Objective To explore the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis. Methods The study overall collected and discussed the influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis patients by adopting the principles and methods of clinical epidemiology based on the previous research of TCM syndrome characteristics. Results The important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis were total alcohol intakes and the total alcohol intakes under family alcoholism history condition. Conclusion The degree of viscera damage by alcohol is closely related to the distribution of TCM syndrome characteristics of alcoholic hepatic fibrosis and its pathogenesis evolution. The genetic constitution is one of the important influence factors of TCM syndrome characteristics distribution of alcoholic hepatic fibrosis.

Objective To investigate the correlation between the distribution of the charactcristics of TCM syndrome of alcoholic liver fibrosis and alcoholic consumption. Methods Our group studied clinical cases in multi-center prospective method. In virtue of Factor Analysis, we explored the characteristics of TCM syndrome of alcoholic liver fibrosis, and the forming characteristics of alcoholic liver fibrosis in inland. Rerults Among the subjects, the characteristics of TCM syndrome of alcoholic liver fibrosis mainly manifested excess syndrome with the common manifestations of deficiency and excess. The visceral position was mainly in liver and spleen, related to gallbladder and stomach. The result suggested that stagnation of Qi stagnation, blood stasis, damp heat, with deficiency of genuine Qi were the interpretation of the causes of alcoholic liver fibrosis. The total alcoholic consumption was one of the important factors which effected on the distribution of thecharacteristics of TCM syndrome of alcoholic liver fibrosis. Total bilirubin had mostly striking effect on the distribution of the characteristics of TCM syndrome. Conclusions The total alcoholic consumption was one of the important factors which effected on the distribution of the characteristics of TCM syndrome of alcoholic liver fibrosis.

Objective To evaluate the relationship between emergency department length of stay (EDLOS) and outcome of multiple trauma patients in ICU.Methods A retrospective cohort study was performed in multiple trauma patients admitted from the emergency department to ICU during 2010.Patients' data were recorded,including demographic information (gender,age,etc.),characteristics of injury (injury causes,diagnosis,ISS,GCS,emergency operation rate,type of operation),and outcome (inhospital mortality,length of ICU stay,total length of hospital stay,expenditure).Patients were assorted into delayed group (EDLOS ＞ 6 h) and non-delayed group (EDLOS ≤ 6 h),then demographic information,characteristics of injury,and outcome were compared between the two groups.Multivariate Logistic and linear regression analyses were performed to identify the correlation between EDLOS and outcome for all patients and for those with and without emergency operation.Results A total of 476 patients aged (47.5 ± 16.0) years were enrolled in the study and male patients accounted for 73.5％.Median ISS was 29 points (interquartile range,22-34 points),median EDLOS was 4.0 hours (interquartile range,2.8-6.4 hours),and inhospital mortality was 9.2％.Delayed (n =135) and non-delayed (n =341) groups were similar in age,gender,ISS,inhospital mortality (13.3％ vs 7.6％),length of ICU stay,and total length of hospital stay (P ＞ 0.05).Multivariate analysis demonstrated prolonged EDLOS increased inhospital mortality (OR=3.19,95％ CI 1.28-7.95,P ＜ 0.05),especially in patients without emergent operation (OR =4.01,95％ CI 1.31-12.27,P ＜ 0.05).However,prolonged EDLOS produced no effect on mortality in patients with emergent operation (OR =1.72,95％ CI 0.79-3.43,P ＞0.05),length of ICU stay,total length of hospital stay,and expenditure.Conclusion Prolonged EDLOS increases mortality of multiple trauma patients admitted to ICU,especially in patients without emergency operation,thus rapid transportation of these patients from emergency room to ICU will improve the outcome.

Chronic hepatitis B and its related diseases remain important public health problems and tough medical issues in China and even around the world, and now there is still a lack of effective radical treatment methods. This article reviews the traditional Chinese Medicine treatment regimens, the integrated traditional Chinese and Western Medicine treatment regimens, and related research highlights formed for hepatitis B (including various disease stages such as HBV carriers, chronic hepatitis B, liver fibrosis, liver cirrhosis, precancerous lesions of hepatocellular carcinoma, liver cancer, and liver failure) under the support of National Science and Technology Major Project from "The 11th Five-Year Plan" to "The 13th Five-Year Plan" (Prevention and Treatment of Major Infectious Diseases such as AIDS and Viral Hepatitis), and it also summarizes the role of traditional Chinese Medicine in the comprehensive prevention and treatment of chronic hepatitis B and its related diseases.

ObjectiveTo determine thallium in whole blood by atomic absorption detection method, and to investigate the eliminating effect of hemoperfusion (HP) for thallium in blood.Methods The blood of Beagle dogs which had not exposed to thallium before were obtained for preparation of thallium nitrate (TlNO3)-containing solution in three concentrations according to the conversion formula based on animal weight and volume of blood. HP was performed in the simulated in vivo environment. The content of TlNO3 in blood of the next group was determined on the amount of TlNO3 for the last HP of the former dose group. Thallium quantity in different samples was measured with atomic absorption spectrometer blood samples before and after HP. Finally, the thallium concentration in blood was analyzed statistically.Results Thallium concentrations showed a good linear relationship in the range of 0-200μg/L (r = 0.998 4). The intra-day precision (RSD) was lower than 4.913%, the intra-day recovery rate was 96.2%-111.9%; the inter-day precision (RSD) was lower than 7.502%, the inter-day recovery rate was 89.6%-105.2%. The concentration of thallium in blood was significantly reduced after HP per time in high, middle, and low dose groups [(453.43±27.80) mg/L to (56.09±14.44) mg/L in high dose group,F = 8.820,P = 0.003;(64.51±13.60) mg/L to (3.19±0.23) mg/L in middle dose group,F = 36.312,P = 0.000; (5.40±0.98) mg/L to (0.38±0.25) mg/L in low dose group,F = 46.240,P = 0.000]. The adsorption rate of four times of HP in high, middle and low dose group were (87.63±2.48)%, (95.06±1.54)% and (92.76±4.87)%, respectively, without significant difference (F = 4.231,P = 0.070 ).Conclusions The method for measuring thallium was established, and it shows a very stable, simple, sensitive for determination of thallium. HP can effectively remove thallium from blood. Thallium concentration can be reduced by 90% after four times of HP. HP is also effective even when thallium concentration is not high.

Objective To investigate the effect of Kangxian Yiai Prescription(KXYA)on the mTOR/HIF-1α/VEGF signaling pathway in a rat model of precancerous lesions of liver cancer.Methods A total of 40 male Wistar rats were divided into normal group,model group,KXYA group,and Biejia Rangan Tablets(BJRG)group,with 10 rats in each group.The rats in the normal group were given intraperitoneal injection of normal saline at a dose of 0.4 mL/100 g,and those in the other three groups were given intraperitoneal injection of diethylnitrosamine at a dose of 50 mg/kg to establish a rat model of the precancerous lesions of liver cancer.Immunohistochemistry and Western Blot were used to measure the expression level of GST-Pi,and quantitative real-time PCR and Western Blot were used to measure the mRNA and protein expression levels of mTOR,HIF-1α,VEGF,PKM2,and GLUT1.A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.Results Compared with the normal group,the model group had a significant increase in the protein expression level of GST-Pi in liver tissue(P＜0.01),and compared with the model group,the KXYA group had a significant reduction in the protein expression level of GST-Pi(P＜0.05).Compared with the normal group,the model group had significant increases in the mRNA expression levels of GLUT1 and PKM2 in liver tissue(P＜0.01),and compared with the model group,the BJRG group and the KXYA group had a significant reduction in the mRNA expression level of GLUT1(P＜0.05).Compared with the normal group,the model group had significant increases in the protein expression levels of GLUT1 and PKM2 in liver tissue(P＜0.01).Compared with the normal group,the model group had significant increases in the mRNA expression levels of mTOR,HIF-1α,and VEGF in liver tissue(P＜0.01);compared with the model group,the BJRG group had significant reductions in the mRNA expression levels of mTOR and VEGF(P＜0.05),and the KXYA group also had significant reductions in the mRNA expression levels of mTOR and VEGF(P＜0.01).Compared with the normal group,the model group had significant increases in the protein expression levels of mTOR,HIF-1α,and VEGF in liver tissue(P＜0.01);compared with the model group,the BJRG group had a significant reduction in the protein expression level of mTOR(P＜0.01),and the KXYA group had significant reductions in the protein expression levels of mTOR,HIF-1α,and VEGF(P＜0.05);compared with the BJRG group,the KXYA group had a significantly higher protein expression level of mTOR(P＜0.01).Conclusion KXYA can inhibit the precancerous lesions of liver cancer by regulating the mTOR/HIF-1α/VEGF signaling pathway.

The European Association for the Study of Liver Diseases issued the "Clinical Practice Guidelines for the Management of Hepatic Encephalopathy" in 2022, which included recommendations for clinical diagnosis, assessment, treatment, management, and prevention. The Society’s "Hepatic Encephalopathy Clinical Practice Guidelines in Chronic Liver Disease," which was last published in 2014, and the "Guidelines for the Diagnosis and Treatment of Hepatic Encephalopathy in Cirrhosis," which the Chinese Society of Hepatology, Chinese Medical Association, released in 2018, have certain differences and updates in terms of comparison to terminology, grading and classification, diagnosis, clinical evaluation and treatment, management, and prevention. Herein, the updated points of this guideline and the differences between it and our nation’s guidelines are summarized in order to refine and understand the guiding role of the new version of the guideline for the clinical treatment of hepatic encephalopathy and provide aid for standardizing clinical diagnosis and treatment.

The connotation of theory of"toxin"in TCM is rich,and"toxin"is closely related to the occurrence and development of chronic liver disease.Treatment from"toxin"is an important treatment for chronic liver disease.In this article,by summarizing the ancient and modern literature to explain the theory of"toxin",and combined with clinical experience,it concluded that"toxin"has the pathogenic characteristics of strong bias,lingering nature,complex and changeable in chronic liver disease.The authors put forward the view that"toxin leads to disease occurrence and accelerates disease progression",and explored the idea of treating chronic liver disease from"toxin",including tracing the source of toxins,clarifying the nature of toxins,identifying changes of toxins,strengthening the body and eliminating toxins,in order to provide ideas for the clinical treatment of chronic liver disease.

Liver fibrosis and cirrhosis are the common outcomes of various chronic liver diseases after progression,and studies have shown that liver fibrosis and early liver cirrhosis can be reversed.Compound traditional Chinese medicine prescriptions have a marked therapeutic effect in reversing liver fibrosis and early liver cirrhosis,and their mechanism of action remains unclear.By reviewing related articles in China and globally,this article summarizes the six main phenotypic mechanisms involved in the efficacy of compound traditional Chinese medicine prescriptions,i.e.,inhibiting liver inflammation and regulating liver immune response,regulating hepatic stellate cell activation and extracellular matrix(ECM)generation,promoting ECM degradation,reversing hepatic sinusoidal capillarization,regulating hepatocyte regeneration,and regulating gut microbiota,and in addition,this article also analyzes the advances and shortcomings in current studies on each phenotype.Future studies on compound traditional Chinese medicine prescriptions should focus on experimental exploration and rescue experiments to verify the above phenotypes and further explore the upstream and downstream signaling pathways with a marked effect.This article aims to help clarify the direction and ideas of studies on the therapeutic mechanism of compound traditional Chinese medicine prescriptions,in order to provide a basis for clarifying the scientific essence of compound traditional Chinese medicine prescriptions.