Objective To study the effect of CpG containing oligodeoxynucleotide(CpG-ODN) on the phenotypes,function and expression of signal transductors and activators of transcription(STAT) and suppressors of cell signaling(SOCS) of peripheral blood dendritic cells(DC) in patients with chronic hepatitis B(CHB).Methods Monocytes isolated from peripheral blood of CHB and healthy volunteers were cultured and induced by granulocyte-monocyte colony stimulating factor(GM-CSF) and interleukin-4(IL-4).Then,CpG-ODN or TNF-? were added to stimulate the immatured DC,their effects on the phenotypes and function of DC were evaluated.(The expression of) signaling molecules of STAT1,3,4,5,6 and SOCS1,3 in DC were detected by Western blotting.Results The(expression) rates of HLA-DR of DC in CHB with the treatment of CpG-ODN or TNF-? were obviously increased;Both the IL-12p70 expression and stimulating capacity of DC to allogenic T lymphocytes were improved significantly in CpG-ODN group and TNF-? group(P

Esophageal variceal bleeding is a severe complication of cirrhotic portal hypertension and the main cause of mortality in patients. Studies revealed no significant differences in emergency hemostasis rate,fatality rate,and rebleeding rate between patients receiving endo-scopic treatment and vasoactive agents.The advances in emergency management of esophageal variceal bleeding,including endoscopic band ligation,sclerotherapy,and use of vasoactive agents,are reviewed,with emphasis on emergency endoscopic treatment and drug therapy for esophageal variceal bleeding.

As a series of multifunctional cells,recent studies indicate that most of the CD4 + T lymphocyte subsets involve in the tumor angiogenesis and invasion,the apoptosis of tumor cells,and the expressions of acute phase proteins and cancer-promoting genes by activating or inhibiting the innate immune cells,the adaptive immune cells and non-immune cells,thus function as tumor promoters or inhibitors in hepatocellular carcinoma (HCC).

Autoimmune hepatitis is a type of autoimmune disease and has known pathogenesis at present, which is believed to be associated with immune imbalance in the body. In inflammatory diseases, regulatory B cells (Bregs) inhibits the differentiation of CD4+ T lymphocytes into T helper 1 cells and T helper 17 cells by secreting interleukin-10 (IL-10) to inhibit inflammatory response. Patients with autoimmune hepatitis have reductions in the level of IL-10 in peripheral blood and the number and function of Bregs, which leads to the fact that Bregs cannot effectively inhibit inflammatory response, suggesting that Bregs play a certain role in the pathogenesis of autoimmune hepatitis. This article reviews the mechanism of action of Breg subsets in autoimmune hepatitis.

Serum cholinesterase (ChE) is synthesized by hepatic parenchymal cells and is released into blood immediately after synthesis,and therefore,serum ChE can be used as an objective and sensitive indicator of liver function.Serum ChE has been used as an independent factor for the evaluation of liver function for a long time and can reflect the synthetic function of the liver and help to determine the severity of liver diseases.Combined measurement of serum ChE and serum prealbumin,total cholesterol,total bile acid,and prothrombin time has an important value in the diagnosis and treatment of liver diseases.At the same time,serum ChE combined with Child-Turcotte-Pugh score or MELD score can accurately evaluate liver reserve function,which may help with the prognostic evaluation of patients with liver diseases.

Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is a new type of secondary sclerosing cholangitis which was discovered recently and has unknown pathogenesis.IgG4-SC is characterized by an increased serum level of immunoglobulin G4 (IgG4),chronic progressive obstructive jaundice,diffuse or local infiltration of a large number of IgG4-positive plasma cells and lymphocytes,fibrosis,and obstructive phlebitis.This article reviews the diagnosis and treatment of IgG4-SC and its association with primary sclerosing cholangitis and cholangiocarcinoma.

Autoimmune hepatitis (AIH) is a chronic autoimmune disease in the liver, with major clinical manifestations of positive autoantibody, abnormal elevation of aminotransferases, and hypergammaglobulinemia. Current studies have shown that regulatory T (Treg)/T helper 17 (Th17) and T helper 1 (Th1)/T helper 2 (Th2) imbalance is one of the mechanisms of the development and progression of AIH. OX40 (also known as CD134, TNFRSF4, or ACT35) and its ligand OX40L are members of the tumor necrosis factor family, and they participate in immune response as co-stimulators of T cell activation and can regulate Treg/Th17 and Th1/Th2 balance, thus affecting the progression of various autoimmune diseases. However, there are few reports on the role of OX40 and OX40L in AIH. With reference to related articles, this article reviews the role of Treg/Th17 and Th1/Th2 balance in AIH and the potential association between OX40/OX40L (new targets for immunological diagnosis and treatment) and AIH.

Nonalcoholic fatty liver disease (NAFLD) is closely associated with insulin resistance and genetic susceptibility and is one of the chronic liver diseases that threaten human health .Under certain conditions, Th17 cells and regulatory T (Treg) cells can be transformed to each other to maintain immune homeostasis.In recent years, more and more studies have been performed on the involvement of Th 17 and Treg cells in the development and progression of liver diseases .Th17 cells, Treg cells, and their balance may become the new targets for the treatment of NAFLD.This article reviews the latest research advances in the association of Th 17 and Treg cells with NAFLD and the role of Th17/Treg balance in the development and progression of NAFLD .

ObjectiveTo investigate the value of albumin-bilirubin (ALBI) score in predicting the prognosis of cirrhotic patients with esophagogastric variceal bleeding, and to identify risk stratification and increase clinical applicability. MethodsA retrospective analysis was performed for the clinical data of 273 cirrhotic patients with esophagogastric variceal bleeding who were hospitalized in Subei People’s Hospital of Jiangsu from October 2012 to August 2018, and all patients received standard management after admission. Survival status was obtained through electronic medical records and telephone follow-up, and according to the prognosis in August 2020, the patients were divided into death group with 109 patients and survival group with 164 patients. General data were compared between the two groups. The Mann-Whitney U test was used for comparison of continuous variables between two groups, and the chi-square test or the Fisher’s exact test was used for comparison of categorical variables between two groups; univariate and multivariate Cox regression analyses were used to identify independent risk factors for prognosis. The Kaplan-Meier curve was used to analyze the survival rates of patients with different ALBI grades, and the log-rank test was used for comparison between groups; the receiver operating characteristic (ROC) curve was plotted to compare the ability of ALBI score, Child-Turcotte-Pugh (CTP) score, and Model for End-Stage Liver Disease (MELD) score in predicting short-term (6 weeks) and long-term prognoses. ResultsDuring follow-up, 109 patients (39.9%) died, and the death group had a significantly higher ALBI score than the survival group ［-1.49 (-1.82 to -1.11) vs -1.79 (-2.22 to -1.49), Z=5.630, P＜0.001］. The univariate analysis showed that age ≥55 years, hemoglobin ≤100 g/L, neutrophil count ≥3.4×109/L, platelet count ≤42×109/L, albumin ≤28 g/L, total bilirubin ≥21 μmol/L, alanine aminotransferase ≥42 U/L or aspartate aminotransferase ≥48 U/L, creatinine ≥94 μmol/L, serum sodium ≤137 mmol/L, international normalized ratio of prothrombin ≥1.5, ascites, and hepatic encephalopathy were risk factors for death in cirrhotic patients with esophagogastric variceal bleeding, and the patients with ALBI grade 3 had a significantly higher risk of death than those with ALBI grade 1 or 2; prophylactic ligation was a protective factor for survival improvement in cirrhotic patients with esophagogastric variceal bleeding (all P＜0.05). The multivariate analysis showed that age ≥55 years (hazard ratio ［HR］=2.531, 95% confidence interval ［CI］: 1.624-3.946, P＜0.001), creatinine ≥94 μmol/L (HR=1.935, 95% CI: 1.208-3.100, P=0.006), serum sodium ≤137 mmol/L ［HR=1.519, 95% CI: 1.015-2.274, P=0.042］, ascites (HR=1.641, 95% CI: 1.041-2.585, P=0.033), hepatic encephalopathy (HR=9.972, 95% CI: 3.961-25.106, P＜0.001), and ALBI grade 3 (HR=1591, 95% CI: 1.007-2.515, P=0.047) were independent risk factors for death. The patients with ALBI grade 3 had a significantly lower survival rate than those with ALBI grade 1 (χ2=18.691, P＜0.001) and ALBI grade 2 (χ2=21.364, P＜0.001), and the patients with ALBI grade 1 had a significantly higher survival rate than those with ALBI grade 2 (χ2=6513, P=0.011). The ROC curve analysis showed that ALBI score, CTP score, and MELD score had an area under the ROC curve (AUC) of 0770, 0.730, and 0.706, respectively, in predicting short-term (6 weeks) prognosis, and they had an AUC of 0.701, 0685, and 0659, respectively, in predicting long-term prognosis. ConclusionALBI score has a good value in predicting short-term (6 weeks) and long-term prognoses of cirrhotic patients with esophagogastric variceal bleeding, and the risk of death increases with ALBI grade. ALBI score can be used as an objective and simple model in clinical practice.