Traditional Chinese medicine (TCM) has certain advantages in the treatment of chronic liver diseases, especially chronic inflammatory injury and liver fibrosis.However, the studies on medicinal components and action mechanism of TCM prescriptions are confronted with a great challenge.The computational pharmacology methods used in recent years, mainly including virtual screening technique, omics technologies, and network pharmacology approaches, as well as their application in TCM research, are presented;given the previous research work, the progress in research on active ingredients and action mechanism of TCM prescriptions using computational pharmacology methods is reviewed.It is thought that computational pharmacology techniques combined with conventional molecular biological and pharmacological methods are an important research strategy for the material basis and action mechanism of TCM prescriptions for treating chronic liver diseases.

The compound of active ingredients of traditional Chinese medicine (TCM) , whose material base is relatively clear, adheres to the concept and advantages of formula compatibility of TCM.Thus, it is an important approach to modern TCM research.The significance of research on compound of TCM components / ingredients, as well as the research ideas, is sketched out, and the current research on compound of TCM components for the prevention and treatment of liver diseases is reviewed.The research strategies for TCM composition / compound for the prevention and treatment of liver diseases are elucidated from the following two aspects:exploring the compound of TCM components based on clinical TCM compound and studying the composition aiming at the effective components or ingredients of TCM that have been known;it is pointed out that the compatibility of effective TCM components, which provides the method and technology system for innovative drug research, is an innovative research model for inheriting and developing the TCM theory and is one of the important approaches to modern TCM research.

Since the prevalence of nonalcoholic fatty liver disease (NAFLD) has been rising in recent years, more and more attention is being paid to clinical trials of traditional Chinese medicine (TCM) treatment, which is one of the main methods for treating NAFLD.According to the reported clinical trials, consensus needs to be reached on such key points as syndrome selectivity, diagnostic criteria for disease, control of behavior intervention, and establishment of outcome assessment indices.Considering the recent research progress in the world, these issues are reviewed, in order to provide better measures and suggestions for improving the quality of clinical trials of TCM treatment of NAFLD.

Portal hypertension, endotoxemia, hepatic encephalopathy, and ascites are common complications of liver cirrhosis, and there are few effective treatment methods for them in modern medicine.Common concepts, methods, and application of external therapy of traditional Chinese medicine (TCM) , such as acupoint application, TCM enema, acupoint injection, and irradiation of the liver region using liver disease therapy instrument, are introduced.The literature on the efficacy and mechanism of acupoint application, TCM enema, acupoint injection, and irradiation of the liver region using liver disease therapy instrument is reviewed from the aspects of portal hypertension, endotoxemia, hepatic encephalopathy, and ascites in patients with liver cirrhosis and even response to antiviral therapy for hepatitis B cirrhosis.It is concluded that external therapy of TCM is effective, easy to operate, safe, and inexpensive in the treatment of the complications of liver cirrhosis, with easy acceptance by patients.Meanwhile, further research is recommended to investigate more topics in external therapy of TCM, such as the use of transdermal enhancer to improve drug absorption, the design of control group, etc.

Budd- Chiari syndrome (BCS) is a rare liver disease, and there are mutual influences between BCS and pregnancy.The relationship between BCS and pregnancy is systematically discussed, and the points we should pay attention to in the diagnosis and treatment of this disease are pointed out as follows:First, pregnancy is a risk factor for BCS;pregnant women with the clinical manifestations of portal hypertension and (or) inferior vena cava hypertension should be highly suspected of having BCS.Second, pregnancy is risky in BCS patients;pregnancy is allowable in BCS patients who have a stable condition after treatment, but they should be kept under rigorous surveillance during pregnancy and after delivery to avoid thrombosis recurrence.Third, BCS may lead to infertility in women;patients with unexplained infertility should be evaluated by abdominal ultrasound and computed tomography to clarify the diagnosis of BCS.

Objective To investigate the treatment methods for chronic hepatitis B (CHB) with diabetes.Methods Sixty- eight patients with CHB accompanied by diabetes who were hospitalized in the division of infectious diseases of our hospital from January 2008 to December 2012 were included in the study.These patients were divided into treatment group (n = 41) and control group (n = 27) based on treatment methods.In addition to conventional liver protection treatment, NovoRapid 30 was given to the control group, while NovoRapid 30 combined with modified Yinchenhao decoction were given to the treatment group.During treatment, liver function, blood glucose levels, and glycosylated hemoglobin levels were monitored periodically;liver function recovery time was analyzed statistically;the incidence of hypoglycemia for each patient and daily dose of insulin were recorded and analyzed statistically.Before- after comparison and between- group comparison of means were made by t test.Results After treatment, both groups showed a significant improvement in liver function (P < 0.01) and significant decreases in blood glucose and glycosylated hemoglobin levels (P < 0.01) ;the treatment group had a significantly lower glycosylated hemoglobin level than the control group (6.3% ± 0.6% vs 7.3% ± 0.5%, t = 7.46, P < 0.01) .Compared with the control group, the treatment group had a significantly shorter liver function recovery time (28.7 ± 5.61 days vs 35.5 ± 6.33 days, t = 4.53, P < 0.01) , a significantly lower incidence of hypoglycemia (0.8 ± 0.3 times / patient vs 2.2 ± 0.8 times / patient, t = 8.78, P < 0.01) , and a significantly lower daily dose of insulin (37.4 ± 5.2 U vs 44.6 ± 6.5 U, t = 4.86, P < 0.01) .Conclusion Combination therapy with NovoRapid and modified Yinchenhao decoction is an effective, safe, and economical approach to the treatment of CHB with diabetes.

Objective To observe the clinical efficacy of entecavir combined with Xinganbao capsules in the treatment of liver cirrhosis among patients with chronic hepatitis B (CHB) .Methods Sixty CHB patients with liver cirrhosis were randomly divided into two groups:treatment group (n = 30) given entecavir combined with Xinganbao capsules and control group (n = 30) given entecavir alone.The course of treatment was 6 months.The treatment outcomes were evaluated based on liver function, serum fibrosis markers, and imaging findings of the liver and spleen.Comparison of continuous data between groups was made by t test, while comparison of categorical data was made by chi- square test.Results After treatment, the treatment group had significantly lower serum levels of alanine aminotransferase and aspartate aminotransferase (P < 0.05) , significantly reduced serum fibrosis markers (P < 0.01) , and significantly improved imaging findings of the liver and spleen (P < 0.01) , as compared with the control group.Conclusion Entecavir combined with Xinganbao capsules can improve liver function, reduce hepatic inflammation and fibrosis, and decrease portal pressure and spleen thickness in the treatment of liver cirrhosis among CHB patients.

Objective To observe the therapeutic efficacy of Ganshuang granules in the treatment of hepatic fibrosis.Methods Sixty- eight patients with cirrhosis due to chronic hepatitis B (CHB) were divided into experimental group (n = 34) and control group (n = 34) .Both groups received adefovir dipivoxil for 6 months, and the experimental group received Ganshuang granules additionally for 24 weeks.After treatment, the changes in hepatic fibrosis indices including hyaluronic acid (HA) , laminin (LN) , collagen Ⅳ (C Ⅳ) , and precollagen Ⅲ (PC Ⅲ) , as well as liver stiffness value were evaluated by paired t test.Results In the experimental group, the serum levels of HA, LN, C Ⅳ, and PC Ⅲ were significantly decreased by 37.5%, 34.2%, 35.4%, and 39.9%, respectively (t = 2.238, 2.151, 2.148, and 2.198, P < 0.05 for all) , and the liver stiffness value was significantly cut by 40.6% (t = 2.189, P < 0.05) .However, the control group showed no significant changes in these indices.Conclusion For patients with cirrhosis due to CHB, Ganshuang granules can effectively reduce serum markers of hepatic fibrosis and liver stiffness value and have a good therapeutic efficacy in the treatment of hepatic fibrosis.

Objective To investigate the relationship between percentages of T lymphocytes in peripheral blood and deficiency of vital qi in patients with hepatitis B virus- related acute- on- chronic liver failure (HBV- ACLF) .Methods Forty patients with early- stage HBV-ACLF were enrolled as liver failure group, and 50 patients with chronic hepatitis B (CHB) as CHB group;20 healthy subjects who underwent physical examination in the clinic during the same period were selected as control group.Flow cytometry was used to determine the percentages of CD3+T lymphocytes, CD4+and CD8+T lymphocytes, and CD4+CD25+regulatory T cells (Tregs) in peripheral blood, as well as CD4+/ CD8+ratio, and the three groups were compared in this regard by analysis of variance.Results Compared with the control group and CHB group, the liver failure group had a significantly decreased percentage of CD3+T lymphocytes in peripheral blood (34.12% ± 22.33% vs 50.31% ± 12.09% and 49.72% ± 20.11%, P < 0.05) , a significantly increased CD4+/ CD8+ratio (1.78 ± 1.25 vs 1.32 ± 0.31 and 1.31 ± 0.52, P < 0.05) , and a significantly decreased percentage of CD4+CD25+Tregs in peripheral blood (0.83% ± 1.00% vs 2.93% ± 1.31% and 3.17% ± 2.29%, P < 0.05) .Conclusion Once HBV- ACLF develops, T lymphocyte cells in peripheral blood and related effector T lymphocytes are“exhausted”, which reveals that the characteristics of its pathogenesis is“deficiency of vital qi”.

Objective To observe the pharmacodynamic characteristics of Danggui Buxue decoction (containing Angelica sinensis) and its separated recipes in treating liver fibrosis and angiogenesis.Methods Forty- eight Wistar rats were randomly divided into 6 groups:normal group, model group, Danggui Buxue decoction group, Astragalus membranaceus group, Angelica sinensis group, and sorafenib control group.In all groups except normal group, a rat model of liver fibrosis was established using carbon tetrachloride combined with high- fat and low-protein diet.Liver tissue inflammation was observed by HE staining, while collagen deposition by Sirius red staining.Serum levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , and albumin (Alb) and the malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, nitric oxide (NO) content, and nitricoxide synthase (NOS) activity in liver tissue were determined by a test kit.The hydroxyproline (Hyp) content in liver tissue was determined by hydrochloric acid hydrolysis.Sinusoidal endothelial fenestrae were observed by scanning electron microscope, and liver capillaries by synchrotron radiation X- ray two- dimensional imaging.Comparisons between groups were made by one- way analysis of variance;the least significant difference test was used when variances were equal, and the Tamhane's T2 test was used when variances were unequal.Results The Danggui Buxue decoction group, Astragalus membranaceus group, and Angelica sinensis group had significantly increased serum Alb levels (P < 0.05) and significantly decreased serum AST levels (P < 0.05) ;the Danggui Buxue decoction group and Astragalus membranaceus group had significantly decreased serum ALT levels (P < 0.05) .All treatment groups had significantly decreased liver hydroxyproline content (P < 0.05) .In the liver tissues of all treatment groups, the vascular texture was reduced, and the number of sinusoidal endothelial fenestrae was increased.The Danggui Buxue decoction group, Astragalus membranaceus group, and Angelica sinensis group had significantly increased SOD activity (P < 0.05) and significantly decreased NOS activity (P < 0.05) ;the Astragalus membranaceus group had significantly decreased liver MDA content (P < 0.05) ;the Danggui Buxue decoction group and Astragalus membranaceus group had significantly decreased liver NO content (P < 0.05) .Conclusion Danggui Buxue decoction and its separated recipes have good efficacy in treating liver fibrosis and angiogenesis.The mechanism may involve protecting liver sinusoidal endothelial cells and reducing lipid peroxidation.Astragalus membranaceus is superior to Angelica sinensis in reducing inflammation, lipid peroxidation, and NO release.

Objective To evaluate the clinical effect of integrated traditional Chinese and Western medicine therapy based on Qingyi Huaji (QYHJ) formula (for clearing the pancreas and dissolving the stasis) in the elderly patients with pancreatic cancer by a retrospective study and to explore a feasible treatment modality for this disease.Methods The data of 190 elderly pancreatic cancer patients (≥ 60 years) , who received integrated traditional Chinese and Western medicine therapy from January 2002 to December 2008, were retrospectively reviewed.These patients were assigned to receive QYHJ formula or non- QYHJ formula.The Kaplan- Meier method was used for calculating survival rates, and the log- rank test was used for survival difference analysis;multivariate analysis was performed using the Cox proportional hazards model.Results The 1-, 3-, and 5- year survival rates of the 190 patients were 28.42%, 6.32%, and 2.11%, respectively, and the median survival was 6.7 months.The QYHJ group (n = 102) had a significantly longer median survival than the non- QYHJ group (n = 88) (8.7 months vs 4.7 months, P < 0.05) .For the elderly patients with pancreatic cancer, KPS < 80, CA19- 9≥500 U / ml, weight loss (≥10% within six months) , and liver metastasis were poor prognostic factors, while radical surgery, systemic chemotherapy, and QYHJ formula were favorable prognostic factors.Conclusion Radical surgery, systemic chemotherapy, and QYHJ formula are protective factors for long- term survival in elderly patients with pancreatic cancer.Combination therapy with chemotherapy and QYHJ formula is suitable for elderly patients with stage Ⅲ pancreatic cancer, while herbal formula combined with the optimal symptomatic and supportive treatment are suitable for those with stage Ⅳ pancreatic cancer.

Objective To investigate the inhibitory effect of Anfate on the expression of transforming growth factor β1 (TGFβ1) /small mothers against decapentaplegic homolog 2 (Smad2) signaling pathway in the treatment of hepatic fibrosis in mice.Methods Ninety healthy male ICR mice were randomly divided into three groups:normal control group (n = 10) , model group (n = 20) , and high-, middle-, and low- dose treatment groups (n = 20 for each) .In the model group and treatment groups, a mouse model of hepatic fibrosis was established by hypodermic injection of 30% carbon tetrachloride (CCl4) .At 8 weeks after the model was established, the mice in treatment groups received high-, middle-, or low- dose Anfate by gavage once daily for 4 weeks, while the normal control group and model group received the same volume of saline by gavage.The liver tissues were observed under a light microscope after HE staining.The mRNA and protein expression levels of TGFβ1 and Smad2 were measured by Real- Time PCR and immunohistochemistry / Western Blot, respectively.Comparison of means between groups was made by One- Way analysis of variance (ANOVA) .Levene's test was used for assessing the equality of variances;comparison of sample means was made by One- Way ANOVA, and the Kruskal- Wallis test was used when the variances were unequal.Correlation analysis was performed using the Pearson linear correlation coefficient.Results The mRNA and protein expression of TGFβ1 and Smad2 was low in the normal control group and high in the model group;compared with the model group, the treatment groups showed decreases in the mRNA and protein expression of TGFβ1 and Smad2, most significant in the high- dose treatment group, followed by the middle- dose treatment group and high- dose treatment group;there were significant differences in the mRNA expression of TGFβ1 and Smad2 between these groups (χ2= 27.877, P < 0.05;χ2= 26.688, P < 0.05) .The linear correlation analysis showed that the mRNA expression of TGFβ1 and Smad2 was negatively correlated with the dose of Anfate (r =- 0.967, P < 0.05;r =- 0.956;P < 0.05) .Conclusion Anfate inhibits the expression of TGFβ1 and Smad2 in liver tissues in a dose- dependent manner, and that may be related to the mechanism by which Anfate relieves the hepatic fibrosis in mice.

Objective To observe the effects of Ruangan Huajian granules on the serum levels of matrix metalloproteinase-13 (MMP-13) and tissue inhibitor of metalloproteinase- 1 (TIMP- 1) and the mRNA expression of MMP- 13 and TIMP- 1 in liver tissue among C57 mice with hepatic fibrosis.Methods Forty C57 mice were randomly divided into normal control group (n = 10) , model control group (n = 10) , Ruangan Huajian granule group (n = 10) , and colchicine group (n = 10) .A rat model of hepatic fibrosis was established by intraperitoneal injection of carbon tetrachloride in the model control group, Ruangan Huajian granule group, and colchicine group.The serum levels of MMPs and TIMP- 1 and the mRNA expression of MMP- 13 and TIMP- 1 in liver tissue were measured by enzyme- linked immunosorbent assay and real- time quantitative PCR, respectively.Comparison of continuous data between groups was made by analysis of variance.Results Compared with the normal control group, the model control group had a significantly decreased serum level of MMPs (P = 0.003) and a significantly increased serum level of TIMP-1 (P = 0.027) .There were no significant differences in serum levels of MMPs and TIMP- 1 between the normal control group and Ruangan Huajian granule group (P = 0.364 and 0.217) .Compared with the normal control group, the Ruangan Huajian granule group had significantly increased mRNA expression of MMP- 13 in liver tissue (P = 0.005) , but the mRNA expression of TIMP- 1 showed no significant difference between the two groups (P = 0.997) .The model control group had significantly increased mRNA expression of TIMP- 1 in liver tissue compared with the normal control group (P = 0.009) .Conclusion Ruangan Huajian granules can not only promote the production of MMPs, but also inhibit the production of TIMP- 1, thus promoting extracellular matrix degradation, which may be one of the action mechanisms of Ruangan Huajian granules in the treatment of hepatic fibrosis.

Objective To investigate the role of Jak /Stat pathway in the CCl4- induced rat liver fibrosis model and the molecular action mechanism of Fuzheng Huayu recipe in the treatment of liver fibrosis.Methods Experimental rats were randomly divided into control group, CCl4- induced liver fibrosis model group (model group) , and Fuzheng Huayu recipe group (FZHY group) .Blood and liver tissue samples were collected at different time points during fibrosis development, reversion, and intervention.Serum levels of alanine aminotransferase (ALT) and hyaluronic acid (HA) were determined by Olympus AU2700 automatic biochemical analyzer and radioimmunoassay, respectively.The degree of liver fibrosis was evaluated by the Ishak score system.The protein expression of alpha- smooth muscle actin (α-SMA) was measured by immunohistochemistry.The mRNA and protein expression of Jak1 and Stat3 was measured by RT- PCR and Western- Blot, respectively.Comparison between groups was made by one- way analysis of variance.Results During treatment with CCl4, the model group had increasing liver tissue inflammation and fibrosis, as well as elevated protein expression of α- SMA and mRNA and protein expression of Jak1 and Stat3, and these indices reached the peak levels at week 8;later, the rats showed improvements in liver tissue inflammation and fibrosis and significant decreases in the above indices after CCl4were discontinued.At weeks 4, 6, and 8, the FZHY group had significantly decreased serum levels of ALT and HA, significantly reduced liver tissue inflammation and fibrosis, and significantly down-regulated mRNA and protein expression of Jak1 and Stat3, as compared with the model group.Conclusion The Jak / Stat pathway plays an important role in the development and reversion of liver fibrosis.Fuzheng Huayu recipe can reduce liver fibrosis by blocking the Jak / Stat pathway and inhibiting activation of hepatic stellate cells.

Objective Data on liver stiffness measurement (LSM) in chronic hepatitis B (CHB) patients with persistently normal alanine aminotransferase (ALT) (PNALT) and persistently or intermittently elevated ALT (PIEALT) were limited.In this study, we aimed to assess LSMs in these patients and determine the potential influential factors for LSMs, thus providing reference for clinical practice.Methods Two hundred and eight CHB patients without antiviral treatment during the previous one year with ALT < 2 × ULN were included.All of them underwent FibroScan.These patients were grouped according to the results of follow- ups performed at least three times (intervals > 2 months) in the past one year:group 1 (PNALT) , with ALT persistently less than 1 × ULN;group 2 (PIEALT) , with ALT elevated to above 1 × ULN but less than 2 × ULN at least once;group 3 (PIEALT) , with ALT elevated to above 2 × ULN at least once.According to previous studies, the LSM cut- off values to exclude and diagnose advanced liver fibrosis were < 7.4 kPa and ≥10.6 kPa in CHB patients with ALT < 2 × ULN.Results The mean LSM was 6.2 ± 2.9 kPa.Of PNALT patients, 14.3% (18 /126) had an LSM of ≥7.4 kPa, and 2.4% (3 /126) had an LSM of ≥10.6 kPa;the proportions were 35.4% (29 /82) and 13.4% (11 /82) in all PIEALT patients.The multivariate regression analysis showed that ALT > 1 × ULN (OR =2.63, P =0.037) and male (OR =5.29, P =0.012) were independently associated with LSM ≥7.4 kPa;HBV DNA ≥5 log10copies / ml was the independent predictor of LSM ≥10.6 kPa (OR = 13.84, P = 0.046) .Conclusion Among CHB patients, 35% of PIEALT cases and 14% of PNALT cases might progress to advanced liver fibrosis;around 13% of patients with PIEALT could be diagnosed with advanced liver fibrosis.Close follow- ups are recommended for male CHB patients with ALT > 1 × ULN and HBV DNA ≥5 log10copies / ml.

Objective To investigate the relationship of serum adiponectin level with body fat, blood lipids, and insulin resistance (IR) in the patients with chronic hepatitis B (CHB) and patients with CHB and fatty liver.Methods Twenty patients CHB, 20 cases of CHB with fatty liver, and 18 healthy controls were included in the study;there were no significant differences in sex and age between the three groups.Fasting body weight, waist circumference (WC) , hip circumference (HC) , fasting insulin (FINS) , fasting blood glucose (FBG) , total cholesterol (TC) , triglyceride (TG) , high- density lipoprotein cholesterol (HDL- C) , low- density lipoprotein cholesterol (LDL- C) , alanine aminotransferase (ALT) , and aspartate aminotransferase (AST) were measured, and body mass index (BMI) , waist- to- hip ratio (WHR) , and homeostasis model assessment of insulin resistance were calculated.Serum concentrations of adiponectin were determined by enzyme- linked immunosorbent assay.Continuous data was expressed as x ± s, and comparisons between groups were made by one- way analysis of variance;comparisons of categorical data between groups were made by R × C χ2test;correlation analysis was performed by Pearson correlation test.Results The serum adiponectin concentrations of patients with CHB, patients with CHB and fatty liver, and healthy controls were 10.56 ± 2.48, 4.46 ± 2.16, and 6.38 ± 2.91 mg / L, respectively, with significant differences between the three groups (F = 30.537, P = 0.000) .The patients with CHB and fatty liver had significantly higher BMI, WC, WHR, and serum TG level than the CHB patients and healthy controls (P < 0.01) ;there were no significant differences in serum FINS, FBG, TC, HDL- C, LDL- C, and IR values between the three groups.Serum adiponectin level was only negatively correlated with TG in patients with CHB and fatty liver (r =- 0.485, P = 0.015) , but not correlated with BMI, WC, WHR, IR, FINS, FBG, TC, HDL- C, and LDL- C in all patients with CHB.Conclusion Serum adiponectin level significantly increases in the patients with CHB, which may presumably be the result of adiponectin exerting a protective effect on the liver, while it significantly decreases in the patients with CHB and fatty liver, which is closely related to elevated TG.

Objective To analyze the early warning indicators of tuberculous peritonitis (TBP) in patients with cirrhotic ascites.Methods A retrospective analysis was performed on the clinical data of 62 patients with cirrhotic ascites hospitalized in the Second Affiliated Hospital of Chongqing Medical University from January 2010 to December 2012.The chi- square test and Mann- Whitney U test were used for univariate analysis, while the logistic regression model was used for multivariate analysis.Results There were significant differences between TBP group and non- TBP group in sex, history of primary peritonitis, erythrocyte sedimentation rate (ESR) , serum tuberculosis antibody, percentage of lymphocytes in ascites (≥50%) , and prothrombin activity (PTA) (P < 0.05 for all) .The odds ratios (ORs) of history of primary peritonitis, PTA, ESR, and percentage of lymphocytes in ascites (≥50%) for development of TBP in patients with cirrhotic ascites were 1.933, 3.205, 2.716, and 11.701, respectively (P < 0.05 for all) , and the areas under the receiver operating characteristic curve were 0.831, 0.815, 0.775, and 0.935, respectively (P < 0.05 for all) .Conclusion History of primary peritonitis, PTA, ESR, and percentage of lymphocytes in ascites (≥50%) are the early warning indicators of TBP in patients with cirrhotic ascites;these early warning indicators, especially percentage of lymphocytes in ascites (≥50%) , have good predictive values.

Objective To evaluate the efficacy and safety of Baquting (hemocoagulase for injection) for hemostasis in biliary surgery.Methods A total of 240 patients were divided into hemocoagulase group (n = 120) and control group (n = 120) .Normal saline was used instead of hemocoagulase in the control group.The two groups were compared in terms of intraoperative blood loss, blood loss per unit area, total drainage volume at 3 d after operation, and transfusion volume of suspended red blood cells (RBCs) in the perioperative period, and the effect of hemocoagulase on coagulation function was evaluated.Comparison of measurement data was made by t test.Results Compared with the control group, the hemocoagulase group had significantly less intraoperative blood loss (94.3 ± 11.4 vs 128.6 ± 10.3 ml, t = 24.456, P < 0.05) , significantly less blood loss per unit area (0.2 ± 0.1 vs 0.3 ± 0.2 g / cm2, t =4.899, P<0.05) , and significantly lower transfusion volume of RBCs (0.7 ± 0.3 vs 1.9 ± 1.1 U, t = 11.529, P < 0.05) .There were no significant differences in coagulation function between the two groups before and after operation (P >0.05) .Conclusion Hemocoagulase is effective and safe in preventing and treating bleeding during and after biliary surgery and can reduce intraoperative and postoperative blood loss and requirement for suspended RBC transfusion in the perioperative period.

Objective To investigate the preventive and therapeutic effects of lamivudine and entecavir on hepatitis B virus (HBV) reactivation among non- Hodgkin lymphoma (NHL) patients with chronic HBV infection during chemotherapy.Methods From January 2008 to April 2013, a total of 94 NHL patients with HBV infection were recruited from our hospital and divided into lamivudine treatment group and entecavir treatment group.The lamivudine treatment group received chemotherapy with lamivudine (100 mg / d) , and the entecavir treatment group received chemotherapy with entecavir (0.5 mg / d) .The rates of virological breakthrough, primary non- response, and virological breakthrough- related hepatitis flare were compared between groups.The t- test was used for comparison between two groups of independent samples;one- way analysis of variance was conducted for comparison between three groups of independent samples;the chi- square test was used to conduct intergroup comparison.Results For the patients with HBV DNA levels lower than 103copies / ml before anti- HBV treatment, no significant difference was found in the rate of virological breakthrough or rate of hepatitis flare between lamivudine treatment group and entecavir treatment group (χ2= 1.03, P > 0.05) .For the patients with HBV DNA levels higher than 103copies / ml before anti-HBV treatment, the lamivudine treatment group had a virological breakthrough rate of 37.5%, a primary non- response rate of 9.4%, a hepatitis flare rate of 28.1%, and a liver failure rate of 3.1%, and the aforementioned rates for entecavir treatment group were 3.1%, 0, 0, and 0, respectively;there were significant differences in the rates of virological breakthrough and hepatitis flare between the two groups (χ2= 11.68, P < 0.05;χ2= 10.47, P < 0.05) .Conclusion Among NHL patients with HBV infection whose HBV DNA levels are lower than 103copies / ml, the preventive and therapeutic effects of lamivudine and entecavir on HBV reactivation are similar;among NHL patients with HBV infection whose HBV DNA levels are higher than 103copies / ml, those treated with entecavir have lower rates of virological breakthrough and hepatitis flare than those treated with lamivudine, which helps patients have a smoother progress of chemotherapy.

Objective To investigate the short- term prognosis in hepatitis B virus (HBV) - related acute- on- chronic liver failure (ACLF) treated with artificial liver support system (ALSS) and its relationship with clinical indices including HBeAg and to provide reference for the timely, accurate prognostic evaluation of HBV- related ACLF.Methods A retrospective analysis was performed on the clinical data of 81 patients with HBV- related ACLF (55 HBeAg- negative cases and 26 HBeAg- positive cases) who received ALSS treatment and comprehensive medical treatment.The HBeAg- negative cases and HBeAg- positive cases were compared in terms of treatment outcome and laboratory indices including alanine aminotransferase, total bilirubin, albumin, prealbumin (PA) , cholinesterase, international normalized ratio (INR) , blood ammonia, and alpha- fetoprotein (AFP) .Comparison between two groups was made by chi- square test or non- parametric test.Results There was no significant difference in treatment outcome between the HBeAg- negative cases and HBeAg- positive cases (P = 0.158) .There were significant differences in PA, AFP, and INR between the patients with response to treatment and those without response to treatment (P < 0.000 1, P = 0.000 5, and P < 0.000 1) .The receiver operating characteristic (ROC) curves of PA, AFP, and INR were drawn, and their areas under the ROC curves were 0.875, 0.795, and 0.792, respectively.Conclusion There is no significant difference in treatment outcome between HBeAg- positive and HBeAg- negative patients with HBV- related ACLF treated with ALSS.PA, AFP, and INR can be used as accurate indices for prognostic evaluation of HBV- related ACLF.

Hepatitis B surface antibody (HBsAb) is formed in response to hepatitic B virus (HBV) infection, which is a typical characteristic of virus clearance.It is theoretically impossible to detect sequential expression of hepatitis B surface antigen (HBsAg) and HBsAb in the same patient.In recent years, however, cases of coexistence of HBsAg and HBsAb have been frequently reported.Clinically, coexistence of HBsAg and HBsAb is commonly seen in patients with chronic hepatitis B and those injected with hepatitis B vaccine or given high-dose monoclonal anti- HBs.The mechanism of this special phenomenon remains unclear.The relevant research findings in China and the rest of the world are summarized.Analysis shows that coexistence of HBsAg and HBsAb may be related to HBV S gene mutation, decreased binding force of HBsAb, etc.

There has been rapid research progress in the biological characteristics and function of osteopontin (OPN) over the last 20 years.OPN, synthesized and secreted by many tissue cells, has a similar structure as many matrix proteins and possesses the functional characteristics of cytokines.It is involved in the physiological and pathological processes such as inflammation, wound healing, bone formation, and remodeling, as well as development of cancer and liver diseases.Recent studies on the biological characteristics of OPN and its role in hepatitis, liver fibrosis, and liver cancer are reviewed.These studies have shown that abnormal changes in OPN expression occur in many liver diseases and may play an important role in the development and progression of these diseases and that detecting or suppressing OPN expression is of clinical significance for preventing and treating hepatitis, liver fibrosis, and liver cancer.

With the development of radiotherapy techniques, the efficacy of radiotherapy for liver tumors has been improved, and radiotherapy can be considered as an alternative treatment for patients who are not suitable for surgery.The progress in liver tumor radiotherapy reported in the 55th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in 2013, particularly the efficacy and safety of stereotactic body radiation therapy for liver tumors, is reviewed.In the future, radiotherapy may be increasingly used as an effective method in the treatment of liver tumors.The main studies reported at the meeting are sorted as follows in this article.