Objective The aim of this study was to explore the protective effects of erigeron breviscapus,a herbal medicine,on liver and intestinal mucosal barrier functions in rats with hepatic ischemia-reperfusion injury （IRI）. Methods 45 SD rats were randomly divided into control,model and breviscapine-intervened group,and the hepatic and intestinal IRI models were established. The intestinal mucosal SIgA and plasma endotoxin were detected by ELISA,and the inducible nitric oxide synthase （iNOS）,endothelial （eNOS） and total nitric oxide （NO） in intestinal tissues were detected. Serum procalcitonin （PCT）,diamine oxidase （DAO）,TNF-α and IL-1β levels were detected by kits. The Toll-like receptor 4（TLR4） and nuclear factor （NF）-κB were detected by Western blotting. Results The SlgA in model group was significantly lower than that in control group [（0.2±0.1） μg/kg vs. （0.7±0.1） μg/kg,P<0.01],the endotoxin in model group was significantly higher than that in control [（0.8±0.1） EU/ml vs.（0.2±0.1） EU/ml,P<0.01],the iNOS in model group was significantly higher than that in control group [（0.7±0.1）U/g vs.（0.2±0.1） U/g,P<0.01],the eNOS in model group was significantly lower than that in control group [（0.2±0.1） U/g vs. （0.4±0.1） U/g,P<0.01],and the NO in model group was significantly lower than that in control group [（0.2±0.1） μmol/g vs. （0.4±0.0） μmol/g,P<0.01];the PCT in breviscapine-intervened group was significantly higher than that in model group [（5.0±1.2） ng/ml vs.（3.5±0.98） ng/ml,P<0.01],the SlgA in breviscapine intervention group was significantly higher than that in model group [（0.7±0.1） μg/kg vs.（0.2±0.1）μg/kg,P<0.01],while the endotoxin was significantly lower than that in model group [（0.3±0.1） EU/ml vs.（0.8±0.1） EU/ml,P<0.01],the iNOS was significantly lower than that in model group [（0.3±0.1） U/g vs.（0.7±0.1 U/g,P<0.01],the eNOS was significantly higher than that in model group [（0.8±0.2） U/g vs. （0.2±0.1） U/g,P<0.01],and the NO was significantly higher than that in model group[（0.8±0.1） μmol/g vs.（0.2±0.1） μmol/g,P<0.01];the PCT was significantly lower than that in the model group [（3.9±1.0） ng/ml vs. （5.0±1.2） ng/ml,P<0.01],and the DAO was significantly lower than that in the model group [（7.5±1.3） Ku/L vs.（10.5±1.6） Ku/L,P<0.01];the expression of TLR4 and NF-κB in liver tissues and serum TNF-α and IL-1β levels in model group were significantly higher than those in control group （P<0.01）,while they all significantly decreased in breviscapine-intervened group （P<0.01）. Conclusion s Breviscapine might protect hepatic and intestinal mucosal barrier functions in rats with IRI by promoting eNOS/NO expression and down-regulating expression of TLR4 and NF-κB, which might reduce plasma endotoxin.

Objective To explore the protective effect and its mechanism of sevoflurane on sepsis-induced liver injury in rats. Methods Sixty SD rats were randomly divided into t sham operation,sepsis group and sevoflurane pretreatment group with 20 in each. In the sham operation group,the rats were only treated with open and closed abdominal suture,the sepsis model were established by cecal ligation perforation （CLP） and the animals in sevoflurane group were pretreated with sevoflurane anaesthesia before the establishment of CLP sepsis. The pathological changes of liver tissues were observed,and hepatic expression of lymphocyte function-associated antigen-1 （LFA-1） and macrophage-1 antigen （Mac-1） were detected by Western bloting. Results The pathological examination showed that the obvious inflammatory cell infiltration and hepatic cords arranged disorderly in model animals,while this kind of deformed morphology improved greatly in sevoflurane pretreatment group;serum AST,ALT and bilirubin levels in sepsis group were（156.8±14.7） U/L,（75.6±7.5） U/L and （4.5±0.6） μmol/L,while they decreased greatly in sevoflurane pretreatment group [（100.5±7.9） U/L,（61.5±10.1） U/L and （3.2±0.5） μmol/L,respectively,P<0.05];the Western bloting detection results demonstrated that the relative expression of hepatic LFA-1 and MAC-1 in sepsis animals were （1.2±0.2） and （1.0±0.2）,while they decreased greatly in sevoflurane pretreatment group[（0.7±0.2） and（0.6±0.1）,respectively,P<0.05]. Conclusion The application of sevoflurane for pretreatment anaesthesia might have a protective effect on sepsis-induced liver injury in rats,which is related to the down-regulation of hepatic LFA-1 and MAC-1 expression.

Objective The aim of this study was to investigate the efficacy of of combination of tenofovir and Anluo Huaxian pill,a herbal medicine,in the treatment of patients with HBeAg-negative chronic hepatitis B （CHB）. Methods A total of 68 patients with HBeAg-negative CHB were recruited in our hospital bwtween March 2015 and May 2017,and were divided randomly into two groups,with 34 patients in each. The patients in the control group were treated with tenofovir orally and those in the observation were treated with combination of tenofovir and Anluo Huaxian pill for 48 weeks. Serum interleukin（IL）-6,IL-2,and tumor necrosis factor-α（TNF-α） by enzyme-linked immunosorbent assay,and serum type III procollagen（PC-III）,hyaluronic acid （HA）,laminin （LN） and type IV collagen （IV-C） were detected by radioimmunoassay. Results At the end of 48 w treatment,serum HA,LN,IV-C,and PC-III levels in the combination group were（94.5±31.5） ng/ml,（113.2±51.6） ng/ml, （72.4±20.3） g/L and （102.4±19.6） g/L,significantly lower than [（121.6±37.5） ng/ml,（132.5±53.8） ng/ml,（94.6 ±22.1） μg/L and（134.7±21.5） g/L,respectively,P<0.05] in the control;serum IL-2 level was （173.6±28.3） ng/L, significantly higher than [（145.7±26.4） ng/L,P<0.05], while serum IL- 6 and TNF-α levels were （94.5±16.2） pg/ml and（26.6±6.8） pg/ml,significantly lower than [（112.6±17.8） pg/ml and（35.7±8.3） pg/ml,respectively,P<0.05] in the control;serum HBV DNA loss were 91.2% and 88.2% in the two groups（P<0.05） and serum ALT normalization rates in the two groups were 94.1% and 94.1%. Conclusion The administration of tenofovir and Anluo Huaxian pills is effective in the treatment of patients with HBeAg-negative CHB, which might alleviate liver fibrosis and reduce intrahepatic inflammation.

Objective To compare the efficacy of interferon alpha -2b and peginterferon alpha -2a（PEG-IFN alpha-2a） in the treatment of patients with chronic hepatitis B（CHB）. Methods 116 patients with CHB were enrolled in our hospital between August 2015 and August 2017,and were divided randomly into two groups,with 58 in each. The patients in control were treated with interferon alpha -2b,and those in the observation group were treated with PEG-IFN alpha-2a. The regimen in both groups lasted for 48 weeks. Serum laminin （LN）,hyaluronic acid （HA）,collagen type Ⅳ （Ⅳ-C） and pro-Ⅲ type collagen peptide （P Ⅲ P） and serum interleukin 4（IL-4）,IL-6,IL-10 and interferon gamma（IFN-gamma） were detected. Results Serum HBV DNA negative conversion,HBeAg negative conversion,serum HBeAg conversion to anti-HBe and ALT normalization rates in the observation group were 75.9%,29.3%,22.4% and 70.7%,all significantly higher than 51.7%,19.0%,10.3% and 55.2%,respectively （P<0.05）;serum LN,HA,Ⅳ-C and PⅢP levels were significantly lower than in thecontrol （P<0.05）;serum IL-4 level was significantly lower than,while serum IL-6,IL-10 and IFN-γ levels significantly higher than in the control （P<0.05）;the incidence of thrombocytop nia was 51.7%,much higher than 12.1% in the control（P<0.05）. Conclusion PEG-IFN alpha-2a might be superior to domestic IFN alpha-2b in the treatment of patients with CHB,which should be the first-line choice for antiviral therapy.

Objective To analyze the diagnostic efficacy of hepatic fibrosis by liver stiffness measurement （LSM） in patients with chronic hepatitis B（CHB）. Methods 112 patients with CHB and 30 healthy volunteers were recruited between January 2016 and July 2018,and LSM was detected by FibroTouch. The liver biopsies were conducted in all patients with CHB and the hepatic fibrosis staging were performed by Ishak scoring system. The diagnostic efficacy of hepatic fibrosis by LSM was analyzed by area under the receiver operating characteristic （AUC）. Results Out of the 112 patients with CHB,the hepatic fibrosis stage S0 was found in 16（14.3%）,mild hepatic fibrosis stage S1 was found in 40（35.7%）,moderate hepatic fibrosis S2 to S3 was found in 40（35.7%）, and significant hepatic fibrosis stage S4,e.g. liver cirrhosis,was found in 16（14.3%） by Ishak scoring system; the LSM were （5.4±0.8） kPa,（7.1±2.1） kPa,（9.9±2.5） kPa and （15.8±3.4） kPa,respectively,in patients with hepatic fibrosis S0,S1,S2 to S3 and S4,while it was （5.3±0.9） kPa in healthy volunteers;by setting the LSM=5.90,LSM=7.61,LSM=9.25 and LSM=14.84,respectively,as the cut-off-value for diagnosing hepatic fibrosis S0,S1,S2 to S3 and S4,the AUC were 0.943,0.800,0.568 and 1.000,respectively,and their sensitivities and specificities were 100.0% and 89.6%,100.0% and 69.4%,100.0% and 52.1%,and 100.0% and 100.0%,respectively. Conclusion The application of LSM by FibroTouch examination in diagnosing hepatic fibrosis in patients with CHB is efficacious, which should be further validated in clinical practice.

Objective To investigate the distribution of HCV genotypes between patients with HIV/HCV co-infection and with HCV mono-infection in Guangzhou. Methods A total of 233 patients with chronic hepatitis C were enrolled in this study,including 95 patients with HIV/HCV co-infection and 138 patients with HCV mono-infection. The HCV core and NS5B gene fragments were used for genotyping by using Illumina Miseq platform PE300 model,and for the samples which the NGS data contained mixed HCV infection（more than 1% reads mapping to other genotypes）,the NS5A genotypes specific primers were used to validate the mixed HCV infection. The data was compared by x2 test,fisher’s exact test,t-Student and Mann-Whitney U test. Results The percentage of intravenous drug users（IDUs） in patients with HIV/HCV co-infection was significantly higher than in patients with HCV mono-infection（77.7% vs. 19.6%,P<0.001）,and the percentage of blood transfusion history in patients with HCV mono-infection was much higher than in those with HIV/HCV co-infection（48.6% vs. 3.2%,P<0.001）;the average reads of HCV core gene in patients with HIV/HCV co-infection were（15456±6689） reads,no significantly different as compared to（14323±5321） reads in patients with HCV mono-infection,and th e average reads of HCV NS5B gene in patients with HIV/HCV co-infection were（16432±3467） reads,also no significantly different compared to（17611±5632） reads in patients with HCV mono-infection（P>0.05）;228 patients （97.9%） in our series were infected with single HCV genotypes,and HCV genotype 6a and 3b infections were more prevalent in patients with HIV/HCV co-infection than in with HCV mono-infection （47.4% vs. 26.8%,P=0.001 and 13.7% vs. 3.6%,respectively,P=0.005） and HCV genotype 1b infection was more prevalent in patients with HCV mono-infection than in patients with HIV/HCV co-infection （59.4% vs. 20.0%,P<0.001）;5 patients （2.1%） were found with mix HCV genotype infection,including 4 patients with HIV/HCV co-infection and 1 patient with HCV mono-infection. Conclusion The prevalence of infected HCV genotypes in patients with HIV/HCV co-infection and in with HCV mono-infection might be different,which worth further investigation.

Objective To observe the short-term efficacy of herbal medicine in treatment of patients with nonalcoholic fatty liver disease （NAFLD）. Methods 100 patients with NAFLD were recruited in our hospital between January 2015 and January 2017,and were randomly divided into the observation（n=50） and the control group （n=50） by office-software-generated randomized number. The patients in control were guided for food and exercise modulation,and the patients in observation were given herbal medicine for 8 weeks. Serum total antioxidant capacity （T-AOC）,superoxide dismutase （SOD）,malondialdehyde （MDA）,and nitric oxide （NO） level were detected by ELISA,and serum fasting blood glucose （FBG） as well as fasting insulin （FINS） were assayed to calculate the insulin resistance index （HOMA IR）. Results At the end of 8-week treatment,serum ALT,AST and GGT levels in the observation were （65.1±7.8）U/L,（69.4±8.5）U/L and （95.4±12.3） U/L,significantly lower than（94.1±12.3） U/L,（99.3±8.6） U/L and （141.9±15.7）U/L,respectively,in the control （P<0.05）;serum T-AOC,SOD,NO and MDA levels were（38.1±5.1） U/ml,（89.1±12.1） μg/ml,（20.1±1.8） mg/L and（8.4±1.1）ng/ml,significantly different as compared to （25.1±3.2） U/ml,（62.1±6.9） μg/ml,（13.1±1.2） mg/L and （12.0±1.2） ng/ml in the control （P<0.05）;serum FBG,HOMA-IR, TC and TG levels were（6.1±1.2） mmol/L,（5.8±0.9）,（2.2±0.1） mmol/L and（0.4±0.1） mmol/L,significantly lower than （6.8±2.3） mmol/L,（6.4±1.9）,（2.7±0.3） mmol/L and（0.7±0.3） mmol/L,respectively,in the control（P<0.05）. Conclusion The application of herbal medicine in the treatment of patients with NAFLD might have a short-term efficacy,which could decrease serum liver enzymes and regulate the glycolipid metabolism.

Objective The aim of this study was to investigate the pregnant outcomes in 112 patients with liver injuries during gestation periods. Methods A total of 112 patients with liver injuries during gestation periods and 50 healthy pregnant women with normal liver function tests were recruited in our hospital between April 2013 and April 2018,and the pregnant outcomes were recorded and compared between the two groups. Results Before delivery,serum alanine aminotransferase and aspartate aminotransferase peak levels in pregnant women with liver injuries were（146.0±46.4） U/L and （112.5±50.1） U/L,both returned back to normal after birth;the gestational duration,neonatal length and Apgar score at 60 s in pregnant women with liver injuries were not significantly different （P>0.05） as compared to those in control women,while postpartum blood loss was （206.9±80.1） ml,and neonatal body weight was （3086.3±252.4）g,much different as compared to those in the healthy women 【（189.8±72.2） ml and （3302.7±320.1） g,respectively,P<0.05】;the proportion of clean amniotic fluid in the women with liver injuries was 65.2%,much lower than 82.0% in the control,and the proportions of amniotic fluid contamination grade III,premature delivery,premature rupture of membranes and intrauterine neonatal respiratory distress in liver injury groups were 23.2%,17.0%,25.9% and 18.8%,significantly higher than 8.0%,2.0%,12.0% and 6.0% in the control group （P<0.05）. Conclusion Liver damage during gestation period might lead to untoward effects on maternal and fetal outcomes,which should taken into consideration and deal with carefully early.

Objective To summarize the clinical features of herb-induced liver injury （HILI）. Methods Seventy-five patients with HILI were diagnosed by Uclaf causality assessment method（RUCAM） scores greater than 3 between January 2015 and December 2015. Results There were 59 patients with hepatocellular,11 with cholestatic and 5 with mixed injuries in this series;among the 75 cases,63 （84.0%） were acute HILI;in 39 patients with definite Chinese medicine ingredients,17 cases（43.6%） were caused by polygonum multiflorum;3 cases （60.0%） in mixed liver injuries had pruritus,significantly higher than 6 cases （10.2%） in patients with hepatocellular or 4 cases （36.4%） in cholestasitic liver injuries （P=0.00）;serum alanine aminotransferase level in patients with hepatocellular liver injury was （623.4±450.2） U/L,significantly higher than （84.4±57.4） U/L in patients with mixed or（179.5±75.5） U/L in those with cholestasis liver injury（P<0.05）;total serum bilirubin level in patients with hepatocellular,mixed and cholestasitic damages were（148.0±127.0） μmol/L,（150.8±102.6） μmol/L and（128.8±76.2） μmol/L,respectively（P>0.05）. Conclusion s Polygonum multiflorum is the most common cause of HILI,hepatocellular damage is more common in patients with HILI,and most cases presents as acute onset. The prognosis of patients with HILI is good.

Objective To investigate the changes of implication of serum diamine oxidase（DAO） level in patients with hepatitis B-induced acute-on-chronic liver failure（ACLF）. Methods A total of 104 patients with ACLF were admitted to our hospital between August 2014 and April 2017,and 64 patients survived and 40 died in 60 day observation. Serum DAO levels were detected by ELISA,and the factors affecting the prognosis of patients were analyzed by Logistic regression analysis. Results Serum DAO level in the survival group was （15.1±4.8） ng/mL,significantly lower than（68.4±25.4） ng/mL （P<0.05） in the fatal group;univariate analysis showed that serum TBIL,AST,ALT,INR,ALB,Cr,and MEID score,WBC,spontaneous bacterial peritonitis,hepatic encephalopathy,ascites,as well as cirrhosis were associated with the bad prognosis,and multivariate regression analysis demonstrated that high MELD scores,high DAO levels and patients’ age were the independent risk factors for death of patient with ACLF;the survival rates in patients with serum DAO≥48.7 ng/mL and with serum DAO<48.7 ng/mL were 50.0% and 77.3% （x2=7.977,P=0.005）,the survival rates in patients with MELD≥26.1 and with MELD<26.1 were 45.5% and 79.6%,and the survival rates in patients greater than 40-yr-old and under 40 were 50.8% and 79.5%,respectively （all P<0.05）. Conclusion Serum DAO levels might be used as a new parameter for predicting the prognosis of patients with ACLF,which needs further investigation.

Objective To investigate the efficacy of voriconazole in the treatment of patients with liver failure complicated by pulmonary fungal infection（PFI）. Methods 26 patients with liver failure complicated by PFI were recruited in our hospital between February 2015 and August 2018,and 14 patients received voriconazole and 12 patients received itraconazole. All patients were followed-up for 12 weeks. Serum interleukin-6 （IL-6） and tumor necrosis factor-alpha（TNF-alpha） were detected by ELISA,and peripheral lymphocyte subsets were assayed by FC. Results At the end of 4 weeks,serum bilibubin level in patients receiving voriconazole was（96.2±54.3）μmol/L,much lower than[（178.3±89.4） μmol/L,P<0.05] in itraconazole-treated patients;serum IL-6 level was （11.5±6.7） pg/ml,significantly lower than[（18.5±6.8）pg/ml,P<0.05] in itraconazole-treated patients;the average time of fungal infection occurrence in all the patients was （27.21±15.96） d,while the onset of infection in patients with chronic-0n-acute liver failure was（17.8±6.9） d much earlier than[（37.2±16.4）d,P<0.05] in patients with chronic liver failure;there were no significant differences as respect to the changes of peripheral blood lymphocyte subsets and liver or renal function tests;no severe untoward reaction was found after the anti-fungal therapy;at the end of 12-week followed-up,6（42.9%） out of voriconazole-treated patients,while only 3 （25.0%,P<0.05） of itraconazole-treated patients survived. Conclusion The application of voriconazole could effectively control the pulmonary fungal infection in patients with liver failure,and prolong the survival,which might be related to the inhibition of general inflammatory reaction.

Objective The aim of this study was to explore the clinical value of quantitative assessment of liver functions by energy dispersive CT imaging in patients with Budd-Chiari syndrome before and after treatment. Methods Fifty-eight patients with BCS were enrolled to our hospital between May 2012 and April 2018,and they were classified into Child class A（n=21）,class B （n=18） and class C（n=19）. All the patients underwent transjugular intrahepatic portosystemic shunt （TIPS） and before and after the treatment,the energy spectrum CT scanning was performed. After CT scanning,the image was transmitted to the post-processing workstation. Regions of interest（ROI） was plotted in Couinaud segment I-VIII. The normalized iodine concentration at each segment of the liver before and after the treatment were calculated. Results Before TIPS,the normalized iodine concentration at segment I to VIII in patients with Child class A were（0.32±0.21）,（0.33±0.12）,（0.31±0.07）,（0.31±0.02）,（0.31±0.02）,（0.31±0.03）,（0.31±0.09） and（0.31±0.11）,all significantly greater than【（0.28±0.14）,（0.28±0.13）,（0.28±0.08）,（0.27±0.09）,（0.22±0.09）,（0.25±0.10）,（0.27±0.13） and （0.28±0.10）,respectively,P<0.05】 in patients with Child class B or【（0.21±0.10）,（0.20±0.09）,（0.19±0.07）,（0.19±0.11）,（0.19±0.12）,（0.19±0.10）,（0.20±0.11） and（0.19±0.10）,respectively,P<0.05】 in patients with Child class C;after the TIPS procedure,the normalized iodine concentration at each segment in patients with different liver function classification elevated obviously as the liver functions improved,and the normalized iodine concentration in patients with Child class A elevated greatly. Conclusion The application of energy-spectrum CT imaging has important value in quantitatively evaluating the liver functions in patients with Budd-Chiari syndrome before and after treatment. It might indirectly reflect the blood supply of liver according to the normalized iodine concentration,by which the clinicians might therefore quantitatively evaluate the curative efficacy of any treatment in patients with BCS. The materials might provide further effective information for clinical managements.

Objective The purpose of this study was to investigate the short-term efficacy of terlipressin and octreotide combination in treatment of decompensated cirrhotic patients complicated by hepatorenal syndrome （HRS）. Methods A total of 66 patients with decompensated cirrhosis and HRS were enrolled in this study,and were randomly divided into combination and control groups with 33 cases in each. The patients received combination of terlipressin and octreotide or terlipressin alone therapy for one week. Results At the end of the regimen,the body mass,abdominal circumference and urine volume in patients with combination therapy were（52.6±4.7） kg,（89.6±6.5） cm and （1213.6±489.4） ml/24 h,significantly different as compared to 【（57.3±4.8） kg,（95.5±7.8）cm and （747.5±310.9） ml/24 h】 in the control （P<0.01）;serum bilirubin and albumin levels in combination group were （14.6±16.5） μmol/L and （34.5±3.4） g/L,significantly different as compared to 【（20.5±19.4） μmol/L and （29.5±3.1） g/L】 in the control（P<0.01）;blood urea nitrogen and Na+ levels in combination group were （11.6±2.3） mmol/L and （133.4±5.3） mmol/L,significantly different as compared to 【（15.4±4.3） mmol/L and （127.4±4.7） mmol/L】 in the control （P<0.01）;the changes of portal vein and splenic vein diameters as well as the thickness of spleens in the two group before and after the treatment weren’t significantly different（P>0.01）. Conclusion The administration of terlipressin and octreotide might help subside ascites,increase urine volumes,and improve the short-term quality of life in patients with decompensated liver cirrhosis and HRS.

Objective To investigate hepatic expression of interferon inducible protein -10 （IP-10） in patients with hepatitis B liver cirrhosis and hepatogenic diabetes mellitus. Methods The specimens of liver tissues from 70 patients with hepatitis B-induced liver cirrhosis and hepatogenic diabetes mellitus and another 70 patients with hepatitis B-induced liver cirrhosis were obtained by liver biopsies between March 2016 and May 2018,and serum IP-10 were assayed by ELISA,and hepatic IP-10 mRNA and its protein expression were detected by PCR and immunohistochemistry. Results Serum IP-10 level in patients with hepatitis B-induced liver cirrhosis and hepatogenic diabetes mellitus was （236.59±28.30） pg/mL,significantly higher than [（205.31±26.92） pg/mL,P<0.001] in patient with liver cirrhosis without hepatogenic diabetes mellitus; hepatic IP-10 mRNA was （0.59±0.91）,significantly higher than [（0.21±0.66）,P<0.05] in patients without diabetes mellitus;the immunohistochemical staining results showed that the hepatic IP-10 expression positive rate was 31.4%,significantly higher than（12.9%,x2=7.002,P<0.05） in patients without diabetes mellitus. Conclusion The expression of IP-10 in liver tissues and serum IP-10 levels in patients with hepatogenic diabetes mellitus with underlying hepatitis B liver cirrhosis is sig-nificantly increased,which might be involved in the pathogenesis of hepatogenic diabetes mellitus through inflammatory mechanism.

Objective To investigate the efficacy of endoscopic sequential variceal 1igation plus sclerotherapy （EVLS） in treatment of patients with hepatitis B-induced liver cirrhosis （LC） complicated by esophageal gastric varices bleeding （EGVB）. Methods A retrospective analysis of 80 patients with hepatitis B-induced liver cirrhosis complicated by EGVB were recruited in our hospital between February 2016 and October 2017,and the patients were randomly divided into observation （n=40） and control group （n=40）. All patients received conventional hemostasis therapy,and 40 patients in observation group received EVLS at the base of conventional supporting therapy. Serum gastrin （GAS） and glucagon （GLC） levels were detected by ELISA. The portal venous pressure （PVP）,portal vein diameter （PVD）,portal vein velocity （PVV） and portal vein blood flow （PVF） were detected by ultrasound. All patients were followed-up for 12 months. Results At the end of 2 weeks,three （7.5%） in observation and 10（25.0%） in the control died,and the effective hemostatic rates were 92.5% vs. 75.0% （P<0.05） in the two groups;the PVP,PVD and PVF in the observation were（22.5±1.6） mmHg,（11.7±0.4） mm and （546.2±131.6） ml/min,significantly lower than （25.3±2.0） mmHg,（13.8±0.5） mm and （742.6±162.8） ml/min （P<0.05） in the control;serum GAS and GLC levels in the observation were （72.5±10.4） ng/L and （52.4±7.8）ng/L,significantly lower tha （95.8±14.7） ng/L and （59.6±8.9） ng/L （P<0.05） in the control;at the end of 12 month follow-up,2（5.4%） patients in the observation,while 8（26.7%,x2=4.114,P=0.043） patients in the control had re-bleeding. Conclusion The application of EVLS at the base of conventional supporting therapy in the treatment of patients with liver cirrhosis with EGVB is highly efficacious and safe, which warrants further investigation.

Objective To investigate the clinical value of MRI enhanced exchange hemodynamic model in evaluating liver cirrhosis. Methods

Results Out of 60 patients with chronic hepatitis B and chronic hepatitis C,the histopathological examination showed that fibrosis S1 in 3,S2 in 3,S3 in 1 and S4 in 53;the Ktrans and Ve in patients with advanced fibrosis decreased,while HPI,MTT and TTP increased significantly as compared to those without （P<0.05）;ROC analysis showed that Ktrans,HPI,MTT and TTP had a high efficacy in diagnosing liver cirrhosis（P<0.05）. Conclusion Several quantitative parameters can be obtained in DCE-MRI based on double-input and double chamber exchange hemodynamics model,which might be good parameters in guiding the diagnosis of patients with liver cirrhosis.

Objective Currently,an available options for treatment of decompensated hepatitis B-induced liver cirrhosis are limited. Recently,stem cell transplantation has emerged as a promising alternative in this setting. The aim of this study was to evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation （APBSCT） in patients with hepatitis B cirrhosis. Methods A total of 100 patients with hepatitis B-induced liver cirrhosis（LC） were devided into transplantation and control group,and 50 patients in control group were treated with conventional therapies,and other 50 patients in transplantation group were mobilized by injection of recombinant human granulocyte colony stimulating factor （rhG-CGF）,the peripheral blood stem cells were separated and collected and then the stem cells were injected directly into the proper hepatic artery. A six-month follow-up survey was conducted in all the patients. Results One month after the APBSCT,the main indexes of liver functions in the transplantation group improved as compared with those before operation,and serum bilirubin levels in transplantation group and control group were （34.5±17.2） μmol/L and （59.3±12.8） μmol/L,respectively,significantly different （P<0.05）,and serum albumin levels were （35.3±3.2） g/L and （30.2±1.5） g/L,significantly different （P<0.05）;at the end of six month transplantation,serum albumin levels were（30.6±4.4） g/L and （27.6±1.9）g/L,and Child-Pugh scores were （8.4±2.1） and （9.7±3.3）,respectively,significantly different （P<0.05）. Conclusion s Autologous peripheral blood stem cells transplantation for patients with LC is a safe and feasible procedure,which might improve the liver functions and life quality at short-term observation.

Objective To investigate the preventive application of meropenem in patients with liver cirrhosis complicated by upper gastrointestinal bleeding（UGB）. Methods 92 patients with liver cirrhosis complicated by UBG were admitted to the ICU of our hospital between November 2016 and October 2018,and were randomly divided into the control and the observation group,with 46 patients in each group. Patients in the control group didn’t received antimicrobial therapy until the infection was identified,and patients in the observation group were intravenously given prophylactic meropenem administration at presentation. Blood procalcitonin （PCT） level was assayed. Results At the end of ten day treatment,one patient in the observation and two in the control died;in survivals in the observation,the white blood cell count was（5.6±1.9）×109/L,and blood PCT level was （0.25±0.03） ng/mL,significantly lower than （9.8±1.2）×109/L and（0.42±0.06） ng/mL in the control,while the platelet count was （106.2±15.7）×109/L,significantly higher than （93.6±20.1）×109/L in the control （P<0.05）;the re-bleeding rate and incidence of infection in the observation were 8.9% and 11.1%,both much lower than 25.0% and 43.2%,respectively,in the control（P<0.05）;a total of 8 strains and 24 strains were separated in the observation group and in the control group,respectively,and the main infected bacteria was Escherichia Coli in the two groups,followed by Klebsiella pneumonia. Conclusion Prophylactic use of antibiotics is feasible in patients with liver cirrhosis complicated by UGB,which might significantly reduce the incidences of nosocomial infection and re-bleeding.

Objective To analyze the risk factors of portal vein thrombosis （PVT） after splenectomy in patients with liver cirrhosis and portal hypertension. Methods 94 patients with liver cirrhosis and portal hypertension were admitted to our hospital between January 2015 to June 2018,and all the patients received splenectomy and pericardial devascularization. Color Doppler ultrasonography was carried out for PVT. Multivariate Logistic regression analysis was applied to reveal the risk factors for postoperative PVT. Results 30 patients were found to have the PVT by ultrasonography one month after the operation,and the proportion of ascites in patients with PVT was significantly higher than that in non-PVT group [56.7% vs. 32.8%,P<0.05],the spleen thickness was significantly greater than that in non- PVT group [（75.8±9.4） mm vs. （69.1±8.8） mm,P<0.05],the spleen volume was significantly larger than that in non-PVT group [（141.7±18.1） mm2 vs. （126.8±17.2） mm2,P<0.05],the portal vein diameter was significantly wider than that in non-PVT group [（16.2±2.1） mm vs.（14.1±1.9） mm,P<0.05],the portal vein velocity was significantly slower than that in non-PVT group [（12.2±1.5） cm/s vs. （14.6±1.6） cm/s,P<0.05],the proportion of patients had having low molecular weight dextran or low molecular weight heparin therapy was significantly lower than that in non-PVT group （P<0.05）;the Logistic regression analysis showed that absence of anti-coagulative therapy （OR=0.503,P=0.023）,slowed portal vein velocity（OR=0.491,P=0.014）,increased spleen volume （OR=1.872,P=0.044） and increased portal vein diameter （OR=1.982,P=0.021） were the independent risk factors for postoperative PVT formation in patients with liver cirrhosis after splenectomy. Conclusion s The clinicians must take the risk factors of PVT formation into consideration in dealing with portal hypertension by splenectomy and devascularization,and give the appropriate prophylactic management.

Objective The purpose of this study was to explore the clinical value of dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI in evaluating liver hemodynamics and liver functions in patients with hepatitis B-induced liver cirrhosis （LC）. Methods 130 patients with hepatitis B cirrhosis and 30 individuals with normal liver function tests were recruited in our hospital between June 2016 and June 2018. The dynamic contrast-enhanced MRI scan and dual-energy CT enhanced scan were performed and the blood flow parameter peak （PV）,maximum rise slope（MSI）,maximum drop slope （MSD）,positive enhancement integral （PEI） and signal enhancement rate （SER） in the liver parenchyma were measured. The liver iodine concentration （Ia）,portal iodine concentration （Ip）,hepatic artery iodine fraction（AIF）,and portal iodine concentration （PVIC） were also calculated. Results The PV value of liver parenchyma in patients with LC was（522.1±96.7）,significantly lower than [（609.2±108.8）,P<0.05] in the control,and the liver parenchymal PEI value was （200.2±53.3）,significantly lower than [（241.3±61.5）,P<0.05] in the control;the PV value in 15 patients with CTP class C was（443.4±57.3）,significantly lower than [（587.4±94.5）,P<0.05] in 89 patients with CTP class A,the MSI value was（170.1±54.6）,significantly lower than [（310.6±69.5）,P<0.05] in patients with CTP class A,the MSD value was（31.9±22.5）,significantly lower than [（67.8±19.6）,P<0.05] in patients with CTP class A, the PEI value was （155.6±29.7）,significantly lower than [（236.7±53.4）,P<0.05] in patients with CTP class A,and the SER value was （109.3±7.5）,significantly lower than[（125.6±13.5）,P<0.05] in patients with CTP class A;the Ia value in 26 patients with CTP class B was （0.7±0.2） mgI/ml,in class C was （0.8±0.2） mgI/ml,both significantly higher than 【（0.5±0.1） mgI/ml,P<0.05】 in the control,and the Ip value in patients with CTP A was （2.2±0.5） mgI/ml,in patients with class B was （2.0±0.5） mgI/ml,in patients with class C was（1.8±0.3） mgI/ml,all significantly lower than 【（2.6±0.6） mgI/ml,P<0.05】 in the control,and AIF in patients with CTP class B was（31.7±5.0） %,and in those with class C was（47.8±8.9）%,both significantly higher than 【（21.1±4.3） %,P<0.05】 in the control. Conclusion Dual-energy CT iodine quantification combined with dynamic contrast-enhanced MRI is useful in clinical practice,which might help evaluate hepatic hemodynamics in patients with liver cirrhosis.

Objective To investigate serum thyroid hormone level changes in patients with primary biliary cholangitis （PBC） receiving ursodeoxycholic acid therapy. Methods 70 patients with primary biliary cholangitis,95 with primary liver cirrhosis,and 20 healthy persons were recruited in our hospital between January 2016 and June 2017,and all patients were treated with ursodeoxycholic acid（UDCA） for three months. Serum biochemical tests and thyroid hormone levels were detected before and after 3 month treatment. Results At the end of 3 month treatment,the liver function tests in patients with cholangitis and liver cirrhosis were improved;at presentation,serum TT3,FT3,TT4 and FT4 levels in patients with liver cirrhosis were 1.6±0.2 nmol/L,3.2±0.4 pmol/L,95.6±28.7 nmol/L and 10.3±3.6 pmol/L,and in patients with cholangitis were 1.1±0.2 nmol/L,3.0±0.3 pmol/L,88.2±26.7 nmol/L and 9.7±2.5 pmol/L,all significantly lower than 2.5±0.5 nmol/L,4.7±0.8 pmol/L,115.7±31.6 nmol/L and 13.8±4.1 pmol/L in healthy persons（P<0.05）,while serum TSH levels in the three groups were not significantly different （2.9±0.5 mIU/L and 2.9±0.7 mIU/L vs. 3.3±0.6 mIU/L,respectively,P>0.05）;at the end of 3 month treatment,serum TT3,FT3,TT4 and FT4 levels in patients with cholangitis were 2.4±0.6 nmol/L,4.5±0.8 pmol/L,108.2±36.2 nmol/L and 12.9±3.5 pmol/L,not significantly different as compared to those in healthy persons,while they were 1.2±0.3 nmol/L,3.4±0.4 pmol/L,93.7±29.8 nmol/L and 9.9±3.1 pmol/L in patients with liver cirrhosis,still significantly lower than those in healthy persons（P<0.05）. Conclusion The thyroid hormone levels decrease and might be improved after the treatment of ursodeoxycholic acid in patients with primary biliary cholangitis,which should start as early as possible.

Objective To investigate peripheral blood Th22 cells and plasma interleukin-22 （IL-22） level changes in patients with hepatocellular carcinoma（HCC） after hepatectomy and administration of ulinastatin. Methods A total of 88 patients with HCC were recruited in Department of General Surgery,Kunming General Hospital of PLA between July 2015 and April 2017,and all patients underwent hepatectomy. After the operation, 51 received routine supporting therapies and 37 received ulinastatin treatment for seven days. Thirty healthy individuals were also enrolled serving as normal controls （NC）. Peripheral blood mononuclear cells （PBMC） and plasma were isolated and percentage of CD3⁺CD4⁺IL-22⁺ Th22 cells were investigated by flow cytometry,and plasma IL-22 levels was measured by enzyme linked immunosorbent assay. The differences of Th22 percentages and IL-22 levels were compared between patients with HCC and NC. The independent samples t test was used for comparison of normally distributed continuous data, and Mann-Whitney test was used for comparison of continuous data with skewed distribution. Results Peripheral blood Th22 cell percentage in HCC patients was（1.4±0.3）%, significantly elevated than that in NC [（0.8±0.1）%,P<0.0001];plasma IL-22 level in HCC patients was （116.9±32.6） pg/ml,significantly higher than that in NC（42.1±18.2） pg/ml（P<0.01）;serum ALT level in ulinastatin-treated group and routine treatment group were [219.4（40.1,510.9） IU/L and 450.6 （56.1,820.7） IU/L,P<0.05] at the end of 3 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were [108.8（82.5,439.1） IU/L and 257.3（115.3,7265） IU/L,P<0.01],respectively;serum ALT level in ulinastatin-treated group and routine treatment group were [72.4（25.6,471.5） IU/L and 115.4（35.7,625.2） IU/L,P<0.05] at the end of 7 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were[61.4（29.4,351.4） IU/L and 90.5（45.5,293.8） IU/L,P<0.05],respectively;peripheral blood Th22 cell percentages were （1.2±0.4） % and （1.1±0.3） % at day 3 and at day 7 post-operation in ulinastatin- treated group,respectively,notably lower than those in routine treatment group [（1.3±0.3） %,P<0.05 and （1.3±0.2） %,P<0.05];plasma IL-22 levels were （98.1±20.1） pg/ml and（94.1±24.7） pg/ml in ulinastatin-treated group, respectively,significantly lower than those in routine treatment group[（109.7±29.8） pg/ml,P<0.05 and（110.7±37.1） %,P<0.05]. Conclusion Ulinastatin treatment might down-regulate peripheral blood Th22 cell counts and plasma IL-22 levels,showing liver function protection in patients with HCC after hepatectomy.

Objective To analyze cancerous XPO5 gene level changes in patients with hepatocellular carcinoma （HCC） and its clinical significance based on internet data bank. Methods The XPO5 mRNA in cancerous tissues in patients with HCC was analyzed by using Oncomine database and verified in TCGA GEPIA database. The methylation level of XPO5 gene in HCC tissues was analyzed by using MethHC database. The impact of XPO5 gene on the survival of patients with HCC was analyzed by GEPIA. The STRING database was used to analyze certain proteins interacted with XPO5. Results XPO5 mRNA was upregulated in cancerous tissues in patients with HCC compared with in normal liver tissues （P<0.01）,and its level increased mostly in cancerous tissues with pathological grading Ⅲ;the survival in HCC patients with high cancerous XPO5 mRNA level were significantly shorter than in patients with low XPO5 mRNA level（P<0.01）;low methylation in XPO5 gene body was found in HCC tissues （P<0.005）;the analysis of protein interaction network showed that XPO5 interacting with DICER1 and RAN proteins participated in miRNA regulation. Conclusion XPO5 gene is up-regulated in cancerous tissues in patients with HCC, which might be associated with prognosis of patients with HCC. At present,we can fully use internet database online to review the documented literature and provide reference for the biological treatment of patients with HCC.

Objective To investigate the effects of sevoflurane inhalation on hepatic ischemia-reperfusion injury （HIRI） in patients with primary liver cancer （PLC） undergoing partial hepatectomy. Methods 60 patients with PLC undergoing selective partial hepatectomy were recruited in this study between July 2013 and July 2017,and were randomly divided into pre-inhalation,post-inhalation and whole-course inhalation group,with 20 cases in each group according to the time of sevoflurane inhalation difference. All patients received partial hepatectomy. The indexes of liver function,serum superoxide dismutase （SOD）,malondialdehyde （MDA）,serum prealbumin （PA） and C reactive protein （CRP）,and interleukin 6 （IL-6）,IL-10 and tumor necrosis factor-α （TNF-α） were measured and compared in the three groups. The blockage times of porta hepatis and block periods,the times of operation,the amounts of blood loss and hospital stay after operation were also recorded and compared. Results At the end of seven days after operation,serum ALT levels in pre-inhalation,post-inhalation and whole-course inhalation groups were （56.7±6.2） U/L,（148.2±13.2） U/L and （95.2±15.2） U/L,respectively （P<0.05）,serum AST levels were（40.4±10.1） U/L,（184.5±12.5） U/L and （134.2±15.6） U/L,respectively （P<0.05）,serum bilirubin levels were（29.8±6.7） μmol/L,（46.7±6.8） μmol/L and （35.1±6.7） μmol/L,respectively （P<0.05）,INR were （1.1±0.7）,（1.4±1.2） and （1.2±1.1）,respectively （P<0.05）;serum MDA levels were （9.4±3.6） U/L,（19.7±6.5） U/L and （11.4±4.9） U/L,respectively （P<0.05）,SOD levels were （36.7±6.4） nmol/mL,（13.4±5.2） nmol/mL and （24.8±16.7） nmol/mL,respectively （P<0.05）,PA levels were （159.8±15.8） mg/L,（102.1±16.3） mg/L and （129.9±21.2） mg/L,respectively （P<0.05）,and CRP levels were （29.3±1.2） mg/L,（44.8±3.5） mg/L and （33.6±1.6） mg/L,respectively （P<0.05）;serum IL-6 levels were （16.3±2.3） pg/ml,（9.6±2.4） pg/ml and （4.2±1.6） pg/ml,respectively （P<0.05）,IL-10 levels were （9.1±1.3） pg/ml,（5.2±2.5） pg/ml and （7.4±1.4） pg/ml,respectively （P<0.05）,and serum TNF-α levels were （15.4±2.7） pg/ml,（42.3±3.5） pg/ml and（28.4±2.7） pg/ml,respectively（P<0.05）. Conclusion The applicaton of sevoflurane pre-inhalation has efficacious protective effect on HIRI in PLC patients undergoing partial hepatectomy,which warrants further investigation.

Objective To investigate the efficacy of percutaneous microwave ablation in patients with hepatic cavernous hemangioma（HCHs） and to summarize the experience of management of hemoglobinuria. Methods Fifty-four patients with HCHs and 80 lesions were rectuited in our hospital between February 2012 and December 2017,and all patients were treated by ultrasound-guided percutaneous microwave ablation. All patients were followed-up for 6 to 12 months. Postoperative complications,especially the management of hemoglobinuria were presented. Results Out of the 80 lesions from the 54 patients with HCHs,78 disappeared after ablation,and 2 were destroyed largely because of the special occupation;at the end of followed-up,the CT and/or ultrasound showed that all lesions were shrunk,and totally disappeared in 41（75.9%）,shrank greater than 50% in 8（14.8%）,shrank less than 50%,but greater than 25% in 4（7.4%）,shrank less than 25% in 1（1.9%）;on one with post-operational liver or renal function abnormality was found in our series,and 3 to 4 days after the operation,8 patients 14.8%） had hemoglobinuria,and turned to normal two days after symptomatic management;2（3.7%） had ascites,5 had right upper quadrant of abdominal pain,and 7（12.3%） had nausea and vomiting,all subsided after appropriate management. Conclusion Percutaneous microwave ablation is an efficacious,relatively simple and safe in treatment of patients with HCHs. The hemoglobinuria is a common complications after operation because of thermal effect and injuries,which should be taken into consideration after microwave ablation therapy in clinical practice.

Objective To investigate the impact of blood supply on efficacy of hepatic artery embolization in treatment of patients with hepatic hemangioma. Methods 100 patients with hepatic hemangioma were recruited in our hospital between January 2013 and August 2017,and the patients were divided into group A（n=37） with rich blood supply,group B （n=34） with moderate blood supply and group C （n=29） with poor blood supply. All the patients with hepatic hemangioma received transcatheter hepatic arterial embolization with pingyangmycin and iodized oil. All the patients were followed-up for 12 months. Results At the end of six and twelve months,the efficient rate in group A were 64.9% and 81.1%,significantly higher than 61.8% and 67.7% in group B or 3.5% and 10.3% in group C （P<0.05）;the volumes of pingyangmycin and iodized oil in group A,group B and group C were （11.4±2.6） ml,（9.7±1.9） ml and （4.3±1.0） ml,significantly different among the three groups （P<0.05）;at the end of twelve month,the diameter of focus in group C was （6.6±0.7） mm,much larger than （2.8±0.2） mm in group A or （3.2±0.3） mm in group B（P<0.05）;the short-term post-operational complications such as liver injury in group A was 18.9%,significantly higher than 8.8% in group B or 3.4% in group C（P<0.05）. Conclusion The therapeutic effect of hepatic artery embolization for different blood supply types of hepatic aneurysms should be obviously different. In clinical practice,it should pay attention to choosing reasonable therapeutic methods according to the blood supply tipu to improve the therapeutic effect and safety.

Objective The aim of this study was to investigate the efficacyof endoscopic retrograde cholangiopancreatography （ERCP） in treatment of patients with acute obstructive suppurative cholangitis （AOSC）. Methods 160 patients with AOSC were enrolled in our hospital between November 2016 and November 2018,and undergone ERCP. The patients' bile was extracted for bacterial culture and drug sensitivity measurement. The sensitivity of bacteria to various antimicrobial agents was detected by paper diffusion method. Results Out of 160 patients with AOSC,the success rate of general intubation was 92.5%;total serum bilirubin level was（60.2±43.3） μmol/L 3 days after effective drainage,which was significantly lower than [（110.1±53.0） μmol/L,P<0.05] before operation,and the percentage of neutrophils was（60.2±5.6） %,significantly lower than[（78.4±12.4）%,P<0.05] before operation;the clinical symptoms were not obviously alleviated in 13 patients and all of them cured after re-endoscopy or drug treatment and interventional therapy;no death,perforation,bleeding and other complications occurred;among 148 patients completing the surgical treatment,the positive rate of bile culture was 66.2%,130 strains of pathogenic bacteria were detected and the gram-negative bacilli faecalis,accounted for 66.2% and gram-positive cocci accounted for 33.8%;Enterococcus faecalis,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main ones,among which Escherichia coli accounted for 33.1%;except for Gram-positive cocci were 100.0% sensitive to vancomycin and imipenem and Gram-negative bacilli were 100.0% sensitive to imipenem,the other bacteria showed different degrees of resistance to antibiotics. Conclusion ERCP is effective in dealing with patients with AOSC,and the appropriate administration of antibiotics base on the results of bile culture might improveefficacy and prevent drug resistance in clinical practice.

Objective To investigate the efficacy of percutaneous choledocholithotomy for the treatment of patients with intrahepatic bile duct stones. Methods The clinical data of 894 patients with intrahepatic bile duct stones were analyzed between January 2013 and January 2017 in our hospital by retrospective cross-sectional study,and the percutaneous cholangiography and lithotripsy was performed after T tube drainage. All patients were followed-up for postoperative recurrence of stones by ultrasonography,and the risk factors of postoperative recurrence were analyzed by Logistic regression analysis. Results Out of the 894 cases,87 patients （9.7%） had recurrence of stones,and univariate analysis showed that the percentages of patients older than 60 years,the maximum diameters of gallstones greater than 1 cm,the numbers of gallstones more than 10, the bile duct dilatation,physical jaundice,the positive bile bacteria cultures and cholelithiasis or mixed stones in patients with recurrent stone were found be much higher than in those without （all P<0.05）;further multivariate analysis demonstrated that the age ≥60 years,the maximum diameter of gallstones ≥1cm,and the number of gallstones≥10 cases were the independent risk factors for the recurrence of postoperative stones. Conclusion Percutaneous choledochotomy lithotripsy has a good efficacy in dealing with patients with intrahepatic bile duct stones,and the patients with high risk factors for postoperative bile duct stone recurrence should be followed-up regularly for early diagnosis and management in time.

Objective To explore the effects of dexmedetomidine（Dex） on perioperative brain function in elderly patients with intrahepatic bile duct stones. Methods 72 elderly patients with intrahepatic bile duct stones were recruited in our hospital between September 2017 and June 2018,and divided into control group （n=36） and observation group（n=36）. The patients in control was given normal saline before anesthesia induction,those in observation group was given Dex. The conventional anesthesia was induced and laparoscopic hepatectomy was carried out in all the patients. The blood oxygen content（CaO2）,difference of arteriovenous blood oxygen content（Da-jvO2） and cerebral oxygen uptake rate （CERO2） were monitored before anesthesia induction （T0）,before stone removal （T1） after stone removal （T2）,at the end of surgery （T3） and at 48 h after surgery （T4）,and serum contents of neuron-specific enolase（NSE） and S100β were detected by ELISA. Mini-mental state examination （MMSE） scores were performed. Results At 12 h,24 h and 48 h after surgery,the MMSE scores were（26.3±0.5）,（27.1±0.7） and （27.6±0.2） in the observation group,much higher than [（24.8±0.6）,（25.1±0.5） and （25.4±0.4）,respectively,P<0.01] in the control; at T1 to T3,the CaO2,Da-jvO2 and CERO2,and serum contents of NSE and S100β in observation group were significantly lower than those in the control group （P<0.05）;at phase T4,the Da-jvO2,CERO2 and serum contents of NSE and S100β were （4.6±1.2） mL/dL,（24.8±3.3）%,（14.6±3.1） μg/L and（0.8±0.3）μg/L in observation group,significantly lower than[（5.8±1.6） mL/dL,（33.8±3.9）%,（17.3±4.2） μg/L and （1.4±0.4） μg /L,respectively,P<0.01] in the control. Conclusion s Dex has a protective effect on perioperative brain function in elderly patients with intrahepatic bile duct stones,which might be related to the stabilization of hemodynamic parameters,reduction of blood oxygen uptake and serum S100β and NSE contents.