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World Journal of Gastroenterology 2008年第47期14卷 7260-7263页

作者： Ling Lu Feng Zhang Xiang-Cheng Li Guo-Qiang Li Chuan-Yong Zhang Xue-Hao Wang Key Laboratory of LivingDonor liver Transplantation of Ministry of Public Health Department of Liver Transplantation the First AffiliatedHospital of Nanjing Medical University Nanjing 210029Jiangsu Province China

Portopulmonary hypertension(PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension,with or without advanced hepatic *** signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory *** signs of advanced liver disease can be observed in severe PPH,with ascites and lower extremity *** hypertension is usually diagnosed after anesthetic induction during liver transplantation(LT).We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic *** this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years,it was necessary to send him to the intensive care unit after *** study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

关键词：肺动脉高压肝移植门静脉高压肝硬化肝炎

Meta-analysis of the immunogenicity of standard and booster SARS-CoV-2 vaccination in patients with chronic liver disease and post-liver transplantation

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Portal Hypertension & Cirrhosis 2023年第2期2卷 61-77页

作者： Wen-Xin Wang Jitao Wang Rui Jia Silvia Martini Jiaye Liu Yifei Huang Fu-Sheng Wang Xiaolong Qi Junliang Fu Senior Department of Infectious Diseases The Fifth Medical Center of Chinese PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijingChina Peking University 302 Clinical Medical School BeijingChina CHESS-COVID-19 Group Xingtai People's HospitalXingtaiHebeiChina Department of Gastroenterology The 985th Hospital of Joint Logistic Support Force of Chinese PLATaiyuanShanxiChina Neonatal intensive Care unit AOU BolognaDepartment of Medical and Surgical Sciences(DIMEC)University of BolognaBolognaItaly CHESS Center Institute of Portal HypertensionThe First Hospital of Lanzhou UniversityLanzhouGansuChina Center of Portal Hypertension Department of RadiologyZhongda HospitalMedical SchoolSoutheast UniversityNanjingJiangsuChina

Aims:Patients with liver disease may exhibit higher infection rates and mortality rates from coronavirus disease 2019(COVID-19)than healthy individuals,and vaccination against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is an effective prevention *** metaanalysis aimed to assess the effectiveness and safety of SARS-CoV-2 vaccines in patients with chronic liver disease(CLD)and post-liver transplantation(LT).Methods:The PubMed,Embase,and Cochrane databases were searched.A random-effects model meta-analysis was used to determine the seropositivity rates of SARS-CoV-2 antibodies,odds ratio(OR)compared with healthy controls(HC),risk ratio(RR)between the booster and standard vaccination regimen,and the rate of adverse reactions(ADR).Results:In the standard vaccination regimen analysis,17 controlled articles were included for effectiveness analysis,and six articles for ADR *** pooled seropositivity rates of SARS-CoV-2 antibodies in patients with CLD and post-LT were 93.3%(95%confidence interval[CI]:89.0%-97.6%)and 69.1%(95%CI:63.0%-75.3%),*** rates were lower than those in HC(p<0.001).The differences remained significant after sorting by detection interval,vaccine type,antibody type,or CLD *** recipients showed much lower seropositivity rates of antibodies than patients with CLD(69.1%vs.93.3%)or HC(OR:0.055).The pooled total ADR rate of patients was 24.0%(95%CI:16.2%-31.8%).In the booster vaccination regimen analysis,11 prospective studies were enrolled,and the seropositivity rates of antibodies after the booster dose were increased by 27%compared with those of the standard vaccination regimen(RR:1.27,95%CI:1.15-1.41,p<0.001).Conclusion:Patients with CLD and post-LT can gain protection against COVID-19 from standard vaccines,demonstrating a potentially weaker immunogenic response than *** vaccines can compensate for this ***,patients with CLD and post-LT should be prioritized for receiving the COVI

关键词： COVID‐19 serological testing COVID‐19 vaccine booster shot COVID‐19 vaccines liver diseases liver transplantation

Distinct durability of IgM/IgG antibody responses in COVID-19 patients with differing severity

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Science China(Life Sciences) 2022年第1期65卷 223-226页

作者： Junyan Han Ning Zhang Danying Chen Yuhuan Gong Guoli Li Yaxian Kong Lin Pu Chen Chen Jingyuan Liu Qi Wang Ju Zhang Xuesen Zhao Juan Du Kai Han Chuan Song Linghang Wang Mingxi Hua Yu Hao Rui Song Yangzi Song Fengting Yu Siyuan Yang Haofeng Xiong Wei Zhang George F.Gao Fujie Zhang Ang Li Hui Zeng Yuhai Bi Beijing Key Laboratory of Emerging Infectious Diseases Institute of Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China CAS Key Laboratory of Pathogenic Microbiology and Immunology Institute of MicrobiologyCenter for Influenza Research andEarly-warning(CASCIRE)CAS-TWAS Center of Excellence for Emerging Infectious Diseases(CEEID)Chinese Academy of SciencesBeijing 100101China Institutes of Physical Science and Information Technology Anhui UniversityHefei 230601China intensive Care Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Center of liver Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Laboratory of Infectious Diseases Center of Beijing Ditan Hospital Capital Medical UniversityBeijing 100015China The Infectious Disease Diagnostic Therapeutic and Research CentersBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China Clinical Center for HIV/AIDS Clinical and Research Center of Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China University of Chinese Academy of Sciences Beijing 100049China

Dear Editor,The coronavirus disease 2019(COVID-19)pandemic is generating a demand for simultaneous vaccine development,which is expected to prevent future outbreaks by eliciting sufficient and protective immunity.

关键词： protective vaccine severity

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

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liver Research 2021年第4期5卷 209-216页

作者： Jianrong Liu Chao Yu Qing Yang Xiaofeng Yuan Fan Yang Panlong Li Guihua Chen Weicheng Liang Yang Yang Department of Hepatic Surgery and liver Transplantation Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Surgical and Transplant intensive Care unit The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Cell-gene therapy Translational Medicine Research Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Medical Examination Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Organ Transplantation Research Center of Guangdong Province The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Biotherapy Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Department of Infectious Diseases The People's Hospital of KashgarKashgarXinjiangChina Department of Infectious Diseases Xinjiang Medical UniversityUrumqiChina Organ Transplantation Institute of Sun Yat-sen University The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Guangdong Province Engineering Laboratory for Transplantation Medicine The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina

Background and aim:Coronavirus disease 2019(COVID-19)is a life-threatening disease that predomi-nantly causes respiratory *** impact of COVID-19 on other organs remains ***,we aimed to investigate the effects of COVID-19 on the hepatobiliary ***:In the current study,we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February *** detailed clinical features and laboratory findings were collected for *** analysis was conducted to evaluate the correlation between gamma-glutamyl transferase(GGT)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entry receptor angiotensin-converting enzyme 2(ACE2).Results:In this cohort,30(51.7%)patients had abnormal liver function on admission,which was asso-ciated with disease severity and enriched in the male and diabetic *** elevated levels of direct bilirubin(P¼0.029)and GGT(P¼0.004)were common in patients with severe pneumonia when compared with those with mild *** addition,elevated levels of GGT(P¼0.003)and aspartate aminotransferase(AST)(P¼0.007)were positively associated with longer hospital *** expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1 b(HNF1B).Conclusions:Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease *** to the consistent expression with ACE2,GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.

关键词： Coronavirus disease 2019(COVID-19) Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Gamma-glutamyl transpeptidase(GGT) Angiotensin-converting enzyme 2(ACE2) liver injury Bile duct injury

Impaired coagulation,liver dysfunction and COVID-19:Discovering an intriguing relationship

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World Journal of Gastroenterology 2022年第11期28卷 1102-1112页

作者： Damiano D'Ardes Andrea Boccatonda Giulio Cocco Stefano Fabiani Ilaria Rossi Marco Bucci Maria Teresa Guagnano Cosima Schiavone Francesco Cipollone “Clinica Medica”Institute Department of Medicine and Aging Sciences“G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy unit of Ultrasound “G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy

Coronavirus disease 2019(COVID-19)is,at present,one of the most relevant global health *** the literature hepatic alterations have been described in COVID-19 patients,and they are mainly represented by worsening of underlying chronic liver disease leading to hepatic decompensation and liver failure with higher *** potential mechanisms used by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)to cause liver damage have been ***-19 primary liver injury is less common than secondary liver *** of the available data demonstrate how liver damage in SARSCo V-2 infection is likely due to systemic inflammation,and it is less likely mediated by a cytopathic effect directed on liver ***,liver alterations could be caused by hypoxic injury and drugs(antibiotics and non-steroidal antiinflammatory drugs,remdesivir,tocilizumab,tofacitinib and dexamethasone).SARS-Co V-2 infection can induce multiple vascular district atherothrombosis by affecting simultaneously cerebral,coronary and peripheral vascular *** in the literature highlight how the virus triggers an exaggerated immune response,which added to the cytopathic effect of the virus can induce endothelial damage and a prothrombotic dysregulation of *** leads to a higher incidence of symptomatic and confirmed venous thrombosis and of pulmonary embolisms,especially in central,lobar or segmental pulmonary arteries,in *** are currently fewer data for arterial thrombosis,while myocardial injury was identified in 7%-17%of patients hospitalized with SARS-Co V-2 infection and 22%-31%in the intensive care unit *** data also revealed a higher occurrence of stroke and more serious forms of peripheral arterial disease in COVID-19 *** dysregulation is observed during the COVID-19 *** platelet count,mildly increased prothrombin time and increased Ddimer are typical laboratory features of patients with severe SAR

关键词： COVID-19 SARS-CoV-2 liver Coagulation

Sclerosing cholangitis secondary to bleomycin-iodinated embolization for liver hemangioma

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World Journal of Gastroenterology 2014年第46期20卷 17680-17685页

作者： Shuo Jin Xiao-Ju Shi Xiao-Dong Sun Si-Yuan Wang Guang-Yi Wang Department of Hepatobiliary and Pancreatic Surgery the First Norman Bethune Hospital Affiliated to Jilin University Department of Surgery intensive Care unit Beijing Chao-yang Hospital Affiliated to Capital Medical University

Sclerosing cholangitis(SC)is a rarely reported morbidity secondary to transcatheter arterial chemoembolization(TACE)with bleomycin-iodinated oil(BIO)for liver cavernous hemangioma(LCH).This report retrospectively evaluated the diagnostic and therapeutic course of a patient with LDH who presented obstructive jaundice 6 years after TACE with *** imaging identified a suspected malignant biliary stricture located at the convergence of the left and right hepatic *** exploration demonstrated a full-thickness sclerosis of the hilar bile duct with right hepatic duct stricture and right lobe *** hepatic hilar resection with right-side hemihepatectomy and Roux-en-Y hepaticojejunostomy was performed because hilar cancer could not be excluded on frozen *** results showed chronic pyogenic inflammation of the common and right hepatic ducts with SC in the portal *** SC is a long-term complication that may occur in LCH patients after TACE with BIO and must be differentiated from hilar *** duct plasty is a definitive but technically challenging treatment modality for secondary SC.

关键词： Sclerosing cholangitis Secondary Transcatheter art

Prevalence and clinical characteristics of autoimmune liver disease in hospitalized patients with cirrhosis and acute decompensation in China

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World Journal of Gastroenterology 2022年第31期28卷 4417-4430页

作者： Zi-Xuan Shen Dan-Dan Wu Jie Xia Xian-Bo Wang Xin Zheng Yan Huang Bei-Ling Li Zhong-Ji Meng Yan-Hang Gao Zhi-Ping Qian Feng Liu Xiao-Bo Lu Jia Shang Hua-Dong Yan Yu-Bao Zheng Wen-Yi Gu Yan Zhang Jian-Yi Wei Wen-Ting Tan Yi-Xin Hou Qun Zhang Yan Xiong Cong-Cong Zou Jun Chen Ze-Bing Huang Xiu-Hua Jiang Sen Luo Yuan-Yuan Chen Na Gao Chun-Yan Liu Wei Yuan Xue Mei Jing Li Tao Li Xin-Yi Zhou Guo-Hong Deng Jin-Jun Chen Xiong Ma Hai Li Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Shanghai Institute of Digestive Disease Key Laboratory of Gastroenterology and HepatologyChinese Ministry of HealthShanghai Jiao Tong UniversityShanghai 200001China Department of Infectious Diseases Southwest HospitalThe Third Military Medical University(Army Medical University)Chongqing 400038China Center of Integrative Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100102China Department of Infectious Diseases Institute of Infection and ImmunologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina Department of Infectious Diseases Hunan Key Laboratory of Viral HepatitisXiangya HospitalCentral South UniversityChangsha 410008Hunan ProvinceChina Hepatology unit Department of Infectious DiseasesNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Infectious Disease Taihe HospitalHubei University of MedicineShiyan 430418Hubei ProvinceChina Department of Hepatology The First Hospital of Jilin UniversityChangchun 130031Jilin ProvinceChina Department of liver intensive Care unit Shanghai Public Health Clinical CentreFudan UniversityShanghai 201508China Tianjin Institute of Hepatology Nankai University Second People’s HospitalTianjin 300102China Department of Infectious Diseases and Hepatology The Second Hospital of Shandong UniversityJinan 250033Shandong ProvinceChina Infectious Disease Center The First Affiliated Hospital of Xinjiang Medical UniversityUrumqi 830054XinjiangChina Department of Infectious Diseases Henan Provincial People’s HospitalZhengzhou 450003Henan ProvinceChina Department of Infectious Diseases Hwamei HospitalThe Second Hospital of NingboUniversity of Chinese Academy of SciencesNingbo 315153Zhejiang ProvinceChina Department of Infectious Diseases The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 5

BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is *** To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in *** We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic *** were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree ***-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the liver(EASL).Risk factors for death were analyzed with logistic regression *** In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,*** ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related *** etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate *** bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate *** development of ACLF during hospitalization only independently correlated to TB and international normalized *** AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the m

关键词： Prevalence Autoimmune liver disease Cirrhosis and acute decompensation Mortality Acuteon-chronic liver failure

Ischemic preconditioning enhances hepatocyte proliferation in the early phase after ischemia under hemi-hepatectomy in rats

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Hepatobiliary & Pancreatic Diseases International 2012年第5期11卷 521-526页

作者： Li-Ming Jin, Shui-Fang Jin, Yuan-Xing Liu, Lin Zhou, Hai-Yang Xie, Sheng Yan, Xiao Xu , Shu-Sen Zheng Department of General Surgery and intensive Care unit, First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou 310006, China Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Zhejiang Province, and Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China Department of General Surgery First Affiliated Hospital Zhejiang Chinese Medical University Hangzhou 310006 Hangzhou China intensive Care unit First Affiliated Hospital Zhejiang Chinese Medical University Hangzhou 310006 Hangzhou China Key Laboratory of Combined Multi-organ Transplantation Ministry of Public Health Key Laboratory of Organ Transplantation Zhejiang Province and Division of Hepatobiliary and Pancreatic Surgery First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 Hangzhou China

BACKGROUND: Ischemia/reperfusion (I/R) injury is an important barrier to liver surgery and transplantation because it impairs remnant liver/reduced-size-graft regeneration. Ischemic preconditioning (IPC), as an effective measure to overcome I/R injury, has been shown to enhance the regenerative capacity of hepatocytes. However, investigations have always focused on regeneration in the late phase after reperfusion. This study aimed to investigate whether IPC enhances hepatocyte proliferation in the early phase after reperfusion and possible underlying mechanisms. METHODS: A total of 90 rats were divided into three groups: hemi-hepatectomy alone (PHx group), 60 minutes of ischemia plus hemi-hepatectomy (I/R group), and a cycle of 10 minutes of alternating I/R prior to 60 minutes of ischemia plus hemi-hepatectomy (IPC group). Each group was divided into five subgroups sacrificed after 0.5, 2, 6, 12 or 24 hours (n=6/ subgroup). Subsequently, serum concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were measured; caspase-3 and proliferating cell nuclear antigen (PCNA) proteins were also determined by Western blotting. Furthermore, PCNA was detected by immunohistochemistry to identify the expression ***: Serum ALT and AST levels after 2-24 hours of reperfusion in the PHx and IPC groups were remarkably decreased compared to the I/R group, and the serum TNF-α was relatively lower. A significant increase of serum IL-6 levels was found in the PHx and IPC groups compared with the I/R group at each time point. Furthermore, PCNA expression was remarkably increased in the IPC group after 6-12 hours of reperfusion, and in the earlier 0.5 and 6 hours time points after reperfusion have shown the massive PCNA-positive hepatocytes. At the same time, the expression of liver p-JNK was higher in the IPC group in the early phase after reperfusion than that of the I/R group and its expre

关键词： reperfusion injury ischemic preconditioning hepatocytes proliferation hemi-hepatectomy

Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage

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World Journal of Gastrointestinal Surgery 2018年第4期10卷 40-48页

作者： Brendan T Everett Steven D Lidofsky Gastroenterology and Hepatology unit University of Vermont Medical Center

AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences *** We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. Demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.

关键词： liver cirrhosis Endoscopy Esophageal varices Secondary prevention Patient adherence

Acute-on-chronic liver failure：recent update

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The Journal of Biomedical Research 2017年第4期31卷 283-300页

作者： Azeem Alam Ka Chun Suen Daqing Ma Anaesthetics Pain Medicine and Intensive Care Department of Surgery and Cancer Faculty of Medicine Imperial College London Chelsea & Westminster Hospital London SW7 2AZ UK

Acute on chronic liver failure（ACLF） was first described in 1995 as a clinical syndrome distinct to classic acute *** by complications of decompensation,ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between45%and 90%.Despite the clinical relevance of the condition,it still remains largely undefined with continued disagreement regarding its precise etiological factors,clinical course,prognostic criteria and management *** is concerning that,despite our relative lack of understanding of the condition,the burden of ACLF among cirrhotic patients remains significant with an estimated prevalence of 30.9%.This paper highlights our current understanding of ACLF,including its etiology,diagnostic and prognostic criteria and *** is evident that further refinement of the ACLF classification system is required in order to detect high-risk patients and improve short-term mortality *** field of metabolomics certainly warrants investigation to enhance diagnostic and prognostic parameters,while the use of granulocyte-colony stimulating factor is a promising future therapeutic intervention for patients with ACLF.

关键词： acute liver failure acute decompensation of cirrhosis hepatorenal syndrome chronic hepatic encephalopathy systemic inflammation