guided RPA,and 49 underwent hepatectomy. The independent risk factors affecting their survival was analyzed by Cox univariate and multivariate analysis. Results After treatment,serum ALT level in patients receiving radiofrequency ablation was significantly lower than that in patients receiving hepatectomy （P<0.05）,while serum albumin level was significantly higher than that in hepatectomy group （P<0.05）;the incidences of post-operational complications in the two groups （10.3% vs. 16.3%,P>0.05） were not statistically significantly different;the 1 a,2 a and 3 a overall survival（OS） rates in PRA-treated patients were 84.5%,65.5% and 44.8%,not significantly different as compared to 85.7%,67.3% and 46.9% in hepatectomy-treated patients （x²=0.032,P=0.859;x²=0.040,P=0.842;x²=0.048,P=0.827）;Cox univaritate analysis showed that tumor number （HR=0.372,95%CI:0.105-0.876,P=0.033） was related to the disease-free survival（DFS）,while serum AFP level（HR=3.043,95%CI:1.007-5.248,P=0.035）,tumor number （HR=0.871,95%CI:0.344-0.902,P=0.401） and tumor diameter （HR=1.631,95%CI:1.273-3.045,P=0.005） were related to the OS;Cox multivariate analysis showed that more than one tumor number （HR=0.087,95%CI:0.045-0.498,P=0.009） was the risk factor affecting the DFS,while lower tumor differentiation（HR=2.974,95%CI:1.865-4.097,P=0.046）,multiple tumor （HR=0.062,95%CI:0.033-0.378,P=0.002） and large tumor diameter （HR=2.216,95%CI:1.778-5.026,P=0.007） were the risk factors affecting the OS of patients with HCC. Conclusions Ultrasound-guided percutaneous radiofrequency ablation and hepatectomy are efficient in treating patients with HCC,while the patients undergoing radiofrequency ablation might have little trauma,less liver injuries and recover rapidly.

Objective To summarize the imaging features of solitary necrotic nodules of liver （SNNL）. Methods The imaging data of 43 patients with SNNL in our hospital between March 2013 and March 2017 were retrospectively analyzed. The abdominal MRI scan and enhanced examination were performed to observe the imaging features. Results In 43 SNNL lesions,the diameter was（2.8±0.4） cm,with 38 lesions less than and 5 greater than 3 cm;39 were a single focci and 4 were fusion lesions;36 lesions were located in the right,and 7 in the left lobe of the liver;34 lesions were superficial,and 9 were deep lesions;27 lesions were irregular,while 16 were round or round-like;32 lesions showed low signal intensity,6 showed slightly low signal intensity,and 5 lesions showed iso-signal intensity on T2WI;there were 2 lesions with slightly high signal intensity,and 39 lesions with isointensity on T2WI;21 lesions with equal signal intensity and 22 lesions with high signal intensity or slightly hyperintense signal intensity on DWI sequences;in 43 cases,no enhancement was found in the lesions after enhanced scanning. Conclusions MRI plain scan and dynamic contrast enhancement might provide relatively special imaging feature of SNNL,by which the clinicians could make decision for proper management in this setting.

Objective To investigate the prevalence metabolic syndrome（MS） and new-onset cholelithiasis in the elderly and to analyze the risk factors affecting the occurrence of cholelithiasis. Methods 508 elderly individuals underwent physical examination in our hospital between January 2013 and December 2017. According to generally approved criteria,246 patients were found to have MS,and 262 haven’t,respectively. The demographic data,height,body mass,waist circumference,blood pressure,blood biochemical parameters,e.g. fasting blood glucose（GLU）,triglyceride （TG） and high density lipoprotein （HDL） were collected. The multivariate Logistic analysis was applied to find out the risk factors for the occurrence of cholelithiasis in the elderly persons. Results There was no significant difference in the age of individuals between the two groups（P>0.05）;The BMI,systolic blood pressure,diastolic blood pressure and waist circumference in patients with MS were（27.0±3.0） kg/m²,（147.7±18.7） mmHg,（93.8±10.8） mmHg and（93.8±7.4） cm, significantly higher than[（24.1±2.8） kg/m²,（132.7±19.60） mmHg,（86.2±11.9） mmHg and （84.6±8.5） cm] in individuals without MS（P<0.05）;blood glucose and TG levels in patients with MS were（6.5±1.9） mmol/L and（2.3±1.7） mmol/L,respectively,significantly higher than [（5.6±1.3） mmol/L and （1.1±0.6） mmol/L in persons without MS （P<0.05）,while blood HDL in patients with MS was（1.3±0.8） mmol/L,significantly lower than [（1.6±0.4） mmol/L,P<0.05] in persons without MS; the prevalence of cholelithiasis in patients with MS was 19.1%,significantly higher than 3.4% in individuals without MS（x²=31.765,P<0.05）;there was no significant difference as respect to mean age between 56 patients with cholelithiasis and 452 individuals without （P>0.05）;the BMI,systolic blood pressure,diastolic blood pressure and waist circumference in patients with cholelithiasis were （27.6±3.9） kg/m²,（146.5±19.4） mmHg,（95.3±12.2） mmHg and （98.5±8.9） cm,significantly higher than [（25.3±3.2） kg/m²,（139.4±20.6） mmHg,（89.5 ±11.9） mmHg and （90.8±9.7） cm,P<0.05] in persons without cholelithiasis（P<0.05）;blood glucose and TG levels in patients with cholelithiasis were （6.8±1.7） mmol/L and （1.7±1.4） mmol/L,significantly higher than [（5.9±1.6） mmol/L and （1.6±1.3） mmol/L,P<0.05] in persons without, while blood HDL level was（1.2±0.4） mmol/L,significantly lower than[（1.5±0.6） mmol/L,P<0.05] in persons without;the binary Logistic multivariate regression analysis showed that the waist circumference,blood GLU and TG levles were the independent risk factors for cholelithiasis occurrence. Conclusion Metabolic syndrome is positively associated with new-onset cholelithiasis in the elderly population and the waist circumference,blood glucose and TG levels are the independent risk factors for new-onset occurrence of cholelithiasis in the elderly,which should be concerned in clinical practice.

Objective To explore the application value of nasobiliary drainage combined with primary suture of common bile duct in the treatment of patients with choledocholithiasis. Methods 164 patients with cholecystolithiasis and cholelithiasis were recruited in our hospital between March 2014 and March 2017,and were randomly divided into observation group （n=82） and control group （n=82）. Laparoscopic cholecystectomy and bile duct exploration were performed in both groups. The patients in the observation group were treated with intraperitoneal anterograde nasobiliary drainage combined with primary suture of common bile duct,and the patients in the control group were treated with T tube drainage. The amount of blood loss during operation and the operation time were observed in both groups. The recovery of intestinal functions,bile drainage and the complications were compared between the two groups. Results The amount of intraoperative bleeding in the observation group was （36.1±10.2） mL,similar to [（32.2±13.2） mL,P>0.05] in the control;the operative time was （96.6±21.5） min,also similar to[（91.5±19.1） min,P>0.05] in the control;the recovery time of intestinal function was（1.4±0.5） days,significantly shorter than（2.3±0.5） d（P<0.05） in the control;the time of drainage tube placement was （5.5±1.6） days,significantly shorter than （90.8±2.3） d （P<0.05） in the control;the hospitalization stay was （7.4±1.4） days,significantly shorter than （9.5±2.4） days （P<0.05） in the control,while the hospitalization cost was（38822.2±4019.7） yuan,significantly higher than（26744.7±3277.7） yuan in the control group;at day one postoperation the bile drainage in observation group was（267.3±102.8） mL,not significantly different as compared to （266.5±112.6） mL in the control （P>0.05）;at day 2 the bile drainage was （221.3±128.2） mL,significantly lower than （313.3±117.6） mL in the control （P<0.05） and at day 3 the bile drainage was（191.9±138.5） mL,significantly lower than （270.8 ±121.8） mL in the control（P<0.05）;the incidences of complications,such as bile leakage,intestinal hemorrhage,nausea and vomiting,and pancreatitis,in the two groups were not significantly different（8.4% vs. 12.2%,x²=0.591,P>0.05）. Conclusion The application of intraperitoneal anterograde nasobiliary drainage combined with primary suture of common bile duct in the treatment of patients with choledocholithiasis and cholelithiasis is efficient,which might significantly shorten the hospital stay and tube drainage.

Objective To explore the clinical application of endoscopic sphincterotomy （EST） combined with endoscopic papillary balloon dilatation （EPBD） in the treatment of patients with extrahepatic bile duct stones without bile duct dilation. Methods The clinical data of 124 bile duct stone patients with non-dilated extrahepatic bile duct were retrospectively analyzed,and patients in combined underwent EST combined with EPBD （n=49）,in observation underwent EST alone（n=31） and in control group received conventional choledochotomy plus T-tube drainage（n=44）. Results At the end 48 h after operation,serum amylase （AMS） level in combination group was （107.1±34.6） U/L,and hypersensitivity C-reactive protein （hsCRP） level was （37.2±8.9） mg/L,those in observation group were （113.9±35.2） U/L and （38.1±9.4） mg/L,both significantly lower than （221.5±54.8） U/L and （73.2±16.2） mg/L,respectively（P<0.05） in the control;the operation duration in combination group was （95.2±14.8） min,and it in observation group was （113.6±12.7） min,both longer than [（84.8±12.1）,P<0.05] in the control;the incidence rates of pancreatitis and reflux cholangitis in combined group were 2.0% and 4.1%,significantly lower than 19.4% and 22.6% in observation group or 18.2% and 22.7% （P<0.05） in the control. Conclusions The application of EST and EPBD combination is efficacious approach in dealing with patients with choledocholithiasis without extrahepatic bile duct dilation,which might improve fast postoperative recovery,and reduce the short-term and long-term complications.

Non-alcoholic fatty liver disease（NAFLD） is a global public health problem. Adjusting lifestyle and maintaining a healthy mental state are the cornerstones in dealing with patients with NAFLD. This article focuses on the recent progress at home and abroad in medical treatment of NAFLD and reviews the safety and efficacy of targeted therapies in different stages of oxidative stress,inflammatory response,lipid metabolism,fibrogenesis,and apoptosis.

The incidence rate of non-alcoholic fatty liver disease （NAFLD） with concurrent chronic hepatitis B （CHB） is increasing gradually. We will compare serum indexes, image and pathology characteristics among patients with NAFLD,CHB and NAFLD concurrent with CHB. The virus and host are both involved in the pathogenesis of steatosis. We will discuss all the above questions.