Primary biliary cholangitis (PBC)is a commonly seen cholestatic liver disease.Currently,ursodeoxy-cholic acid (UDCA)is the only drug approved for the effective treatment of PBC.However,up to 40% of PBC patients had poor response to UDCA.Farnesoid X receptor (FXR)can inhibit the synthesis of bile acid,regulating the transport of bile acid and playing a role in anti-hepatic fibrosis.This article reviewed the role of FXR in treatment of PBC.

Osteoporosis is a common complication of primary biliary cholangitis (PBC) with a relatively high prevalence rate and a high risk of bone fracture.The pathogenesis of osteoporosis remains unknown.This article reviews the latest advances in the pathogenesis and treatment of osteoporosis in PBC.Studies have shown that osteoporosis in PBC has various causes,including increased bone absorption and reduced bone formation due to many factors.Although many drugs have been used in clinical practice,until now,bisphosphonates are still the most effective drugs.Long-term systematic studies are needed in the future to clarify their effects on fracture in PBC patients.

BACKGROUND: Adipokines are secreted by adipose tissue, including a series of cytokines and chemokines. Additionally, adipokines have been found to play certain roles in pro- and anti-inflammatory regulation. OBJECTIVE: To analyze the regulatory effect of various adipokines in the inflammatory process of autoimmune response and immune diseases, thus providing the strategy for controlling and treating autoimmune diseases and searching effective indexes for assessing disease development, incidence of complications and prognosis. METHODS: CNKI and PubMed databases were retrieved for the articles addressing the role of adipokines in autoimmune diseases published from 1986 to 2016 using the keywords of adipokine, autoimmune in English and Chinese, respectively. RESULTS AND CONCLUSION: Adipose tissue plays a critical role in metabolism regulation, and its effect on the immune system has emerged through a series of studies concerning adipokines regulating immune response. Adipokines exert various functions, and regulate metabolism and inflammation. In the development and occurrence of autoimmune diseases, some factors for immune responses remain unclear, and in-depth studies on adipokines will be helpful for lifting the veil of autoimmune diseases.

Fatigue is one of the most common symptoms of primary biliary cirrhosis (PBC) and greatly affects patients′ quality of life. The pathogenesis of fatigue in PBC remains unknown and there are no effective therapeutic methods. This article reviews the latest advances in the pathogenesis and treatment of fatigue in PBC. Studies have shown that the causes of fatigue in PBC include various central and peripheral factors, such as the changes in the brain, sleep disorders, depression, autonomic nervous dysfunction, and abnormal muscle metabolism. Modafinil does not have a definite therapeutic effect in fatigue in PBC. The causes and treatment of fatigue in PBC still need in-depth systematic studies.

At present, liver biopsy is the gold standard for the diagnosis and grading of liver fibrosis, but its limitations have been widely acknowledged. The non-invasive detection methods are needed in clinical practice, and at present, magnetic resonance elastography (MRE) is a hot research topic. This article reviews the advances in the clinical application of MRE in related fields, and studies have shown that MRE has a high diagnostic value due to its high sensitivity and specificity in the diagnosis and grading of liver fibrosis and an area under the receiver operating characteristic curve as high as 0.95. Compared with serological and other imaging diagnostic methods, MRE can determine fibrosis stage more accurately and has good reproducibility and objectivity. MRE can be widely applied in all patients except those with hemochromatosis, with special advantages in the diagnosis for patients with obesity and ascites, and can make up for the disadvantages of other methods. This article points out that MRE may become the best non-invasive method for the assessment of liver fibrosis, especially advanced fibrosis.

BACKGROUND/AIMS: To screen for serum protein/peptide biomarkers of hepatitis B virus (HBV)-associated chronic hepatic lesions in an attempt to profile the progression of HBV-associated chronic hepatic lesions using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) techniques. METHODS: Using SELDI-TOF MS, serum protein/peptide profiles on the CM10 ProteinChip arrays were obtained from a training group including 26 HBV-associated hepatocellular carcinoma patients with liver cirrhosis (LC), 30 HBV-associated LC patients, 85 patients at different stages of liver fibrosis, and 30 asymptomatic HBV carriers. The most valuable SELDI peak for predicting the progression to LC in HBV-infected patients was identified. RESULTS: A SELDI peak of M/Z 5805 with value for predicting LC in HBV-infected patients was found and was identified as a peptide of the C-terminal fraction of the fibrinogen alpha-chain precursor, isoform 1. CONCLUSIONS: The peptide of the C-terminal fraction of the fibrinogen alpha-chain precursor, isoform 1 with M/Z 5805, may be a serological biomarker for progression to LC in HBV-infected patients.
Adult ; Aged ; Biomarkers/*blood ; Carcinoma, Hepatocellular/*virology ; Disease Progression ; Female ; Hepatitis B virus ; Hepatitis B, Chronic/*blood/complications ; Humans ; Liver Cirrhosis/*blood/pathology/virology ; Liver Neoplasms/*virology ; Male ; Middle Aged ; Protein Array Analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Young Adult

To establish and manage of multicentral colection bio-sample banks of malignant tumors from digestive system, the paper designed a multicentral management system, established the standard operation procedures (SOPs) and leaded ten hospitals nationwide to colect tumor samples. The biobank has been established for half a year, and has colected 695 samples from patients with digestive system malignant tumor. The clinical data is ful and complete, labeled in a unified way and classified to be managed. The clinical and molecular biology researches were based on the biobank, and obtained achievements. The biobank provides a research platform for malignant tumor of digestive system from different regions and of different types.

Primary biliary cirrhosis (PBC)is an autoimmune disease.Ursodeoxycholic acid (UDCA)is the only safe and effective drug for the treatment of PBC,as proved by randomized controlled clinical trials,so it is advocated as first-line therapy.Alternative therapies are urgently needed for patients with poor response to UDCA.In addition to the efficacy of UDCA,the classification of alternative and adjuvant therapies for UDCA nonresponders and the latest research progress in these therapies are reviewed;the efficacy of existing drugs and treat-ment prospects are evaluated,but more long-term clinical studies are needed to confirm the efficacy of immunosuppressants such as budes-onide and etanercept and other drugs.A number of novel molecular therapies for PBC are also undergoing clinical trials.There is currently no consensus on the medical treatment for patients with poor response to UDCA.Although studies have shown that some drugs can improve liver function and liver biochemistries,there is no definitive evidence that they improve long-term outcome.

The education goal of 8-year medical students is to develop both clinical competence and to meet the needs of research and development. After the research ability questionnaires, we consider that these students have requirements the cultivation of research ability. We should formalize, organize the designed research training for them as soon as possible to make them become medical personnel with the ability to adapt to international competition as.

Long educational system is an effective form in training high-level medical talents.Doctor-patient communication skill is one of tbe basic qualifications for 8-year program medical students.Standardized patients can be applied in training and evaluating of the 8-year program medical students'ability to deal with doctor-patient relationship so as to cultivate their communication competence.