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Objective To investigate the clinical characteristics and prognosis in patients with liver failure of unknown etiology (LFUE). Methods Clinical data of 326 LFUE patients in 302 Hospital of PLA from January 2005 to December 2014 were analyzed retrospectively. Results LFUE accounted for 6.50% of the total liver failure, and its incidence was lower than that of HBV-related liver failure and alcohol-related liver failure. LFUE was presented mainly as subacute liver failure (39.88%), followed by acute-on-chronic liver failure (36.50%) and acute liver failure (23.62%), while other types of liver failure (known etiology) were presented mainly as acute-on-chronic liver failure (92.16%). Compared with HBV-related acute-on-chronic liver failure, the deterioration of liver function in LFUE patients was worse (ALT, AST and TBIL were higher and PTA was lower), ALP and the average level of white blood cells were also much higher. LFUE occurred mainly in adult patients (≥18 years

Objective To optimize conditions for hypothermic preservation of rat hepatocyte spheroids without freezing in order to facilitate the application of biological artificial liver. Methods Rat hepatic cells were isolated by a two-step perfusion method, and hepatocyte spheroids formed after 48 hours of rocking culture in serum free medium (SFM). Spheroids were then maintained in rocking culture at 37℃ (control condition), or cold stored at 4℃ for 24 or 48 hours in four different cold storage solutions: SFM alone; SFM+1mmol/L deferoxamine (Def ); SFM+1μmol/L cyclosporin A (CsA); and SFM+1mmol/L Def+1μmol/L CsA. After culturing for another 4 or 5 days, survival rate, changes in ultrastructure, and the production of albumin and urea were observed. Results Cold-induced injury could be reduced significantly by the addition of the iron chelators Def and CsA. The function and structure of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def for 24 hours were similar to those in control conditions. But the function was significantly reduced after hypothermic preservation in SFM alone. After cold storage for 48 hours, the ultrastructure of hepatocyte spheroids obviously changed and the number of dead cells increased. The survival rate of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def was significantly higher than that stored in SFM or SFM+CsA(P0.05). Conclusions Hepatocyte spheroids tolerate 24 hours of cold storage with stable viability and function. Hypothermic preservation increases the availability of cell-based therapy for liver diseases. DOI: 10.11855/j.issn.0577-7402.2014.12.02

Objective To study the clinical characteristics of elderly patients with liver failure. Methods The clinical data of 623 elderly patients with liver failure from Jan. 2003 to Dec. 2013 in 302 Hospital of Chinese PLA were collected, and other 3791 young adult patients with liver failure during the same period were also collected as control group. The etiology and prognosis of elderly patients with liver failure were analyzed retrospectively. Results Elderly patients with liver failure accounted for 13.21% of the total number of liver failure patients in 2003, and 16.01% in 2013. The most frequent causes leading to liver failure were, in order of frequency, hepatitis B(68.06%), unknown causes (7.22%), hepatitis C (5.30%), hepatitis E (4.98%) and drug (4.65%). Acute or chronic liver failure (85.23% vs 90.56%) was the main type in the two groups. HEV infection-induced liver failure in elderly patients was the predominant cause of acute and subacute liver failure, accounting for 33.33% and 33.80% respectively in acute and subacute liver failure patients, which were significantly higher than that in the young adult group (7.77% and 12.94% respectively, P