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As the beginning of the digestive tract, the mouth has a natural connection with the intestines and the liver. Oral diseases are also closely related to liver diseases. Periodontitis is the most common oral disease and its periodontal bacterial lesions often influence the prognosis and progression of liver disease through direct anatomical invasion and the oral-gut-liver axis. Periodontal bacteria can also affect the liver through damaged intestinal epithelium circulating through the portal vein. This article provided a systematic review of periodontitis, the oral-intestinal-hepatic axis, and liver disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stem cells play an important role in liver regeneration and self-repair ability, which is of great significance for clinical diagnosis and treatment of liver diseases. OBJECTIVE: To summarize the current clinical trials and basic research in this field in and outside China, review the types of stem cells used to treat liver diseases in the past, and the treatment programs of various types of stem cells for various types of liver diseases, outline the clinical application prospects of various types of stem cells in the future application of liver diseases, and provide a research basis for the treatment of clinical liver diseases. METHODS: Using “stem cells, mesenchymal stem cells, hepatic stem cell, embryonic stem cell, induced pluripotent stem cell, hematopoietic stem cell, hepatopathy, non-alcoholic fatty liver disease, liver cirrhosis, liver failure, autoimmune hepatitis, hepatocellular carcinoma” as search words, the relevant articles in PubMed, Web of Science and Wiley e-journal databases were searched, and 71 articles were selected for review according to the inclusion criteria. RESULTS AND CONCLUSION: (1) Mesenchymal stem cells, liver stem cells, embryonic stem cells, induced pluripotent stem cells and hematopoietic stem cells are the main stem cells for the treatment of liver diseases. The characteristics, expression period and application of these stem cells in differentiation after liver injury are summarized in this paper. (2) In general, mesenchymal stem cells can repair liver through exosomes, matrix metalloproteinase and anti-inflammatory response. Liver stem cells can differentiate liver oval cells and small hepatocellular progenitor cells to form mature liver cells and promote liver injury repair. Induced pluripotent stem cells, embryonic stem cells and hematopoietic stem cells can transform into mature hepatocytes through rapid proliferation and differentiation. (3) The treatment of various liver diseases by stem cells is mainly achieved by inducing endogenous cell proliferation, immune regulation, inhibiting inflammation, promoting liver cell regeneration and repairing damaged tissues. (4) On the whole, at present, mesenchymal stem cells are relatively easy to obtain, have the broadest application prospects, and do not involve ethical issues. They are transforming from preclinical research to clinical research. Because mesenchymal stem cells can differentiate into various adult stem cells, they have the advantages of low immunogenicity, strong self-proliferation and differentiation ability. Especially for the treatment of immune hepatitis, liver cirrhosis and hepatocellular carcinoma and other liver diseases, mesenchymal stem cells have the most ideal effect. (5) Induced pluripotent stem cells are more effective in the treatment of end-stage liver disease because they can differentiate into specific somatic cells and hepatocytes without immune rejection. (6) However, stem cell transplantation can induce acute rejection, such as diarrhea, jaundice, and skin rashes. Poor histocompatibility between donors and recipients can easily lead to adverse reactions such as graft-versus-host reactions. After stem cell transplantation, the use of stem cells and its clinical safety assessment still need the support of more clinical trials and evidence-based medicine data. [ABSTRACT FROM AUTHOR]

Cell signaling pathway refers to the process that extracellular factors combine with membrane receptors and nuclear receptors to lead to the interaction and biochemical process of a series of proteins in cells so that the genes to be expressed in cells begin to form various biological effects.Hepatic stellate cell（HSC） is an important protective barrier of human liver.For example, when liver injury factors invade in the external environment, HSC will be activated immediately and quickly change from the original static state to the activated state.However, in the process of activation, the body participates in a large number of cells and cytokines, which interact and transform each other, resulting in further aggravation of fibrosis in hepatocytes.Many previous experimental studies have shown that the action mechanism of anti-hepatic fibrosis drugs is multi-level cross regulation, which is a very complex network system.It can inhibit the activation and proliferation of HSC from a variety of signal pathways, so as to inhibit hepatic fibrosis, and inhibit the overall process of liver cirrhosis.This paper summarized seven signaling pathways involved in the study of HSC activation.With the help of the study of HSC activation and proliferation, this paper explored the effect and treatment process of hepatic fibrosis caused by HSC activation and proliferation under the action of signaling pathway. [ABSTRACT FROM AUTHOR]

BACKGROUND: Apelin is an endogenous ligand of putative receptor protein related to angiotensin II type 1 receptor (APJ), with multiple subtypes, each of which has different biological activities. In recent years, it has been discovered that Elabela is another ligand of APJ, which plays a key role in the development of the heart and differentiation of the endoderm. Elabela is different from Apelin in time point and area. OBJECTIVE: To focus on the therapeutic effects and mechanisms for specific diseases based on a large amount of literatures regarding the structure and function of Apelin and Elabela. METHODS: Relevant literature searches were conducted in PubMed, CNKI, WanFang Full-text Database, and VIP database. The time limit was from 1993 to 2020. The search terms were “Apelin, Elabela, nervous system, lung disease, high blood pressure, insulin resistance” in English and Chinese, respectively. Abstracts and conclusions were initially screened, and irrelevant literatures were excluded. Finally, 76 literatures were included for results analysis. RESULTS AND CONCLUSION: Apelin has the effects of relieving pain, reducing lung damage, regulating blood pressure, inhibiting gastric acid secretion, diuresis, reducing insulin resistance, increasing immunity, anti-aging, etc. Elabela is involved in angiogenesis, embryonic development, endoderm differentiation, etc. Both of them are expected to become a therapeutic target for circulatory system, nervous system, and heart diseases, and provide new ideas for the initial prevention of diseases in clinic [ABSTRACT FROM AUTHOR]

慢性乙型肝炎（CHB）可进一步发展为肝硬化和肝癌,患病人数众多,是全球重大的公共卫生问题,其发病机制十分复杂。乙型肝炎（乙肝）病毒（HBV）感染机体后刺激机体产生大量各种细胞因子并参与了乙肝的发病。细胞因子信号传导抑制因子（SOCS）蛋白家族是细胞因子信号的负调节因子,细胞因子诱导的SH2蛋白和SOCS1～7 8个成员均拥有可变长度和高度可变氨基酸序列的N-末端区域,中心的SH2结构域及C-末端同源区域即SOCS盒,通过与磷酸化Janus激酶结合,从而抑制Janus激酶/信号转导与转录激活因子信号通路最终调节细胞因子信号。SOCS1/3是SOCS家族中结构及功能相似的成员,参与了大部分细胞因子信号的调节,其功能失调可导致感染性疾病、炎症性疾病、自身免疫性疾病、肿瘤等发生。SOCS1/3水平异常可导致乙肝相关性肝炎、肝纤维化、肝硬化,甚至肝癌疾病进展,对HBV更易感,导致乙肝慢性化;其也可通过影响干扰素水平进而影响抗HBV疗效。该文主要对SOCS1/3与CHB疾病进展及抗病毒治疗疗效的关系进行综述。 [ABSTRACT FROM AUTHOR]

Liver fibrosis is a necessary stage in the development of chronic liver diseases to liver cirrhosis. Liver cirrhosis is the end-stage change of various chronic liver diseases, and early diagnosis of liver fibrosis has an important value in timely treatment and prognosis. At present, liver biopsy, ultrasound, computed tomography, and magnetic resonance imaging are the main diagnostic methods for liver fibrosis and cirrhosis. Liver biopsy is the gold standard for the diagnosis of liver fibrosis and cirrhosis, but its clinical application is limited by invasiveness and sample error. Conventional noninvasive methods cannot meet the requirements for the diagnosis of liver fibrosis and cirrhosis. Therefore, searching for new serological markers for liver fibrosis and cirrhosis has become a research hotspot. Related studies have shown that serum Golgi protein 73 (GP73) can be used as a serum marker for the diagnosis of liver fibrosis and cirrhosis and has high clinical value. This article reviews the commonly used methods for the diagnosis of liver fibrosis and cirrhosis and elaborates on the biological characteristics of GP73 and its value in the diagnosis of liver fibrosis and cirrhosis. [ABSTRACT FROM AUTHOR]

Esophageal variceal bleeding is a serious complication of liver cirrhosis. Endoscopic therapy is a main method for the prevention and treatment of esophageal variceal bleeding, which includes endoscopic variceal ligation, sclerosing agent injection, endoscopic ultrasound-guided injection of sclerosing agent, tissue adhesive injection, self-expandable covered metallic stent, and combination treatment. This article reviews the indications, clinical effect, and complications of these endoscopic therapies. [ABSTRACT FROM AUTHOR]

Hepatic encephalopathy (HE) is an important indicator of decompensated cirrhosis and is one of the most common causes of death. With the development of research on gut microbiota in patients with liver cirrhosis in recent years, the role of gut microbiota in the pathogenesis of HE has attracted wide attention. At present, next-generation sequencing has deepened the understanding of the composition and function of gut microbiota among researchers, and HE treatment targeting gut microbiota has achieved remarkable results. The research on gut microbiota helps to further clarify the pathogenesis of HE and may provide more treatment methods for patients with HE. [ABSTRACT FROM AUTHOR]

Liver transplantation is considered the best method for the treatment of liver cirrhosis, but its clinical application is limited by the shortage of liver donors, high costs, and immunological rejection. In recent years, bone marrow stem cells ( BMSCs) has shown great prospects in the treatment of liver cirrhosis. Recent clinical studies have shown that BMSC therapy is a safe and effective treatment method for liver cirrhosis, but its mechanism remains unclear, and there are various treatment regimens. 'I'his article reviews the mechanism of BMSCs in the treatment of liver cirrhosis, route of BMSC delivery, indices for therapeutic effect evaluation, and dose of BMSCs. [ABSTRACT FROM AUTHOR]

As the disease progresses, there is a significant change in the body composition of patients with liver cirrhosis, and sarcopenia is one of the common complications in liver cirrhosis, especially in decompensated cirrhosis. About 30% —70% of patients with liver cirrhosis have sarcopenia, which greatly affects patients’ survival and is closely associated with the development of hepatic encephalopathy. Sarcopenia may also increase the risk of infection. Sarcopenia and muscle fatty degeneration can be used as poor prognostic indicators of hepatocellular carcinoma and may increase the risk of recurrence of liver cancer. This article reviews the research advances in the definition of sarcopenia, the association of sarcopenia with liver cirrhosis, arid assessment and clinical management of sarcopenia. [ABSTRACT FROM AUTHOR]

Liver cirrhosis is a progressive chronic liver disease due to one or more causes, with diffuse fibrosis in liver tissue, pseudolobules, and regenerative nodules as major histological features. Once liver cirrhosis enters the decompensated stage, the liver and several other organs are injured, which can hardly be recovered or reversed. This article introduces the process of Toll — like receptors in recognizing the changes in intestinal flora and the influence of this process on the development and progression of liver cirrhosis, as well as the protective effect of bile acid against liver cirrhosis by regulating intestinal flora. This article also reviews the advances in delaying liver cirrhosis after the treatment of intestinal dysbacteriosis and points out that the treatment of intestinal dysbacteriosis may become the major direction of liver cirrhosis treatment in future. [ABSTRACT FROM AUTHOR]

Liver fibrosis is a dynamic process regulated by many factors. An increasing number of evidence has shown that adipokines transmit dynamic functions in the liver and are involved in the regulation of liver fibrosis. This article reviews the research on major adipocytokines (adiponectin and leptin) involved in liver fibrosis and the recent advances in the mechanism of action of these adipocytokines in liver fibrosis. [ABSTRACT FROM AUTHOR]

Liver biopsy is the most sensitive and specific method for the diagnosis and staging of liver fibrosis, but its invasiveness and limitations have promoted the wide application of noninvasive evaluation methods for liver fibrosis in clinical practice in recent years. Various studies have proved the diagnostic efficiency of transient elastography (TE) in chronic liver diseases of various etiologies, such as viral hepatitis, nonalcoholic fatty liver disease, alcoholic liver disease, and autoimmune liver disease, especially in liver fibrosis and liver cirrhosis, and therefore, it has been incorporated into clinical practice guidelines in many countries. However, the diagnostic efficiency of TE in liver fibrosis is affected by several factors including aminotransferases, bilirubin, liver inflammation, and steatosis. Several noninvasive methods should be used in combination based on etiology to improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Anti-mitochondrial antibody (AMA) is a typical serum marker for primary biliary cholangitis (PBC), and the diagnosis of AMA-negative PBC may easily be neglected in clinical practice. This article analyzes the differences in epidemiology, clinical and pathological features, and treatment outcome between AMA-negative and AMA-positive PBC and points out that there are significant differences between them in the symptom of pruritus, immunoglobulin M, and severity of bile duct injury. For patients with a clinical diagnosis of AMA-negative PBC, immunofluorescence assay combined with immunological detection should be performed to exclude the false-negative result of AMA, and a confirmed diagnosis can be made with reference to the manifestation of cholestasis, positive results of anti-sp100, anti-gp210, and anti-ANA antibodies, and typical hyperactive cholangitis based on pathological examination. Differential diagnosis of this disease with other types of bile duct injury or absence of bile duct should be taken seriously in clinical practice. [ABSTRACT FROM AUTHOR]

Besides related etiologies, portal hypertension (PHT) is considered an important physiological link in promoting liver dysfunction. Literature review has shown that compared with the conventional drugs for the prevention and treatment of PHT, simvastatin can induce the expression of Kruppel-like factor-2 and nitric oxide to improve liver function and reduce cirrhotic portal venous pressure. Related analysis shows that simvastatin can be widely used in clinical practice to improve portal vein hemodynamics in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Liver fibrosis is a dynamic pathological process characterized by excessive deposition of extracellular matrix (ECM) or hyperplasia of scar tissue. The activation of hepatic stellate cells (HSCs) is generally considered the central link in the formation of liver fibrosis. HSC activation is regulated by various factors in liver microenvironment, including physical and chemical stimulations and intercellular interactions. Intrinsic cells and immune cells in the liver and HSCs together establish a complex regulatory system to regulate HSC activation and regression. This article introduces the regulatory effect of the cells in liver microenvironment on HSC activation, in order to expand thinking for the research on new diagnosis and treatment methods for liver fibrosis. [ABSTRACT FROM AUTHOR]

Transjugular intrahepatic portosystemic shunt (TIPS) is an important method for the treatment of cirrhotic portal hypertension; however, its clinical application is limited by postoperative complications such as liver failure and hepatic encephalopathy. This article summarizes and analyzes the research advances in the clinical value of serological markers, clinical indices, and scoring systems in prognostic e-valuation of TIPS. Indices can be selected or comprehensive evaluation can be performed based on clinical situations. in order to improve patients ' postoperative survival rate. [ABSTRACT FROM AUTHOR]

Liver fibrosis is a common pathological process in the progression of various chronic liver diseases to liver cirrhosis and liver cancer, and liver biopsy with the highest accuracy in diagnosis cannot be used as a routine examination due to several drawbacks. This article introduces several serological and imaging methods used in clinical practice and analyzes their advantages/disadvantages and the current status of research. It is believed that thanks to the efforts of experts and scholars. noninvasive diagnostic methods have become more and more important and may replace liver biopsy and become an effective method for the diagnosis of liver fibrosis in the near future. [ABSTRACT FROM AUTHOR]

Hepatitis B cirrhosis is a chronic progressive disease caused by hepatitis B virus ( HBV) infection and has various complications such as upper gastrointestinal bleeding, hepatic encephalopathy, and hepatorenal syndrome, and it may progress to liver cancer and even cause death in severe cases. In addition, HBV infection is also a high risk factor for renal injury, and patients with HBV infection had a higher incidence rate of renal injury than those without HBV infection. Renal injury does great harm to patients with hepatitis B cirrhosis, and some patients even have renal failure, with poor prognosis and high mortality. In recent years, hepatitis B cirrhosis with renal injury has become a research hotspot. This article briefly describes the research advances in the indices for hepatitis B cirrhosis with renal injury, compares the influence of different nucleotide analogues on renal function during antiviral therapy, and summarizes how to adjust the medication for patients with renal injury. It is pointed out that early identification and reasonable evaluation of renal function in patients has important clinical significance. [ABSTRACT FROM AUTHOR]

Liver cirrhosis is common in clinical practice and is the common clinical outcome of various chronic liver diseases including chronic hepatitis C virus ( HCV ) infection. Before the development of direct - acting antiviral agents ( DAAs), anti - HCV therapy based on pe-gylated interferon ( PEG - IFN. ) and ribavirin ( KBV ) has a poor clinical effect due to the presence of liver cirrhosis, and decompensated liver cirrhosis itself is an absolute contraindication for PKC - 1K.\ treatment. DAAs have gradually become the first - line drug for HCV infection, and many studies have shown that DAAs have good clinical effects and tolerability in the treatment of cirrhotic patients with HCV infection. On the one hand. DAAs have better clinical effect and safety than PKC - 1KN/BBV in patients with compensated liver cirrhosis; on the other hand. patients with decompensated liver cirrhosis are tolerant to DAAs, and although they have a lower proportion of patients with sustained virologic response than normal patients, they can still benefit from DAAs from many aspects. This article reviews the latest research advances in DAAs in patients with HCV -related liver cirrhosis, in order to provide a reference for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Liver cirrhosis is an end-stage fibrotic disease of chronic liver injury induced by various factors. Many studies have shown that gut microbiota (GM) are involved in the development and progression of liver cirrhosis and related complications, such as portal hypertension, hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatocellular carcinoma. In addition, impaired intestinal barrier, compromised liver immunity, and bacterial translocation play a critical role in the progression of liver cirrhosis. This article summarizes the role of GM in liver cirrhosis and related complications and research advances and problems in GM as a therapeutic target, in order to provide new thoughts for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Liver fibrosis has a complex pathogenesis and involves various intracellular and extracellular signal transduction pathways, but its specific pathogenesis remains unclear. Recent studies have confirmed that the activation of hepatic stellate cells due to abnormal activation of the Wnt signaling pathway is an important cause of liver fibrosis, and targeted inhibition of the Wnt signaling pathway can prevent the activation and proliferation of hepatic stellate cells and thus achieve an antifibrogenic effect. This article reviews the role of the Wnt signaling pathway in the development and progression of liver fibrosis and the latest research advances in the antifibrogenic effect of the interference of the Wnt signaling pathway, in order to provide new ideas for anti-hepatic fibrosis and the delay of early-stage cirrhosis. [ABSTRACT FROM AUTHOR]

The presence of gastroesophageal varices (GOV) is one of the independent risk factors for the death of patients with chronic liver diseases, and at present, non-selective β-blockers or endoscopic treatment is recommended for the prevention of variceal bleeding in patients with chronic liver diseases at a high risk of GOV. This article describes the latest advances in the noninvasive diagnosis of GOV in patients with liver cirrhosis with the help of ultrasound elastography and points out that although new techniques such as shear wave elastography have improved screening performance, a single examination is not sufficient for clinical practice. A combination of various examinations may be more efficient and is worthy of further exploration. [ABSTRACT FROM AUTHOR]

At present, non-alcoholic fatty liver disease (NAFLD) has become the major cause of chronic liver disease in the world and is considered a common pathogenic factor of cryptogenic cirrhosis. In clinical practice, NAFLD is commonly seen in obese patients; however, it is not rare among non-obese individuals, especially in the Asian population. Non-obese NAFLD patients have similar metabolic profiles to obese NAFLD patients, but many studies have revealed that compared with obese NAFLD, non-obese liver fibrosis and liver cirrhosis have unique features. This article reviews the research advances in the pathogenesis and risk factors of non-obese non-alcoholic fatty liver fibrosis and liver cirrhosis in recent years, in order to gain a better understanding of the prevention, diagnosis, and treatment of this disease. [ABSTRACT FROM AUTHOR]

Autophagy is a process of lysosome degradation and has a dual role in the development and progression of diseases, i.e., it can promote cell survival and induce cell death. This article introduces the dual role of autophagy in hepatitis B virus (HBV), chronic hepatitis B, liver fibrosis, and hepatocellular carcinoma and the mechanism of action of autophagy in related liver diseases. It is pointed out that autophagy may be a future research direction for the treatment of HBV-related liver diseases and can provide new ideas for the treatment of liver fibrosis and hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Autoimmune liver diseases mainly include autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and various types of overlap syndromes and are often associated with extrahepatic autoimmune diseases. However, few studies have described the association of autoimmune liver diseases with rheumatic disease and/or skin disease. For this purpose, this article reviews the rheumatic and skin manifestations associated with autoimmune liver diseases in detail and the clinical significance of non-specific antibodies. It is pointed out that individualized treatment should be given to patients with rheumatic disease and/or skin disease. [ABSTRACT FROM AUTHOR]

Nonalcoholic steatohepatitis is a progressive disease that can lead to hepatic fibrosis, liver cirrhosis, and liver cancer, and its early diagnosis is of great significance for delaying disease progression. In recent years, more and more serological markers and models have been found, and the application models based on the combination of various indicators have been updated; these models have a certain diagnostic efficiency for both nonalcoholic steatohepatitis and hepatic fibrosis. This article reviews the research on serological noninvasive diagnosis of nonalcoholic steatohepatitis and hepatic fibrosis. [ABSTRACT FROM AUTHOR]

Patients with decompensated cirrhosis often have varying degrees of portal hypertension, and when portal pressure reaches a certain threshold, various clinical complications may occur and even threaten patients′ lives. Therefore, portal pressure assessment is important for the clinical management and prognosis of such patients. Due to the anatomical characteristics of the portal vein, it is difficult to measure portal pressure directly. At present, hepatic venous pressure gradient is used to replace portal pressure in China and foreign countries. However, the measurement of hepatic venous pressure gradient is an interventional procedure and is difficult to perform in clinical practice. Therefore, noninvasive assessment of portal hypertension has become a research hotspot. This article reviews the research advances in the roles of serum markers, ultrasound elastography, computed tomography, and magnetic resonance imaging/magnetic resonance elastography in noninvasive assessment of portal hypertension. [ABSTRACT FROM AUTHOR]

Patients with liver cirrhosis often die of complications, among which hepatic encephalopathy is the primary cause of death and upper gastrointestinal bleeding is the most common complication of liver cirrhosis. In recent years, with the continuous progress in the research on intestinal flora and inflammatory response in patients with liver cirrhosis, rifaximin, a selective oral antibacterial agent, has attracted more and more attention in China and foreign countries. This article analyzes the studies on rifaximin in the treatment of complications associated with liver cirrhosis, in order to provide reasonable suggestions for subsequent studies and clinical practice. [ABSTRACT FROM AUTHOR]

There are various risk factors for esophagogastric variceal bleeding (EVB) in patients with liver cirrhosis, such as portal hypertension, thrombosis and blood coagulation in the ruptured blood vessel, sclerotic region or number of ligation points, internal environment, degree of risk of malnutrition, Child-Pugh class, the extent of varices, red color sign, severity of bleeding, and diameter of the portal vein. This article reviews the current status of research on risk factors for EVB in patients with liver cirrhosis and classifies such factors into primary and secondary risk factors, and it is pointed out that portal venous pressure, ability of rapid thrombosis in the ruptured blood vessel, presence or absence of emergency treatment, internal environment, degree of risk of malnutrition, and hepatic functional reserve are predominant risk factors for esophagogastric variceal rebleeding in patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]

Present studies on organ fibrosis including liver fibrosis show that coagulation factors and inflammatory response promote the progression of organ fibrosis, which makes people to be aware of the fact that the change in coagulation factors is not only a secondary event to liver fibrosis, and coagulation factors also play an important role in the development and progression of liver fibrosis. Recent studies have shown that most of the coagulation factors with thrombotic tendency promote liver fibrosis, while those with bleeding or hemolytic tendency inhibit liver fibrosis. Anticoagulant therapy can significantly improve or alleviate liver fibrosis, and therefore, it may provide a direction for the treatment of liver fibrosis in future. This article reviews the research advances in the role of coagulation factors in liver fibrosis. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B virus (HBV) infection can lead to varying degrees of liver fibrosis, which is an important pathological basis of liver cirrhosis. The incidence of end-stage liver diseases such as liver cirrhosis and hepatocellular carcinoma can be reduced by controlling and even reversing liver fibrosis. After achieving virologic response (VR) to long-term anti-HBV therapy, patients with chronic HBV infection have resolution of inflammation, varying degrees of reversal of liver fibrosis and even liver cirrhosis, or even complete recovery of normal liver structure, but the specific mechanism and influencing factors remain unclear. This article reviews the recent studies on the reversal of liver fibrosis/cirrhosis after achieving VR in patients with chronic HBV infection, and summarizes the influencing factors for reversal of liver fibrosis/cirrhosis in patients with chronic HBV infection after antiviral therapy, including age, sex, host factors, viral factors, therapeutic factors, and metabolic factors, but a lot of factors still await further investigation. [ABSTRACT FROM AUTHOR]

Cirrhotic patients often have an increased cardiac load and impaired myocardial systolic and diastolic functions, which further cause abnormal myocardial structure, and such patients may develop the symptoms of heart failure under stress, which is called cirrhotic cardiomyopathy (CCM). This disease attracts little attention due to its insidious onset. B-type natriuretic peptide (BNP) is secreted by cardiomyocytes and can sensitively reflect the change in ventricular function, and it is widely used in the pathogenesis, treatment, and prognosis of cardiovascular diseases. BNP plays an important role in the diagnosis and treatment of respiratory and renal diseases, and meanwhile, recent studies have shown a significant increase in BNP in cirrhotic patients, which is closely associated with the severity of cirrhotic ascites, varices, and liver dysfunction. BNP can also reveal myocardial injury when there are no obvious symptoms of CCM. This article reviews the expression of BNP and its significance in patients with CCM. [ABSTRACT FROM AUTHOR]

With the action of various chronic factors for liver injury, hepatic stellate cells ( HSCs) are activated and transformed to myofibroblasts ( MFBs) and then migrate to the injured part and secrete a large amount of extracellular matrix ( ECM ). Excessive deposition of ECM in the liver causes liver fibrosis. The elimination of factors for liver injur)’ or effective treatment helps to achieve liver fibrosis regression. This article introduces the types of cells involved in liver fibrosis regression. MFBs play an important role liver fibrosis regression via senescence, apoptosis, and inactivation; macrophages exert an anti - fibrosis effect by accelerating ECM degradation and inducing MFB senescence; liver sinusoidal endothelial cells help to achieve liver fibrosis regression by maintaining its normal phenotype; natural killer cells are involved in liver fibrosis regression by killing the early activated HSCs and senescent MFBs. [ABSTRACT FROM AUTHOR]

Acute - on - chronic liver failure ( ACLF) is commonly seen in China and has a complex pathogenesis , difficult clinical treatment , and poor prognosis. ACLF has become a hot topic in the research on liver diseases in recent years. This article elaborates on the research advances in ACLF in China and foreign countries from the aspects of the definition, etiology, prognostic evaluation, and treatment regimens of ACLF, in order to provide new ideas and methods for clinical diagnosis and treatment, reduce mortality rate, and improve the clinical outcome of patients with ACLF. [ABSTRACT FROM AUTHOR]

Nuclear factor - kappa B ( NF - kB ) plays an important role in various physiological and pathological processes by regulating gene expression, such as cell survival. growth, proliferation, activation, and apoptosis. In particular, the NF - kB signaling pathway has an important regulatory' effect on die progression of hepatic fibrosis. This article reviews the structure and function of NF - kB , die regulatory' effect of NF - kB on hepatoeytes, Kupffer cells, and hepatic stellate cells in the progression of hepade fibrosis . and the anti - fibrotie mechanism of traditional Chinese medicine by regulating the activity of the NF - kB signaling pathway. We also point out die complex interaction between NF - kB and various types of cells in certain diseases and emphasize the clinical significance of traditional Chinese medicine in inhibiting the activity of NF - kB and alleviating hepatic fibrosis. [ABSTRACT FROM AUTHOR]

Cell senescence is a basic cell response triggered by various stimuli and is a basic characteristic of living organism. Liver fibrosis refers to the pathological process of diffuse excessive deposition of extracellular matrix in the liver caused by abnormal proliferation of connective tissue due to various pathogenic factors and can progress to liver cirrhosis and liver cancer. Studies have shown that cell senescence is closely associated with the progression of liver fibrosis. This article reviews the regulatory, effect of different types of cell senescence on liver fibrosis. [ABSTRACT FROM AUTHOR]

Studies have shown that liver fibrosis and some cases of early liver cirrhosis can be reversed, and thus a timely, accurate judgment of fibrosis degree has important clinical significance in prevention/treatment and prognostic evaluation of chronic liver diseases. In recent years, great achievements have been made in the application of serum markers and transient elastography for the evaluation of liver fibrosis. This article introduces the value of serological markers and related models in evaluating liver fibrosis, including CHI3L1, GP model, Forns, APRI, and FIB-4 index, and reviews the advances in the application of transient elastography in determining fibrosis stage in patients with chronic liver diseases. It is pointed out that a combination of these two methods has a high value in evaluating fibrosis degree. [ABSTRACT FROM AUTHOR]

Portal vein thrombosis (PVT) refers to the formation of thrombus within the portal vein or its branches, the splenic vein, or the superior mesenteric vein. PVT is a common complication after splenectomy in patients with portal hypertension and may lead to liver injury., upper gastrointestinal bleeding, hepatic coma, and even ischemic intestinal necrosis. Therefore, early identification and effective intervention of PVT play an important role in reducing the mortality of PVT patients. This article reviews the risk factors for PVT after splenectomy in cirrhotic patients and the treatment of PVT and points out that effective intervention should be performed for PVT as early as possible. [ABSTRACT FROM AUTHOR]

Extracellular vesicles (EVs) are membrane-bound vesicles released by cells into the extracellular environment and can selectively enrich specific proteins and RNA and mediate intercellular communication. Therefore, EVs have the potential of a biomarker for diseases, a therapeutic target, and a delivery vector. This article reviews the research advances in the role of EVs in viral hepatitis, liver fibrosis, and liver cancer and emphasizes the prospects of EVs in liver diseases. [ABSTRACT FROM AUTHOR]

Carvedilol is a new non - selective beta blocker, and studies have proven that the effect of carvedilol in receptor blocking is 2 — 4 times that of propranolol. Carvedilol is widely used in the treatment of heart failure. However, there are still controversies over its effect in reducing portal pressure and preventing esophageal variceal bleeding. This article analyzes and compares the clinical application of carvedilol, propranolol, and endoscopic variceal ligation in the prevention and treatment of bleeding and summarizes the pharmacological action, clinical effect, dose, and adverse reactions of carvedilol. It is pointed out that carvedilol can significantly improve hemodynamic disorder caused by portal hypertension and thus may become a new drug for the prevention and treatment of esophageal variceal bleeding. [ABSTRACT FROM AUTHOR]

Patients with cirrhotic portal hypertension tend to develop multiple organ dysfunction and have special requirements for anesthetic management, which involves disorders in the metabolism of anesthetics, hyperdynamic circulation, perioperative hypoxemia, coagulation disorder, bleeding, thrombosis, and hepatic encephalopathy, and thus it becomes a difficult issue in the work of anesthesiologists. This article reviews the anesthetic management strategies for cirrhotic portal hypertension, in order to provide an effective reference for optimization of perioperative anesthetic management. [ABSTRACT FROM AUTHOR]

It is very important to find suitable serum markers which can accurately identify chronic hepatitis B (CHB) - related liver fibrosis. This article summarizes the differentially expressed serum microRNAs (miRNAs) in the process of CHB - related liver fibrosis. The analysis shows that with the development of liver fibrosis, there are increases in the serum levels of miR -33a, miR - 185, and miR -222 and reductions in the serum levels of miR - 122, miR - 29, and miR -27b. It has been found that miRNAs such as miR - 185 and miR -122 measured alone or in combination with other indices have a certain clinical value in the diagnosis of CHB - related liver fibrosis. It is pointed out that further research should be conducted for differentially expressed serum miRNAs which have a certain value in the diagnosis of CHB - related liver fibrosis. [ABSTRACT FROM AUTHOR]

Portal hypertensive gastropathy (PHG) has a high incidence rate in cirrhotic patients, leading to a high risk of upper gastrointestinal bleeding. Gastric mucosal injury is the major pathological change of PHG. There are few studies focusing on the clinical application of antacids in the treatment of PHG in cirrhotic patients and there are still controversies over this issue. This article reviews the influencing factors for PHG, the mechanism of gastric mucosal injury, and the application of antacids. It is pointed out that during the treatment of PHG, besides the reduction in portal venous pressure, the application of antacids such as proton pump inhibitors can improve the cure rate of PHG. Prospective randomized control trials with a large sample size are needed to further demonstrate the clinical effect and safety of antacids in the treatment of PHG in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Non-selective β-blockers (NSBBs) can effectively reduce hepatic venous pressure gradient (HVPG), and are the first-line drugs for primary and secondary prevention of liver cirrhosis complicated by esophagogastric variceal bleeding. In addition, NSBBs can alleviate inflammatory response in patients with severe liver diseases. However, there are still controversies over the use of NSBBs in patients with liver cirrhosis complicated by intractable ascites, primary bacterial peritonitis, or kidney dysfunction. Therefore, NSBBs have a window period in the prevention of esophageal variceal bleeding with varying doses. Moreover, NSBBs have cardiogenic or non-cardiogenic side-effects, and thus side-effects should be closely monitored and the dose should be adjusted. This article reviews the latest research advances in NSBBs in preventing esophagogastric variceal bleeding. [ABSTRACT FROM AUTHOR]

Hepatic fibrosis is the common pathological basis of various chronic liver diseases. Liver biopsy remains the gold standard for the assessment and diagnosis of liver fibrosis, but its invasiveness and high requirements for operation limit its clinical application. This article introduces the development of noninvasive diagnosis of hepatic fibrosis, such as serological and imaging techniques. However, these methods cannot completely replace liver biopsy. Therefore, a comprehensive noninvasive diagnosis model for hepatic fibrosis has become a research hotspot. [ABSTRACT FROM AUTHOR]

Formation of liver fibrosis mainly involves activation of hepatic stellate cell and imbalance between synthesis and degradation of extracellular matrix. The sphingosine kinase (SphK)/sphingosine 1 - phosphate (SlP)/sphingosine 1 - phosphate receptors (S1PRs) signaling pathway plays an important role in the regulation of cell life activities including proliferation, migration, and inflammatory response. This article introduces the distribution and biological functions of SphK, S1P, and S1PRs and elaborates on the research advances in mechanism of action of the SphK/S1P/and S1PRs signaling pathway in liver fibrosis. Many studies have confirmed the important role of the SphK/ S1P/and S1PRs signaling pathway in liver fibrosis, and in - depth exploration helps to provide new thoughts for clinical treatment of liver fibrosis and development of new drug targets. [ABSTRACT FROM AUTHOR]

Recent studies have shown that complications of cirrhotic portal hypertension often involve multiple organs, which is called multi¬ple organ dysfunction syndrome by some scholars. When multiple organ failure occurs, there is a significant increase in patients^ short - term death rate, and death rate is associated with the number of organs involved. This article briefly describes the physiopathologic mechanisms of portal hypertension and visceral vasodilation and summarizes the pathological changes of vital organs including the heart, lung, kidney, brain, and liver and related pathogenesis. At present, liver transplantation remains the most effective therapy, but it still has some shortcom¬ings. It is pointed out that further studies are needed to investigate the mechanisms of action of each link in disease development, and more targets are needed in the future to prevent and treat multiple organ dysfunction syndrome in patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]