Objectiv To observe the inhibitory effect of 1,25（OH）₂D₃ on liver fibrosis in hepatic stellate cells （HSCs） and in rat model. Method The CCl₄-induced liver fibrosis was made in rats,and the activation of HSCs were induced by 10 pmmol/L TGF-β1 incubation. The miR-146a mimic/inhibitor were transfected in HSCs and 1,25（OH）₂D₃ intervention were paralleled. The miR-146a levels in liver tissues were detected by qPCR,the proliferation of cells was measured by CCK8 and the apoptosis was detected by flow cytometry. Results At the end of 8 weeks,the hepatic fibrosis in 1,25（OH）₂D₃ intervention group was significantly milder than that in the control group;the miR-146a level in 1,25（OH）₂D₃ intervention group was significantly higher than in oil control group[（0.70±0.03） vs.（0.33±0.17）,P<0.05];the proliferation rate in1,25（OH）₂D₃ group was 58.8%,15.91% of lower than in DMSO group,in miR-146a mimic transfected group was 46.5%,53.3% of lower than in control,in miR-146a inhibitor group was132.8%,32.8% of higher than in control（P<0.05）;the apoptosis rate of HSCs in1,25（OH）₂D₃ group was 12.6%,5.2% of higher than in DMSO,in miR-146a mimic transfected group was16.8%,8.2% of higher than in control,and in miR-146a inhibitor transfected group was 6.3%,2.2% of lower than in control （P<0.05）,indicating the inhibition of 1,25（OH）₂D₃ on proliferation and promotion on apoptosis of HSCs. Conclusion 1,25（OH）2D3 might modulate miR-146a levels to inhibit liver fibrosis.

Objectiv To establish a reliable animal model of primary biliary cholangitis（PBC） and to investigate the therapeutic effect of umbilical cord-derived mesenchymal stem cells （UC-MSC） on STAT3 signal in intrahepatic biliary epithelial cells（IBECs） of this PBC animal. Methods C57BL/6 mice were intraperitoneally injected with 2-octynyl acid （2-OA）-bovine serum albumin （BSA） adjuvanted with Freund's adjuvant/incomplete Freund's adjuvant （CFA/IFA） or with same amount of BSA adjuvanted with IFA,or untreated as control. The model mice 22 weeks later were randomly divided into model （n=4）,MSCs transplantation （n=6） and STAT3 inhibitors-treated group（n=6）. The intrahepatic biliary tree and IBECs were obtained,and STAT3/pSTAT3,p62,LC3,PKR/pPKR,Beclin-1,eIF2α/peIF2α and LAMP-1 expression were detected by WB,and STAT3,LC3 and p62-mRNA were detected by RT-PCR. Results The lymphocyte infiltration and granuloma in portal area were found in liver tissues of model mice,while they were obviously alleviated in MSCs-or Stattic-intervened groups;the expressions of Beclin-1,STAT3 and pSTAT3 in IBECs from model intensified as compared to those in BSA-treated group,while they were weaken in MSCs-or Stattic-intervened groups;p62 mRNA levels decreased in model and MSC transplanted grous as compared to that in BSA-treated group,and STAT3 mRNA level in model decreased as compared to that in BSA-treated group. Conclusion Our findings indicate that MSC transplantation might regulate the autophagy and decrease the expression of STAT3 signals in mice with primary biliary cholangitis.

Objectiv The aim of this study was to investigate the G2D expression of peripheral blood natural killer cells in patients with chronic hepatitis B（CHB）. Methods 20 chronic HBV carriers,18 patients with CHB,16 patients with HBV-induced acute-on-chronic liver failure and 20 healthy individuals were recruited in our hospital between July 2015 and July 2018. The liver biopsies were performed in all patents and normal liver tissue was obtained from the adjacent liver tissues of patients with hepatic hemangioma. Flow cytometry was used to detect NK cells and NKG2D⁺NK cells in peripheral blood,serum perforin and granulase B levels were detected by ELISA,and liver tissue NKG2D mRNA and NKG2D protein expression were detected by fluorescence quantitative PCR and Western bloting,respectively. Results The frequencies of NK cells and NKG2D⁺NK cells in HBV carriers were （5.1±1.5）% and （3.4±1.1）%,in patients with CHB were （8.5±2.0）% and （12.3±2.1）%,in patients with liver failure were （8.8±1.6）% and （19.0±2.4）%,and control were （14.2±2.1）% and （7.5±1.5）% （P<0.05）;serum levels of perforin and granzyme B were （15.2±3.2） ng/L and （23.0±3.5） ng/L,（31.5±3.6） ng/L and （52.5±4.0） ng/L,（60.2±11.0） ng/L and （126.8±30.1） ng/L,and （13.9±4.0） ng/L and （21.1±3.9） ng/L） in the four groups（P<0.05）;the NKG2D mRNA levels and NKG2D protein expression were（0.1±0.0） and （0.0±0.0）,（3.5±0.9） and（1.1±0.2）,（7.0±1.2） and （1.8±0.2）,and （0.6±0.2） and （0.3±0.0） in the four groups （P<0.05）. Conclusion NKG2D might exert its action through the synthesis and secretion of perforin and granulase B by NK cells,and down-regulation of NKG2D might improve liver injury and prevent liver failure.

Objectiv To investigate the predictive factors of response to interferon-α（IFN-α） antiviral therapy in children with chronic hepatitis B （CHB）. Methods 70 children with CHB were recruited in our hospital between March 2013 and March 2016,and were randomly divided into IFN-α-treated （n=40） and thymopeptide-treated group （n=30）. All patients were treated for six months. Serum alanine aminotransferase （ALT） normalization rates,the negative rates of serum HBeAg and the negative rates of serum hepatitis B virus deoxyribonucleic acid（HBV DNA） were compared between the two groups. Results At the end of the regimen,serum ALT normalization rate in IFN-α-treated group was 97.5%,not significantly different compared to 93.3% in thymopeptide-treated group （P>0.05）,while serum HBeAg negativity rate was 40.0% and serum HBV DNA loss was 77.5%,both much higher than 10.0% and 3.3% （x²=7.802,x²=37.998,P<0.05） in thymopeptide-treated group;our further analysis about the response of IFN-αshowed that serum HBeAg and HBV DNA negativity rates in 30 children with serum ALT levels greater than 200 u/l were 46.7% and 43.3%,significantly higher than 10.0% and 10.0% （P<0.05） in 10 children with serum ALT levels less than <200 U/L;serum HBeAg and HBV DNA negativity rates in 32 children older than 5 years were 53.1% and 50.0%,significantly higher than 12.5% and 12.5%,respectively（P<0.05） in 8 children younger than 5 years;serum HBeAg and HBV DNA negativity rates in 31 children with serum HBV DNA levels greater than <6 lg copies/ml were 54.8% and 61.3%,significantly higher than 11.1% and 22.2%,respectively（P<0.05） in 9 children with serum HBV DNA levels greater than 6 lg copies/ml,while serum HBeAg and HBV DNA negativity rates in 21 boy were 33.3% and 28.6%,not significantly different compared to 47.4% and 47.4%,respectively（P>0.05） in 19 girls,and serum HBeAg and HBV DNA negativity rates in 5 children with less than one year illness period were 80.0% and 60.0%,not significantly different compared to 45.7% and 48.5%,respectively （P>0.05） in 35 children with disease period longer than one year. Conclusion IFN-α is in short-term effective for the treatment of children with CHB, but the incidence of adverse reactions are common,which warrants further investigation.

Objectiv To explore the efficacy and safety of tenofovir disoproxil fumarate（TDF） and entecavir （ETV） in the treatment of chronic hepatitis B （CHB） patients with viral DNA polymerase 204 site mutation infection. Methods 87 CHB patients with HBV polymerase 204 site mutation infection due to resistance to lamivudine or adefovir therapy were recruited in this study between August of 2013 and September 2015,and 44 patients received TDF and 43 received ETV treatment. The peripheral CD4⁺T lymphocyte counts were detected by FCM,and creatinine clearance （Crcl） was calculated based on serum creatinine levels. Results At the end of 24 w,48 w and 72 w treatment,serum HBV DNA loss in TDF-treated patients were 63.6%,79.6% and 95.5%,significantly higher than 35.6%,55.6% and 82.2%,respectively,in ETV-treated patients（P<0.05）,and serum ALT normalization rates were 84.1%,90.9% and 93.2%,while they were 65.1%（P<0.05）,83.7% and 90.7% in ETV-treated patients;the peripheral blood CD4⁺T cell counts were （481.5±232.4）/μl,（536.5±297.5）/μl and （566.5±321.6）/μl,no significantly different as compared to （475.3±229.3）/μl,（565.8±255.9）/μl and （565.1± 256.5）/μl in ETV-treated patients （P<0.05）;the Crcl levels were （101.2±40.1） ml/min,（104.3±26.8） ml/min and （98.7±21.5） ml/min,also without significantly different as compared to （105.2±42.6） ml/min,（102.5±30.6） ml/min and （99.6±26.8） ml/min in ETV-treated patients（P<0.05）. Conclusion TDF might be the priority option in dealing with CHB patients with HBV mutant infection for rescue therapy as it works early,convenient and safe.

Objectives To investigate the efficacy of domestic pegylated interferonα-2b （peg-IFN-α-2b） in treatment of patients with serum HBeAg positive chronic hepatitis B（CHB）. Methods 500 patients with serum HBeAg positive CHB were recruited in this study between January 2015 and December 2017,and 150 patients in group A were treated by domestic peg-IFN-α-2b,and 350 patients in group B received peg-IFN-α-2a. The regimen lasted for 24 to 48 weeks,and all patients with CHB were followed-up for 24 weeks. Results At presentation,serum HBV DNA loads,serum alanine aminotransferase（ALT） level,body mass index,serum HBeAg and HBsAg levels in group A were （6.1±0.7） lg cps/ml,（81.1±29.8） U/L,（22.1±2.9）,（3.1±0.6） lg s/co and （4.4±0.6） IU/ml,without significantly different as compared to（6.2±0.67） lg cps/ml,（80.7±27.9） u/l,（21.9±2.9）,（3.1±0.1） lg s/co and （4.4±0.5） IU/ml in group B（P>0.05）;at the end of 24 week follow-up,serum ALT normalization rate and serum HBV DNA loss in group A were 64.0% and 60.0%,also no significantly different as compared to 66.9% and 62.9% in group B（P>0.05）;the side effects during the antiviral treatment in the two groups were not significantly different（P>0.05）. Conclusion The application of domestic peg-IFN-α-2b in treatment of patients with serum HBeAg-positive CHB might get the same viralogic and biochemical responses,and the regimen is safe and cheap,which warrants further clinical investigation.

Objectiv The aim of this study was to investigate the clinical efficacy of glucosteroid on blocking disease progress in patients with nucleos（t）ide analogue （NAs） withdrawal hepatitis （WH）. Methods 23 patients with NAsWH,who were diagnosed as in the tendency to hepatic failure owing to inappropriate NAs withdrawal,were recruited in this study,and 11 received conventional supporting therapy at base of enticavir antiviral treatment,and other 12 received hydrocortisone sodium pine succinate at dose of 100 mg daily and tapered as liver function improved. Results At the end of eight week observation,one patient in steroid-treated groupd,and three patients in the conventional treatment died because of progress to liver failure;the disease control time in the former was （22.4±9.4） d,significantly shorter than [（36.7±13.1） d,P<0.05] in the latter;at presentation,serum bilirubin,albumin,prothrombin time activities and model of end-stage liver disease scores in the two groups were not significantly different（P>0.05）,while at the end of eight-week observation,they were（20.8±11.6） μmol/L, （38.3±5.2） g/L,（68.9±11.2）% and（4.8±2.2） in the former,significantly different as compared to[（56.7±81.4） μmol/L,（34.7±23.1）g/L,（55.5±34.8）% and （10.9±2.6）,P<0.05] in the latter. ConclusionThe application of steroid for blocking disease progress to liver failure in patients with NAsWH might be efficacious,which needs further investigation.

Objectiv To observe the efficacy and safety of sofosbuvir/daclatasvir in the treatment of patients with chronic hepatitis C （CHC） and hepatitis C cirrhosis （LC）. Methods 311 patients with CHC and 129 patients with LC were recruited in this real-world study in our hospital between May 2016 and May 2017,and they were treated with sofosbuvir/daclatasvir or combination of sofosbuvir/daclatasvir and ribavirin respectively,for 12 weeks. All patients were followed-up for 12 weeks at the end of discontinuation of the regimen. Sustained virological response at the end of 12 weeks（SVR12）,biochemical response,liver stiffness measurement and adverse reactions were observed. Results At the end of two week treatment,serum bilirubin,ALT and AST levels in patients with LC were（18.10±3.46） μmol/L,（32.48±9.97） IU/L and（31.99±6.65） IU/L,significantly lower than （20.98±28.64）μmol/L,（97.76±106.43） IU/L and （72.47±80.81） IU/L at baseline （P<0.05）; serum bilirubin, ALT and AST levels in patients with CHC were （20.15±3.48） μmol/L,（35.18±18.47） IU/L and AST （35.05±13.22） IU/L,significantly lower than （24.07±18.12） μmol/L,（91.42±54.56） IU/L and （81.06±40.45） IU/L at baseline （P<0.05）;serum HCV RNA load in patients with CHC was（1.83±2.88） lg IU/ml,in patients with LC was （1.67±2.34）lg IU/ml,both significantly lower than（6.12±1.19）lg IU/ml and （5.91±1.17） lg IU/ml at baseline （P<0.01）;LSM in patients with CHC was（8.09±0.90） kPa,and in patients with LC was（13.32±1.47） kPa,both significantly lower than （11.81±3.33） kPa and （17.56±9.86） kPa at baseline（P<0.01）;all patients no matter with any HCV genotype infection in both groups got 94% or over of SVR12;Logistic analysis showed that the baseline cirrhosis and relapse patients non-response to PR therapy were the independent risk factors for failed SVR12;the main adverse reactions were fatigue and headache. Conclusion The application of sofosbuvir/daclatasvir regimen in treatment of patients with CHC or hepatitis C cirrhosis might achieve a very high SVR12,biochemical response rate and improved liver fibrosis with a good safety.

Objection The purpose of this study was to investigate the efficacy of tripterygium glycosides combined with magnesium isoglycyrrhizinate in treatment of patients with autoimmune hepatitis（AIH）. Methods 70 patients with AIH were recruited in our hospital between June 2016 and February 2018,and were randomly divided into combined and control group,with 35 cases in each group. On the basis of routine prednisolone treatment,the patients in the control group were treated with magnesium isoglycyrrhizinate,and those in the combined group were treated with tripterygium glycyrrhizinate and magnesium isoglycyrrhizinate for six months. Methods At the end of six month treatment,serum ALT,AST and alkaline phosphatase levels in the combination treatment group were （52.6±7.3） U/L,（45.3±7.8） U/L and （68.3±2.8） U/L,significantly lower than [（78.4±10.1） U/L,（77.2±8.9） U/L and （90.5±4.6） U/L,P<0.05） in the control group;plasma immunoglobulin （IgG）,IgA,IgM and globulin levels in the combined group were （11.3±2.5） mg/mL,（2170.3±101.7） mg/mL,（2218.3±97.2） mg/mL and （14.6±3.9） g/L,significantly lower than（14.8±2.8） mg/mL,（2857.2±108.9） mg/mL,（2919.4±113.6） mg/mL and （18.9±3.8） g/L,respectively,P<0.05] in the control;serum hyaluronic acid,laminin and type III procollagen levels in the combination group were （112.5±6.7） g/L,（60.7±4.8） g/L and （52.3±3.5） g/L,which were statistically significantly lower than [（164.9±7.4） g/L,（82.8±5.6） g/L and （79.6±4.7） g/L,P<0.05] in the control group. Conclusion The application of tripterygium glycosides and magnesium isoglycyrrhizinate might effectively improve liver function tests,inhibit immune response and lighten the degree of liver fibrosis in patients with AIH.

Objectiv To investigate the clinical features and risk factors of liver injuries in patients with sepsis. Methods A retrospective analysis was performed in 117 patients with sepsis between 2013 and 2017. Out of them,58 were complicated by liver injury. The Logistic regression analysis was applied to explore the risk factors for sepsis-associated liver injury. Results In this series,the primary infection foci included abdomen （48.7%）,respiratory system（32.5%）,skin（7.7%）,urinary system（6.0%）,blood （1.7%）,cardiovascular system （0.9%）,gut（0.9%）,central nervous system（0.9%） and mediastina （0.9%）;the age of patients with liver injuries was （61.0±14.9） yr,significantly older than 【（52.6±18.0）yr,P<0.01】 in patients without,ICU stay was 【9（5,12）】 d, much longer than 【4（4,10）d,P<0.01】,SOFA score was（8.7±2.4）,significantly higher than 【（7.1±2.2）,P<0.01】,and APACHE II score was（21.9±6.4）,significantly higher than 【（18.4±6.0）,P<0.01】 in patients without;out of 58 patients with liver injuries,it presented as hyperbilirubinemia in 21,elevated serum ALT levels in 24 and mixed in 13,serum C-reaction protein levels in patients with different types of liver injuries were statistically different（P<0.05）,and the mortality in patients with mixed liver injuries was 53.8%,much higher than 9.6% in with hyperbilirubinemia or 33.3% in with elevated serum ALT levels（P<0.05）;multivariate analysis showed than the age and APACHE II score were the independent risk factors for liver injuries in patients with sepsis. Conclusion The older the patient with sepsis and the higher the APACHEII score are,the more chance the likelihood of liver damage occur in patients with sepsis,which might take into consideration in clinical practice and deal with properly in time.

Objectiv The aim of this study was to investigate the diagnostic value of diffusion-weighted magnetic resonance imaging in patients with radiation-induced liver injury （RILI） with underlying hepatocelullar carcinoma （HCC）. Methods 90 patients with histologically proven HCC were admitted to our hospital between January 2015 and June 2017,and RILI were confirmed by ultrasound-guided liver biopsies in 47 patients after radiotherapy. The pathological results showed the patients with acute RILI in 14,subacute in 17 and chronic in 16. All patients received MRI checked-up. Results The MRI manifestations in patients with RILI was a patchy abnormal signal area consistent with the radiation therapy,with low signal on T1WI,high signal on T2WI,slightly high signal on diffusion weighted imaging （DWI） sequence,and moderate enhancement on intensified scan;the apparent diffusion coefficient（ADC） value in patients with acute RILI was（85.32±8.41）×10^-6mm^-2/s,significantly lower than （88.44±9.32）×10^-6mm^-2/s in patients with subacute or （101.28±10.01）×10^-6mm^-2/s in patients with chronic RILI（P<0.05）. Conclusion The application of diffusion-weighted MR imaging might help diagnose patients with RILI,which will benefit the patients with HCC undergoing radiotherapy.

Objectiv The aim of this study was to explore the application of acoustic radiation force impulse （ARFI） quantification in the evaluation of liver injuries in patients with non-alcoholic fatty liver disease （NAFLD）. Methods Clinical data of 31 patients with nonalcoholic simple fatty liver（NAFL）,31 with obvious non-alcoholic steatohepatitis（NASH） and 31 with significant NASH,diagnosed by liver pathological examination, and 31 normal persons were retrospectively analyzed. The mean ARFI values at 4 cm,6 cm and 8 cm in left and right livers were detected by sonography. Results The mean ARFI values of 4 cm,6 cm and 8 cm sites in the left liver of patients with normal persons,NAFL,obvious NASH and significant NASH were（1.32±0.15） m/s,（1.25±0.12） m/s,（1.18±0.11） m/s and （1.05±0.10） m/s,in right liver of the three sites were（1.08±0.09） m/s,（0.94±0.08） m/s,（0.89±0.09） m/s and （0.84±0.07） m/s, and the whole liver ARFI of right and left were （1.19±0.10） m/s,（1.10±0.09） m/s,（1.02±0.08） m/s and（0.93±0.08）m/s,showing the significantly decreased ARFI value in patients with significant NASH （P<0.05）;the ARFI of the four groups at 8 cm in left liver were （1.18±0.14）m/s,（1.02±0.13）m/s,（0.87±0.15）m/s and（0.71±0.11） m/s,at 6 cm in right liver were （1.06±0.10） m/s,（0.95±0.09）m/s,（0.90±0.08）m/s and（0.85±0.07）m/s,and at 8 cm in right liver were （1.02±0.07）m/s,（0.91±0.06） m/s,（0.81±0.08）m/s and （0.72±0.05）m/s,all showing decreased ARFI value in patients with significant NASH （all P<0.05）. Conclusions ARFI quantification might be used to evaluate the liver injuries in patients with NAFLD,which needs further investigation.

Objectiv To explore the impact of nutrition support and medusa administration on liver function, erythrocyte and platelet parameters in patients with alcoholic liver diseases（ALD）. Methods 90 patients with ALD were recruited in our hospital between May 2015 and October 2017,and they were divided into two groups with 45 cases in each group. All the patients were given glutathione,portuguese aldehyde lactone intravenously and 45 patients were treated with metadoxine,while another 45 were treated with combination of metadoxine and nutritional support at 35~40 kcat·kg^-1·d^-1. The regimen lasted for four weeks. Results At presentation,serum liver function and blood coagulation function index in the two groups were not statistically significantly different （P>0.05）,while serum ALT,GGT and bilirubin levels at the end of the treatment in the two groups significantly decreased and coagulation function improved;before the treatment,the red blood cell parameters,including RBC counts,HBG levels,HCT,RDW and MCV in the two groups had no statistically significantly different（P>0.05）,while at the end of the treatment,the RBC counts,HBG and HCT in the two groups were significantly increased,e.g.（3.45±0.46）×10¹²/L vs. （5.32±0.51）×10¹²/L,（90.12±3.67） g/L vs. （140.92±6.02） g/L,（0.32±0.12）% vs. （0.46±0.11） % in the combination group,and（3.44±0.42）×10¹²/L vs. （4.96±0.48）×10¹²/L,（89.92±3.54）g/L vs. （135.67±6.23） g/L,（0.32±0.10）% vs. （0.41±0.10） % in metadoxine-treated group,and MCV and RDW decreased,e.g. （19.34±1.92）% vs. （12.43±1.21）% and（109.24±6.34）fL vs. （95.19±5.92） fL in the combination,and （19.15±1.89）% vs. （14.91±1.19）% and （109.01±6.45）fL vs. （99.43±6.42）fL in the metadoxine-treated group （P<0.05）;Before the treatment,the platelet parameters,such as PLT counts,MPV and PDW had no statistically significantly different （P>0.05）,and at the end of the treatment,the platelet counts significantly increased in the two groups,e.g. （98.43±10.02）×10⁹/L vs. （219.04±9.78）×10⁹/L in the combination group,an （98.68±10.13）×10⁹/L vs. （200.43±10.24）×10⁹/L in metadoxine-treated group（P<0.05）,while the MPV and PDW decreased obviously,e.g.（12.74±2.02） fL vs.（10.76±1.13） fL and （17.93±2.01） fL vs. （14.28±1.45） fL in the combination group,and（12.84±2.11） fL vs.（11.63±1.02） fL,and （17.87±1.98） fL vs. （15.89±1.51） fL in metadoxine-treated group （P<0.05）;All the improvements above in combination group were significantly superior to those in metadoxine-treated group （P<0.05）. Conclusion The metadoxine combined with nutrition support in treatment of patients with ALD might significantly improve the liver function,erythrocyte and platelet parameters,which needs further and long-term investigation.

Objectiv To explore the predictive value of urinary neutrophil gelatinase-associated lipocalin （uNGAL） and urine kidney injury factor-1 （KIM-1） for response of patients with hepatorenal syndrome （HRS） to terlipressin combined with albumin infusion treatment. Methods 19 consecutive patients with liver cirrhosis complicated by HRS type one were recruited in You'an hospital between May 1,2017 and April 30,2018,and all the patients received terlipressin and albumin infusion treatment. Urine NGAL and KIM-1 were detected by ELISA. Results At the end of four day treatment,12 （63.2%） responded and 7（36.8%） did not;the age （P=0.605） and gender （P=0.386）,the incidences of spontaneous bacterial peritonitis（P=0.526） and gastrointestinal hemorrhage （P=0.525）,and serum ALT,AST,bilirubin,blood urea nitrogen,and platelet cell counts,hemoglobin levels and while blood cell counts between the two groups were not significantly different （P>0.05）;the prothrombin time activity（PTA） in responded patients was much higher（P=0.006）,and serum Cr level was significantly lower than in patients non-responded（P=0.043）;uNGAL/Cr was 21.8（7.8~65.5） μg/g and uKIM-1/Cr was 4.9（2.0~7.7） μg/g in responded patients,much lower than 97.8（27.1~358.2） μg/g （P=0.010） and 9.1（5.5~13.6） μg/g （P=0.001） in non-responded patients;the 90 d survival in responded patients was 75.0%,not significantly different as compared to 42.9% in non-responded patients（P=0.182）;serum Cr was positively correlated to uNGAL/Cr（r=0.549,P=0.022）,while was not significantly correlated to uKIM-1/Cr（r=0.213,P=0.411）. Conclusion Baseline blood creatinine,PTA and urine NGAL levels might predict the response of patients with HRS to combination of terlipressin and albumin infusion,which warrants further investigation.

Objectiv The aim of this study was to evaluate the clinical efficacy of gastroscopic lauromacrogol injection in treatment of patients with liver cirrhosis and esophageal varices. Methods A retrospective analysis was performed in 80 patients with liver cirrhosis and esophageal varices who underwent endoscopic injection sclerotherapy （EIS） in our hospital between January 2016 and December 2017. Among them,38 patients underwent endoscopic injection with lauromacrogol and 42 cases underwent endoscopic injection of sodium morrhuate. All patients were followed-up for 12 months. The statistical analysis was performed on the disappearance of varices,hemostasis,postoperative complications and recurrence of varices during the followed-up periods. Results In lauromacrogol-injected group,the disappearance of varices and narrowed varices were 65.8% and 26.3%,not significantly different as compared to 69.0% and 26.2%,respectively,in sodium morrhuate-injected group（P>0.05）;the successful rate of emergent hemostasis and incidence of rebleeding in lauromacrogol-injected group were 92.1% and 34.2%, respectively,not significantly different as compared to 95.2% and 31.0%,respectively,in sodium morrhuate-injected group（P>0.05）;the incidence rates of postoperative complications such as fever,chest pain,ulcer and esophageal stricture in the lauromacrogol-injected group were 13.2%,13.2%,10.5% and 2.6%,respectively,which were significantly lower than 33.3%,38.1%,42.9% and 19.1% in sodium morrhuate-injected group（P<0.05）;at 3 months,6 months and 12 months of followed-up,the recurrence rates of varices in lauromacrogol-injected group were 10.53%,18.42% and 28.95%,respectively,not significantly different as compared to 9.52%,14.29% and 30.95%,respectively,in sodium morrhuate-injected group （P>0.05）. Conclusion The successful rate of hemostasis is as high as with morrhuate injection in patients with liver cirrhosis and esophageal varices undergoing gastroscopic injection of lauromacrogol, which might improve clinical efficacy with less postoperative complications. It is a safe and effective treatment regimen.

Objectiv To investigate the value of 3.0 T MR-liver acceleration volume acquisition （LAVA） sequence multi-phase dynamic enhanced scanning in qualitative diagnosis of intrahepatic nodular lesions in patients with liver cirrhosis（LC）. Methods Patients with LC were recruited in our hospital between January 2015 and August 2017. All patients underwent multi-phase dynamic contrast-enhanced CT scan and 3.0 T MR-LAVA sequences scan. Results MR-LAVA scan revealed 80 patients with intrahepatic lesions,while out of them the CT scan demonstrated in 73 cases （91.3%）;the MR-LAVA provided diagnosis of focal nodular hyperplasia in 40,hepatic hemangioma in 13,primary liver cancer in 10, and metastatic tumors in 12 patients,while the CT scan diagnosed focal nodular hyperplasia in 34,hepatic hemangioma in 12,primary liver cancer in 9,and metastatic tumors in 18. Conclusion Multi-phase dynamic enhanced scan of 3.0 T MR-LAVA sequence scan might be an efficient approach in qualitatively diagnosing intrahepatic lesions,which could help clinicians to make decisions early.

Objectiv To investigate the value of multi-slice spiral CT portography （MSCTP） in the evaluation of liver functions in patients with liver cirrhosis. Methods A total of 62 patients with liver cirrhosis and 62 healthy persons in the same period were recruited in this study between August 2015 and September 2017. All the individuals underwent MSCTP and the diameters of splenic vein（SPV）,intra-hepatic left portal vein （IHLPV）,main portal vein （MPV） and intra-hepatic right portal vein （IHRPV） were calculated in the two groups. The above indexes and left gastric vein（LGV） and the section number of esophageal varices in patients with different Child-Pugh class were also compared. Results The diameters of SPV,IHLPV,MPV and IHRPV in patients with liver cirrhosis were （14.4±3.6） mm,（13.5±3.1） mm,（17.9±4.2） mm and （13.8±3.9） mm,significantly greater than [（8.9±1.7）mm,（9.7±2.3） mm,（11.2±2.9） mm and （9.5±2.5） mm,P<0.05] in healthy persons;as the Child-Pugh class deteriorated,the diameters of SPV,IHLPV,MPV and IHRPV increased [（13.2±2.7） mm,（12.1±3.2） mm,（16.4±4.6） mm and（12.3±3.3） mm in patients with Child-Pugh class A,（15.1±3.5） mm,（14.3±3.7） mm,（18.5±4.8） mm and（14.7±3.6） mm in patients with Child-Pugh class B,and（16.3±4.1） mm,（15.8±4.3） mm,（20.8±5.1） mm and（16.1±4.7） mm in with Child-Pugh class C,respectively,P<0.05],and the LGV diameters enlarged,and the number of esophageal varices also increased [（6.4±1.5） mm and（3.8±1.1） in patients with Child-Pugh class A,（9.1±2.2） mm and（7.4±1.6） in with class B,and（9.7±2.6） mm and （7.7±1.8） in with class C,respectively,with the difference between class A and class B or class C statistically significant （P<0.05）. Conclusion MSCTP is of great value in the assessment of liver functions in patients with liver cirrhosis,which warrants further investigation.

Objectiv To analyze the factors influencing liver stiffness measurement （LSM） in patients with chronic hepatitits B （CHB） and liver cirrhosis （LC） in Tibet. Methods 70 patients with CHB and 30 with LC were recruied in Traditional Tibetan Medicine Hospital between January 2017 and March 2018,and FibroScan was used to detect LSM in all the patients. Serum markers of liver function,renal function,blood lipids,blood glucose,blood coagulation function and blood routine examination,and ultrasonic examination were evaluated. Result The LSM was（7.17±12.19） kPa in patients with CHB,significantly lower than 【（14.92±14.01）kPa,P<0.05】 in patients with LC,and the CAP was （210.70±66.22） db/m,not significantly different as compared to （212.00±69.20） db/m in patients with LC（P>0.05）;the APTT,AST,ALP,GGT,GLOB,TBIL and TBA were positively correlated,and WBC,PLT,HGB,PTA,FIB,ALB,GFR and LDL-C were negatively correlated to LSM（P<0.05）,while body mass,ALT,UREA,CREA,UA,TG,HDL-C,GLU,AMY and controlled attenuation parameter were not statistically significantly correlated to LSM（P>0.05）;multivariate regression analysis showed that age（P=0.003）,hepatic echo enhancement （P=0.020）,hepatic echo nodule （P=0.000）,PT （P=0.007）and TBA （P=0.004） were the independent factors influencing the LSM in patients with hepatitis B viral infection. Conclusion Clinicians should take the influencing factors of LSM into consideration in clinical practice in order to deal with the patients properly in time.

Objectiv To investigate the changes of serum and hepatic fibrinogen-like protein 2 （sFGL2） levels in patients with chronic hepatitis B（CHB） and hepatitis B cirrhosis after receiving entecavir therapy. Methods 112 patients with CHB and 112 patients with hepatitis B cirrhosis were admitted to our hospital between June 2016 and June 2017,and among patients with CHB were mild in 38 cases,moderate in 45 cases,and severe in 29 cases. All patients received liver biopsies and were given entecavir treatment for 72 weeks. Serum sFGL2 levels were assayed by ELISA,and hepatic sFGL2 expression was detected by immunohistochemistry. Results The positive rate of hepatic sFGL2 expression in patients with CHB was 63.4% （71/112）,much lower than 82.1% （92/112） in cirrhotic patients （P<0.05）;hepatic sFGL2 expression intensified as liver injuries increased in patients with CHB;at the end of 72 week observation,serum ALT,AST and sFGL2 levels in patients with CHB were （49.8±6.3） U/L,（52.3±7.6）U/L and （84.7±10.3） μg/L,while in patients with liver cirrhosis were （41.8±4.2）U/L,（42.3±5.4） U/L and（104.9±19.4） μg/L,respectively,and the difference was significant between the two groups （P<0.05）;at the end of 24 w,48 w and 72 w,serum sFGL2 level in patients with CHB were（98.2±10.8） μg/L,（81.6±9.5） μg/L and （69.4±8.7） μg/L,in a gradually decreased manner;at the end of 72 w,65 patients with CHB got complete response,31 got partial response and 16 were non-responders,and their serum sFGL2 levels were （74.6±9.1） μg/L,（97.2±11.4） μg/L and（123.6±15.2） μg/L,respectively,with the differences among the three groups significant（P<0.05）. Conclusion Serum and hepatic sFGL2 levels in patients with CHB significantly decrease after antiviral therapy,which might be closely related to the state of disease activity and the response to treatment.

Objectiv The aim of this study was to investigate the diagnostic value of color Doppler ultrasound in predicting esophageal varices （EV） in patients with hepatitis B-induced liver cirrhosis （LC）. Methods Seventy-five patients with hepatitis B-induced LC and twenty-five healthy individuals were recruited in this study and all of them underwent gastroscopy and color Doppler ultrasonography to calculate the portal hemodynamic parameters. Results 56 patients with LC were found having and 19 having not EV in our series by gastroscopy; the diameters of portal veins in patients with and without EV were （13.7±3.2） mm and （12.1±3.2） mm,significantly larger than [（10.9±3.0）mm,P<0.05] in the control,the portal vein blood flow velocities were （9.3±2.1） cm/s and （13.6±2.7） cm/s,respectively,significantly slower than[（17.7±2.4） cm/s,P<0.05] in the control,and the portal vein blood flow volume were（1054.3±336.8） ml/min and（921.6±327.5） ml/min,respectively,significantly higher than [（832.5±234.1） ml/min,P<0.05] in the control;the incidence of reverse hepatic blood flow in left gastric vein in patients with EV was 80.4%,significantly higher than 0.0%（P<0.05） in patients without;the sensitivity was 78.6%,the specificity was 79.0%,the positive predictive value was 91.7% and the negative predictive value was 55.6% when the portal vein blood flow volume equal to 1000 ml/min as the cut-off-value in predicting the existence of EV. Conclusion The check-up of hemodynamics index of portal vein by color Doppler ultrasound might help predict the existence and degrees of EV in patients with hepatitis B-induced LC,which warrants further investigation.

Objectiv The aim of this stud was to investigate the diagnostic value of color Doppler ultrasonography in diagnosis of patients with hepatitis B cirrhosis. Methods 80 patients with hepatitis B-induced liver cirrhosis（LC） and 50 patients with chronic hepatitis B（CHB） were recruited in our hospital between July 2017 and July 2018,and all of them underwent color Doppler ultrasonography. The sonographic features,semi-quantitative ultrasound scores and portal hemodynamics were compared between the two groups. Results The scores of liver capsule,hepatic parenchymal echo,intrahepatic ligament,gallbladder wall,spleen area,hepatic vein resolution and hepatic edge morphology in patients with LC were（4.1±1.1）,（2.5±0.5）,（1.5±0.2）,（2.7±0.3）,（2.6±0.6）,（2.7±0.4） and （2.3±0.3）,significantly higher than [（1.4±0.3）,（1.4±0.3）,（1.0±0.1）,（1.2±0.2）,（1.3±0.3）,（1.2±0.1） and （1.0±0.3）,respectively,P<0.05] in patients with CHB;the diameter of the portal vein was （1.5±0.1） cm,significantly wider than [（1.1±0.1）cm,P<0.05],the blood flow velocity was（12.6±1.3） cm/s,significantly slower than [（22.3±3.6）cm/s,P<0.05] and the blood flow was （1114.4±117.4） ml/min,significantly less than [（1278.3±121.4） ml/min,P<0.05] in patients with CHB; we set the semi-quantitative score of ultrasonography being greater than 15 as the cut-off-value of liver cirrhosis and the liver histological examination as the gold standard,the diagnostic sensitivity was 93.8%,the specificity was 88.0%,the positive predictive value was 92.6%,and the negative prediction was 89.8%. Conclusion The semi-quantitative scoring system by color Doppler ultrasonography can be effectively applied to the diagnosis of patients with hepatitis B-induced early liver cirrhosis.

Objectiv The aim of this study was to investigate the predictive value of preoperative CT/MRI indicators for portal vein thrombosis（PVT） in patients with liver cirrhosis after splenectomy. Methods 87 patients with hepatitis B liver cirrhosis after splenectomy were retrospectively analyzed in our hospital between July 2016 and July 2018,and all patients were followed-up and underwent CT and MRI check-up. Multivariate logistic regression analysis was applied to predict the independent influencing factors of PVT formation after splenectomy. Results At the end of three-month follow-up,46 patients （52.9%） had PVT out of the 87 patients with cirrhosis,belonging to typeⅠPVT,and mural thrombus was found in 45 patients（51.7%）,out of which,14（16.1%） as mural thrombus in superior mesenteric vein;the diameter of portal vain in 46 patients with PVT was（16.7±2.2）mm,significantly wider than 【（14.8±1.5） mm,P<0.05】 in 41 patients without PVT,the difference of portal vein velocity was （8.4±5.5） cm/s, significantly rapider than [（6.1±3.6） cm/s,P<0.05] in non-PVT group and the spleen volume was （1370.8±370.1） cm³,significantly larger than [（1205.2±357.3） cm³,P<0.05] in non-PVT group;multivariate logistic regression analysis showed that the diameter of portal vein（OR=0.869,95%CI=0.608-1.246）,the velocity difference of portal vein（OR=1.185,95%CI=1.079-1.317）,and the spleen volume（OR=3.427,95%CI=2.215-5.302） were the independent influencing factors of PVT formation after splenectomy in patients with cirrhosis （P<0.05）. Conclusion Preoperative CT/MRI diagnostic indexes such as portal vein diameter,portal vein velocity difference and spleen volume are independent influencing factors of PVT formation after splenectomy for liver cirrhosis.

Objectiv To explore the efficacy of contrast-enhanced ultrasonography （CEU） in differential diagnosis of patients with focal nodular hyperplasia （FNH） and hepatocellular carcinoma （HCC）. Methods Ninety patients with FNH and 90 with HCC were enrolled in this study between February 2015 and February 2017, and all patients underwent CEU examination. The region of interest（ROI） was analyzed by SonoLiver CAP software,and the maximum of intensity （IMAX）,the time to peak （TTP）,the rise time （RT）,the mean transit time （mTT） and the perfusion index（PI） were obtained. The types and parameter distributions in dynamic vascular model（DVP） curve were compared between the two groups. Results The IMAX and mTT in FNH group were （142.6±17.8）% and （268.9±34.5） s,significantly greater than [（125.3±14.7）% and （117.8±15.4） s,P<0.05] in HCC group;the RT,PI and TTP were（17.2±2.9） s,（91.2±12.8） and （30.4±5.2） s,much lower than [（21.5±4.3） s,（45.6±7.3） and （34.1±5.9） s,P<0.05] in HCC group;the type I （regression type）,type II （end regression type） and type III （negative type） DVP curve in HCC group accounted for 75.6%,22.2% and 2.2%,significantly different as compared to 43.3%,54.4% and 2.2% in the FNH group （P<0.05）;the percentages of type I,type II and type III DVP parameter distribution in HCC group were 72.2%,25.6% and 2.2%,while they were 40.0%,56.7% and 3.3% in FNH group,respectively,statistically significantly different between the two groups （x²=19.121,P<0.05）. Conclusion Quantitative parameters of CEU and visual imaging of DVP parameters are helpful in differentiating patients with FNH and with HCC in clinical practice.

Objectiv To investigate the protective effect of reduced glutathione （GSH） on liver function in patients with advanced primary liver cancer （PLC） underwent transarterial chemoembolization （TACE）. Methods 138 patients with PLC were recruited in our hospital between February 2010 and July 2014,and were randomly divided into the observation group （n=71） and the control group （n=67）. All patients with PLC received TACE, and those in the observation were treated intravenously with GSH for seven days after TACE. Results At the end of three months,the CT scan showed that the partial response （PR） and stable disease （SD） in the observation group were 23.9% and 60.6%,without significant differences as compared to 20.9% and 58.2%,respectively in the control （P>0.05）;at the end of 10 days,serum ALT and AST levels in the observation were （75.4±18.9）U/L and （101.6±18.4） U/L,significantly lower than 【（98.6±20.4） U/L and （121.2±30.4） U/L,respectively,P<0.05】 in the control;at the end of 2 weeks,the incidences of gastrointestinal reactions,leukopenia,decreased blood hemoglobin levels,and thrombocytopenia in the observation group were 26.8%,22.5%,19.7% and 2.8% respectively,while they were 32.8% （P<0.05）,28.4%,29.9% （P<0.05） and 6.0% in the control;the six-month survival rate in the observation group was 91.5%（65/71）,without significant difference as compared to 85.1%（57/67,P>0.05） in the control and one-year survival rate in the observation group was 84.5%（60/71）,much higher than （61.2% （41/67,P<0.05） in the control group. Conclusion Application of reduced glutathione after TACE in patients with primary liver cancer might alleviate liver function injuries,and decrease the incidence of side effects in this settings.

Objectiv To investigate the clinical efficacy of laparoscopic surgery combined with transhepatic artery embolization（TAE） for the treatment of patients with traumatic liver rupture. Methods 83 patients with traumatic liver rupture were admitted to our hospital between May 2015 and June 2018,and 41 received laparoscopic surgery,and 42 received laparoscopic surgery combined with TAE. Logistic regression analysis was applied to analyze the risk factors affecting postoperative infection in patients with traumatic liver rupture. Results At the end of one week post-operation,the hemostatic rate in combination group was 90.5%,significantly higher than 79.5% in laparoscopic surgery group （x²=3.938,P<0.05）;the incidence of postoperative abdominal infection occurred in 3 cases （7.1%） in the combined group,significantly lower than in 11 cases （26.8%） in the laparoscopic group （x²=5.734,P<0.05）;univariate and multivariate analysis showed that the degree of liver injury,intraoperative blood loss,operation time,white blood cell counts,diabetes mellitus and surgery were the risk factors affecting post-operative infection in patients with traumatic liver rupture （P<0.05）. Conclusion Laparoscopic surgery combined with TAE is effective in hemostasis of liver rupture,and it is an appropriate alternative for patients with traumatic liver rupture in emergency.

Objectiv The purpose of this study was to compare magnetic resonance cholangiopancreatography （MRCP） with color Doppler ultrasound （US） in diagnosis of patients with common bile duct stones. Methods 102 patients with suspected common bile duct stones were recruited in our hospital,and all of them were examined by color Doppler ultrasound and MRCP. The diagnostic efficacies between the two approaches were evaluated by area under the receiver-operating characteristic curve（AUC）. Results Out of the 102 patients with suspected choledocholithiasis,90 were diagnosed having common bile duct stones by post-operational pathology. The US demonstrated single stone in 39（43.3%） and multiple stone in 25（27.8%）,while the MRCP found them in 46（51.1%） and 39（43.3%）,respectively,with the detection rate of 94.4% by MRCP,significantly higher than 71.1%（P<0.05） by US;the detection rates by MRCP in stones with diameters of >1.0 cm,0.5-1.0 cm and <0.5 cm were 36.7%,50.0% and 7.8%,significantly different as compared to 34.4%,35.6% and 1.1% by US （P<0.05）;the diameters of stones showed by MRCP were （1.1~0.8）cm,much smaller than （1.4~0.6）cm by US （P<0.05）,while there was no significant difference between the diameters of undetectable stones by the two methods 【（0.8~0.2） cm vs.（0.6~0.4） cm,P>0.05】;the sensitivity,specificity and Youden's index by US were 71.1%,75.0% and 0.5,while they were 94.4%,91.7% and 0.9 by MRCP（P<0.05）. Conclusion MRCP is a sensitive approach in diagnosing common bile duct stones,which might help clinicians to make decisions.

Objectiv To analyze the risk factors for stone recurrence in patients with common bile duct stones after endoscopic retrograde cholangiopancreatography （ERCP） and endoscopic sphineterotomy （EST） therapy. Methods 357 patients with common bile duct stones were recruited in our hospital,and routine ERCP examination were done. The stone were removed by EST. All patients were followed-up and routine imaging examination were carried out to find the stone recurrence. The risk factors of stone recurrence after ERCP and EST treatment were evaluated by Logistic analysis. Results Out of the 357 patients,ERCP were successfully performed in 349（97.8%） patients,and the stones were successfully removed in 334（93.6%） patients;138 patients were found to have,and 219 have not stone recurrence during the followed-up period;univariate Logistic analysis showed that there were no significant differences in gender,BMI,and presence or absence of gallstones between patients with and without stone recurrence（P>0.05）,while there were significant differences as respect to the course of disease,age and incision size between patients with recurrent stone and those without [（10.9±2.5） yr vs. （7.6±1.7） yr,（66.8±7.2） years old vs. （57.3±8.7） years old,and （15.6±1.9） mm vs. （7.9±2.2） mm,P<0.05];the percentages of biliary surgery history,diverticulum,biliary stricture,biliary or pancreatic inflammation,stone numbers more than 2 and stone diameters greater than 10 mm in patients with stone recurrence were 18.8%,29.7%,30.4%,78.9%,81.9%,and 40.6%,significantly higher than 1.8%,7.3%,11.4%,40.6%,64.8%,and 9.6% in patients without stone recurrence（P<0.05）;multivariate Logistic regression analysis showed that the diameter of common bile duct greater than 10 mm and incision size greater than 15 mm were the independent factors for stone recurrence after operation. Conclusion Patients with larger papillary incision and dilated diameters of common bile duct might have stone recurrence after ERCP and EST operation,and they must be followed-up for early diagnosis.

Objectiv To investigate the efficacy of B-ultrasound-guided percutaneous cholangiostomy pneumatic lithotripsy in treatment of patients with intra-and extrahepatic bile duct stones. Methods 106 patients with intrahepatic and extrahepatic bile duct stones were recruited in our hospital between January 2014 and June 2016，and 57 patients received percutaneous biliary fistula pneumatic lithotripsy（observation group） and 49 received laparoscopic biliary exploration therapy （control group）. All patients were followed-up for two years and the factors affecting postoperative recurrence of stones were analyzed by Logistic regression. Results The hospitalization stay，medical cost，intraoperative blood loss and operation time in the observation group were（5.2±1.7） d，（7321.5±528.3） yuan，（20.4±4.8） mL and（62.5±14.8） min，significantly less or shorter than [（8.7±2.2） d，（10426.4±1032.5） yuan，（25.7±5.1） mL and （71.7±15.3） min，P<0.05] in the control；the complete stone clearance rate in the observation group was 84.2%，significantly higher than 67.3% （P<0.05） in the control；the stone recurrence rate in the observation group was 1.8%，significantly lower 20.4% （P<0.05） in the univariate control；and multivariate Logistic analysis showed that the number of stones， the diameter of stones and surgical methods were the independent factors affecting stone recurrence after operation. Conclusion Percutaneous puncture and pneumatic ballistic lithotripsy is efficacious in the treatment of patients with intrahepatic and extrahepatic bile duct stones， which warrants further investigation.

Objectiv To compare the features of gallbladder CT manifestations between patients with chronic cholecystitis and with chronic liver diseases. Methods 52 patients with chronic liver diseases （chronic hepatitis B in 21,hepatitis B cirrhosis in 26 and primary liver caner in 5） and 32 patients with chronic cholecystitis were checked-up in our Department of Radiology beween November 2014 and October 2017. We analyzed their gallbladder CT manifestations. Results The gallbladder wall thickness in patients with chronic cholecystitis was significantly thicker than in patients with chronic liver disease [（4.5±0.5） mm vs. （3.7±0.4） mm,P<0.05],the incidences of cystic wall enhancement,increased bile density and transient enhancement of adjacent liver tissues were much higher than in patients with chronic liver diseases（100.0% vs. 75.0%,31.3% vs. 5.8% and 18.8% vs. 0.0%）,while the incidences of adhesion to peripheral tissues and gallbladder effusion were significantly lower than in patients with chronic liver diseases （9.4% vs. 75.0% and 9.4% vs. 28.9%,P<0.05）. Conclusion The CT manifestations of gallbladder in patients with chronic cholecystitis and liver disease are different,which might be helpful for clinicians to differentiate them.

The liver and skeletal muscles are responsible for maintaining glucose metabolism. As chronic liver disease progresses to cirrhosis,the liver disfunction leads to the deterioration of glucose metabolism. Consequently,impaired glucose tolerance（IGT） and insulin resistance（IR） are often observed in patients with liver cirrhosis. In early stage,the cirrhotics with hepatogenous diabetes is characterized by marked postprandial hyperglycemia and hyperinsulinemia. Generally,it is possible to underestimate IGT when using either the conventional fasting plasma glucose （FPG） criterion or hemoglobin A1c （HbA1c） levels because many of these patients show lower FPG or HbA1c levels,which might mask their IGT. In this circumstances,the oral glucose tolerance test is recommended to properly evaluate patients with normal FPG levels.

Non-alcoholic fatty liver disease （NAFLD） is currently one of the most common chronic liver diseases worldwide，and the incidence of NAFLD-related hepatocellular carcinoma （NAFLD-HCC） increases recently. Many factors are involved in the pathogenesis of NAFLD-HCC， but the specific mechanism remains unclear. This review summarizes recent research findings about the carcinogenesis of NAFLD-HCC.