［Abstract］　Non-cirrhotic portal hypertension(NCPH) refers to a group of heterogeneous diseases with the clinical manifestations of portal hypertension and complex etiology, and characterized by significantly elevated portal pressure gradient, normal or slightly elevated hepatic vein pressure gradient and hepatic vascular lesions in patients without cirrhosis or incomplete septal cirrhosis(ISC). The nomenclature has not yet been fully unified. The hepatic pathology and clinical manifestations of NCPH caused by the same etiology are different in different stages. Esophagogastric variceal bleeding is the most common complication of NCPH, which is easy to be missed or misdiagnosed as liver cirrhosis. Aiming at the etiology is the key to the successful treatment of NCPH. Endoscopy and drugs are effective methods for the treatment of NCPH complicated with esophagogastric variceal bleeding.]]> 2021/9/4 10:38:08 ZHANG Yan, LIU Hui, DING Hui-guo 5true ［Abstract］　Portal hypertension(PH) in liver cirrhosis may lead to serious complications, such as esophagogastric variceal bleeding(EVB), refractory ascites(RA) and portal vein thrombosis(PVT), which seriously affect the patients′ quality of life and survival. Transjugular intrahepatic portosystemic shunt(TIPS) can significantly reduce portal vein pressure. However, certain controversies exist regarding the benefits of this treatment for the patients, timing of treatment and indications. This paper briefly describes the historical origin of TIPS surgery, the evolution of its status in clinical practice and the current consensuses and guidelines around the world, focuses on the timing and indications of TIPS treatment, reviews the conclusions and views of many current clinical cohort studies, and puts forward the prospect of early TIPS related treatment.]]> 2021/9/4 10:38:08 ZHU Qing-liang, LEI Jia-ming 4true ［Abstract］　Non-alcoholic fatty liver disease(NAFLD) is the most common liver disease in the world, but there are currently no approved drugs for the treatment of NAFLD. In recent years, NAFLD has been considered as metabolic associated fatty liver disease, and the pathogenesis of NAFLD is related to changes in bile acid metabolism. Obeticholic acid is a semi-synthetic bile acid and a potent and highly selective farnesoid X receptor(FXR) agonist, as well as a potent inhibitor of fatty acid transport protein 5(FATP5). At present, compared with high-dose ursodeoxycholic acid(UDCA) and other bile acid drugs in the treatment of NAFLD, low-dose obeticholic acid has more advantages and exploration value in the treatment of NAFLD.]]> 2021/9/4 10:38:08 CHEN Li-xin, LIN Chuang-zhen, YU Bing-qing, et al. 3true ［Abstract］　Objective　To screen the sensitive indicators for the diagnosis of cirrhosis by a noninvasive method in patients with primary biliary cholangitis(PBC). Methods　A total of 380 patients diagnosed with PBC admitted to Beijing Youan Hospital, Capital Medical University from 2011 to 2020 were collected.The patients underwent routine electronic gastroscopy, blood routine, blood coagulation, liver function and B-ultrasound examinations, and the patients′ liver hardness was detected by FibroScan. According to the results of liver puncture and clinical diagnosis, the patients were divided into cirrhosis group(166 cases) and non-cirrhosis group(214 cases). The differences in the indicators between the two groups were compared and analyzed. The patients were randomly divided into the model group and the validation group according to a ratio of 8∶2. The sensitive indicators were screened out from the model group, and a noninvasive diagnostic model of liver cirrhosis was established by using random forest method, and then the efficacy of the diagnostic model was validated by using the patients in the validation group. Results　(1)A total of 9 indicators with the highest impact effectiveness on PBC cirrhosis were screened, including hematocrit(HCT), erythrocyte count, liver hardness, cholinesterase(CHE), uric acid, ratio of aspartate aminotransferase to alanine aminotransferase(AAR), cholesterol(CHO), platelet count and prothrombin activity. The model was established by using random forest method. The area under the receiver operator characteristic(ROC) curve was 89.6%. Among the 9 indicators, HCT had the highest influence weight. (2)The HCT in the cirrhosis group［(29.8±7.1)%］ was significantly lower than that in the non-cirrhosis group［(35.4±6.6)%］, and the difference was statistically significant(P<0.001). Conclusion　HCT can be used as one of the important indicators in the noninvasive diagnostic model of cirrhosis in PBC patients. It is noninvasive and easy to obtain, with low difficulty of detection and good extrapolation, and may make some patients avoid liver biopsy.]]> 2021/9/4 10:38:08 YANG Xue, XU Bin, LIU Yan-min, et al. 2true ［Abstract］　Objective　To investigate the clinical characteristics, and the prevention and treatment of gastroesophageal varices(GOV) bleeding in patients with cirrhotic portal hypertension. Methods　A total of 330 liver cirrhosis inpatients with complete clinical data were included in this study. Among them, there were 138 cases with non-GOV bleeding in cirrhotic portal hypertension,105 cases with GOV bleeding for the first time,and 87 cases with GOV rebleeding. The clinical characteristics of GOV bleeding in cirrhotic portal hypertension were retrospectively analyzed. The risk factors of GOV first bleeding were analyzed by logistic regression with non-GOV bleeding group as control. Results　Among the 330 patients with liver cirrhosis, 192 patients had liver cirrhosis complicated with GOV bleeding. In the primary prevention management, 21 patients(10.93%) previously received primary prevention, including 6 patients(3.13%) treated with non-selective beta blocker(NSBB) and 15 patients(7.81%) treated with endoscopy. In the secondary prevention management, 125 patients(65.10%) previously received secondary prevention, including 18 patients(9.38%) treated with NSBB, 69 patients(35.94%) treated with endoscopy, and 56 patients(29.17%) treated with interventional therapy. Child-Pugh grade(OR=1.651, 95%CI: 1.115-2.444, P=0.012) and infections(OR=2.062, 95%CI: 1.055-4.032, P=0.034). Conclusion　Child-Pugh grade and infections were the independent risk factors for development of GOV bleeding in cirrhotic portal hypertension. For patients with cirrhotic portal hypertension, there are inadequacies in the primary prevention, secondary prevention and treatment of GOV bleeding. It is necessary to strengthen the screening of high-risk populations and improve the prevention of first-time bleeding and rebleeding.]]> 2021/9/4 10:38:08 WANG Wen-juan, ZHANG Guo, YU Lei, et al. 1true