The pathogenesis of primary biliary cholangitis (PBC) remains unclear.Ursodeoxycholic acid (UDCA) is currently the only drug approved by the Food and Drag Administration for the treatment of PBC,but some patients have a poor response to UDCA.New therapies can be considered for these patients.This article reviews the advances in drugs for PBC,including 6or-ethyl-chenodeoxycholic acid,fibrates,budesonide,and biological agents,and points out that these drugs bring new hope for PBC patients,but large-scale clinical studies are needed to confirm the long-term efficacy and safety.

From the view point of drug approval, the research in quality standard and stability of Chinese new drug must be emphasized in order to produce safe and effective new drugs which are competitive in the world. Forthermore, the regulations for new drug approval should be learned repeatedly so as to raise the level of new drug application.

BACKGROUND:Studies have shown that the main functions of mesenchymal stem cels include direct participation in wound healing, growth factor secretion, promoting angiogenesis, immune regulation and inflammation, anti-oxidative stress, which can be used to treat a variety of acute and chronic diseases. OBJECTIVE:To review advances in mesenchymal stem cels in the inflammatory immunomodulation. METHODS: A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles concerning advances in mesenchymal stem cels in the inflammatory immunomodulation published from January 2005 to August 2015. The search terms were “stem cels, mesenchymal stem cels, immune regulation, inflammation, immune cels, inflammatory factors, treatment” in Chinese and English, respectively. Finaly, 40 articles were included in result analysis. RESULTS AND CONCLUSION:Because of their immunomodulation and muti-directional differentiation, mesenchymal stem cels garner increasing attentions. In addition, mesenchymal stem cels can be harvested from different tissues and have goodin vitroamplification capability, which have a broad prospect in the clinical use, including tissue repair and anti-inflammation. As the most promising cels used clinicaly, mesenchymal stem cels show their superiority in the treatment of many diseases, especialy in inflammations induced by immune modulation imbalance. We believe that mesenchymal stem cels wil play an important role in the future cel biotherapy.

ObJective To explore the value of acute physiology and chronic health evaluation Ⅲ(APACHE Ⅲ ) score and the concentration of serum cholinesterase (ChE) in predicting the condition and prognosis of patients with severe acute pancreatitis (SAP) within 24 hours afar hospitalization.Methods Sixty-two SAP patients were enrolled and APACHE Ⅲ score was assessed and the concentration of serum ChE was detected within 24 hours after hospitalization.The correlation between the concentration of serum ChE,APACHE Ⅲ score and the condition and prognosis was analyzed.Results There were 44 survivalcases and 18 dead cases.The APACHE Ⅲ score of the surval patients was significantly lower than that of the dead patients [(52.16 ± 13.76) scores vs.(97.10 ± 15.85) scores] (P＜0.01).The concentration of serum ChE of survival patients was significantly higher than that of the dead patients [ (3685 ± 466) U/L vs.(2109 ± 345) U/L] (P＜ 0.01 ).The higher APACHE Ⅲ score was,the lower the serum ChE concentration was,and the higher the mortality rate was.APACHE Ⅲ score and the concontration of serum ChE both had statistical significances compared with the prognosis in the Logistic regression analysis (P =0.0043,0.0075);APACHE Ⅲ score (95％ CI 1.0306-1.1507),the concentration of serum ChE (95％ CI0.9986-1.0125 ).ROC areas under curve (AUC) of APACHE Ⅲ score,serum ChE concentration with the prognosis were 0.936 and 0.882,respectively.There was no significant difference (P=0.0820).In combined prediction of APACHE Ⅲ score and serum ChE concentration,AUC was 0.952,and its predicting accuracy was higher than either APACHE Ⅲ score or serum ChE concentration (P=0.0016,0.0027).Conclusions APACHE Ⅲ score and the concentration of serum ChE both are significantly correlated with the condition and prognosis of SAP patients.Their combined detection can significantly improve the accuracy of prognosis judgement and provide some clinical guidances for treatment.

Objective Astrgaloside Ⅳ derivative (ASId) is one of Astragaloside Ⅳ (ASI) derivatives with higher water-solubility and may have more druggability than ASI. The present study aims at observing the effects of ASId on cardiovascular parameters in chronic heart failure in rats. Methods Using echocardiographic and haemodynamic measurements, the effects of ASId on congestive heart failure (CHF) induced by ligation of the left coronary artery in rats were investigated.ventricle (LV) pressure (dp/dt) in ASId treated groups were significantly increased. Both LV volumes in diastole and in systole were decreased significantly after ASId treatment, accompanied with a trend towards normalization of relative stress. ASId treatment also inhibited compensatory hypertrophy of depressed heart. Conclusion ASId could improve cardiac functions and inhibite compensatory hypertrophy and LV remodelling, which suggests the possibility of ASId as a new therapeutic drug for the treatment of CHF.

Objective To explore the clinical characteristics of patients with transjugular intrahepatic portosystemic shunt (TIPS) and literature review in patients with clinical features ,and provide clinical reference for carrying out the TIPS .Methods Totally 31 patients in our hospital from January 2009 to May 2014 who received TIPS treatment and strict follow‐up were retro‐spectively analyzed ,the preoperative basic situation ,laboratory index ,the incidence of postoperative bleeding again ,surgical compli‐cations ,the use of anticoagulant drugs and thrombosis ,dissolved ,etc .were statistical analyzed .Results In all patients with TIPS in the diagnosis of cirrhosis and portal hypertension ,hepatitis B ,hepatitis C cirrhosis and portal hypertension ,alcoholic liver cirrhosis and portal hypertension ,unknown cause of liver cirrhosis and portal hypertension ,Budd Chiari syndrome ,hepatitis B and hepatitis C cirrhosis and portal hypertension ,primary biliary cirrhosis and portal hypertension in proportion of 45 .16% ,16 .13% ,12 .90% , 12 .90% ,6 .45% ,3 .22% ,3 .22% respectively ;the incidence of postoperative bleeding again within six months was 9 .68% ;the Child‐Puhg score of preoperative and postoperative 1 week and 3 months ,6 months was (8 .35 ± 2 .52) ,(8 .32 ± 1 .76) ,(9 .29 ± 2 .55) ,(8 .10 ± 1 .85) respectively .Statistical results showed in postoperative 1 week and 3 months ,6 months ,there was no statisti‐cally significant difference compared with preoperative respectively (P>0 .05) ,postoperative 3 months liver function score of Child‐Puhg was higher than that of postoperative 1 week and 6 months (P<0 .05) operation;the rate of abdominal hemorrhage ,hepatic encephalopathy ,stent stenosis were 3 .22% ,22 .58% ,12 .90% ;the proportion of no postoperative taking anticoagulants ,taking as‐pirin ,clopidogrel ,and warfarin were 9 .68% ,38 .71% ,41 .94% ,9 .68% ,respectively ;the formation of portal vein thrombosis (inclu‐ding thrombosis increased) rate was 12 .90% ,thrombus dissolution rate was 100% .Conclusion In China ,liver cirrhosis and portal hypertension is the main source of TIPS and hepatitis B is a major cause of liver cirrhosis ;TIPS have no effect on liver function in Child‐Puhg score;hepatic encephalopathy ,stent restenosis is still the main postoperative complications of TIPS ;rules taking antico‐agulant drugs can dissolve thrombus of the portal vein and prevent thrombosis .

The bile duct is the channel for bile transport in the liver, and the lining epithelial cells in the bile duct have functional and morphological heterogeneity and are the target of various bile duct diseases. In addition to bile metabolism and secretion, biliary epithelial cells are also involved in tissue damage and repair. Biliary epithelial cells have an immune barrier function and can secrete different proinflammatory factors and chemokines. Under the stimulation of endogenous and exogenous factors, biliary epithelial cells present immune reactivity and initiate immune response in the host. This article reviews the current status of research on bile duct lesions and related liver diseases.

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease with unknown etiology. Liver biopsy is an important diagnostic tool, but its clinical application is limited due to its invasiveness. Autoantibodies have special diagnostic and prognostic value for PBC, especially anti-mitochondrial antibodies and antinuclear antibodies, and each antibody has unique clinical significance. This article reviews the diagnostic and prognostic significance of autoantibodies associated with PBC and related research advances.

Primary biliary cholangitis (PBC) is an chronic progressive intrahepatic cholestasis autoimmune liver disease with unknown causes, and at present, the etiology and pathogenesis of PBC remain unclear. Nuclear receptor is a ligand-dependent transcription factor superfamily that regulates cell growth and differentiation by establishing a relationship between signal molecules and transcriptional responses. The human nuclear receptor family consists of 48 members, including peroxisome proliferator-activated receptors, pregnane X receptor, constitutive androstane receptor, liver X receptors, farnesoid X receptor, vitamin D receptor, and glucocorticoid receptor, which have attracted wide attention. These nuclear receptors regulate the key enzymes and transporter genes of bile acid metabolism at the transcriptional level and thus regulate the level of bile acid in the body and participate in inflammatory response. Bile acid metabolism disorder and persistent inflammation may be the key factors for the development and progression of PBC. This article reviews the research advances in nuclear receptors in the development and progression of PBC, in order to provide a theoretical basis for exploring the pathogenesis of PBC and new therapeutic targets.

Primary biliary cholangitis (PBC) is an autoimmune-mediated chronic progressive liver disease and can progress to liver cirrhosis and liver cancer in the late stage. Clinical manifestations and complications of PBC have significant impact on patients’ mind and body, leading to the reduction in Health-related Quality of Life (HRQL). At present, HRQL has attracted more and more attention. This article summarizes the HRQL scales commonly used in China and foreign countries to assess HRQL in PBC patients and analyzes the main influencing factors for HRQL in PBC patients, in order to improve the treatment and monitoring of PBC patients in clinical practice.