Acute-on-chronic liver failure(ACLF),which was first described in 2013,is a severe form of acutely decompensated cirrhosis characterized by the existence of organ system failure(s)and a high risk of short-term mortality.ACLF is caused by an excessive systemic inflammatory response triggered by precipitants that are clinically apparent(e.g.,confirmed microbial infection with sepsis,severe alcohol-related hepatitis)or not.Since the description of ACLF,some important studies have suggested that patients with ACLF may benefit from liver transplantation and should therefore be urgently stabilized for transplantation by receiving appropriate etiological treatment and comprehensive management,including support of organ systems in the intensive care unit(ICU).The goal of the present clinical practice guidelines is to provide the most reliable evidence available to assist the clinical decision-making process in the management of patients with ACLF,to make triage decisions(ICU vs.no ICU),to identify and manage acute precipitants,to identify organ systems that require support or replacement,to define potential criteria for futility of intensive care,and it also provides suggestions for identifying potential indications for liver transplantation.

This Practice Guidance intends to coalesce best practice recommendations for the identification of portal hypertension （PH）， for prevention of initial hepatic decompensation， for the management of acute variceal hemorrhage （AVH）， and for reduction of the risk of recurrent variceal hemorrhage in chronic liver disease. The most significant changes in the current Guidance relate to recognition of the concept of compensated advanced chronic liver disease， codification of methodology to use noninvasive assessments to identify clinically significant PH （CSPH）， and endorsement of a change in paradigm with the recommendation of early utilization of nonselective beta-blocker therapy when CSPH is identified. The updated guidance further explores potential future pharmacotherapy options for PH， clarifies the role of preemptive transjugular intrahepatic portosystemic shunt in AVH， discusses more recent data related to the management of cardiofundal varices， and addresses new topics such as portal hypertensive gastropathy and endoscopy prior to transesophageal echocardiography and antineoplastic therapy.

Acute-on-chronic liver failure (ACLF), which was first described in 2013, is a severe form of acutely decompensated cirrhosis characterised by the existence of organ system failure(s) and a high risk of short-term mortality. ACLF is caused by an excessive systemic inflammatory response triggered by precipitants that are clinically apparent (e.g., comfirmed microbial infection with sepsis, severe alcohol-related hepatitis) or not. Since the description of ACLF, some important studies have suggested that patients with ACLF may benefit from liver transplantation and should therefore be urgently stabilized for transplantation by receiving appropriate etiological treatment and comprehesive management, including support of organ systems in the intensive care unit (ICU). The goal of the present clinical practice guidelines is to provide the most reliable evidence available to assist the clinical decision-making process in the management of patients with ACLF, to make triage decisions (ICU vs. no ICU), to identify and manage acute precipitants, to identify organ systems that require support or replacement, to define potential criteria for futility of intensive care, and it also provides suggestions for identifying potential indications for liver transplantation.

Liver diseases in pregnancy comprise both gestational liver disorders and acute and chronic hepatic disorders occurring coincidentally in pregnancy. Whether pregnancy-related or not, liver diseases in pregnancy are associated with a significant risk of maternal and fetal morbidity and mortality. Thus, the European Association for the Study of Liver invited a panel of experts to develop clinical practice guidelines aimed at providing recommendations, based on the best available evidence, for the management of liver disease in pregnancy for hepatologists, gastroenterologists, obstetric physicians, general physicians, obstetricians, training specialists and other healthcare professionals who provide care for this patient population.

The seventy-two grid palm technique is an important theoretical source of traditional Chinese medicine hand diagnosis. Starting from the ecological medical model， we analyse the seventy-two grid palm technique， and believe that its diagnosis of human body integrates biological， ecological， psychological， social and other factors， and each factor is based on physiological and pathological theories， and its external social interpretation of the nature of the human body is inseparable from health state. It is proposed that the seventy-two grid palm technique should be integrated with the ecological and natural viewpoints based on the biomedical models or bio-psycho-social medical models， and the research should be conducted from the perspective of the ecological medical model， in order to promote the development of hand diagnosis.