8F). The findings establish that SV1 antagonizes KLF6 at least in part by accelerating its degradation. Our findings demonstrate that the SV1/KLF6

mRNA ratio is significantly increased in patients with HCV-associated HCC relative to surrounding tissue, and correlates with features of more aggressive disease. This observation is consistent with findings in gastric,18 lung,21 prostate,27 and pancreatic19 cancers, where increased splicing has been associated with worse patient outcomes. Consistent with these findings, KLF6 depletion in mouse models resulted in significantly increased tumor size, whereas hepatocyte-specific overexpression of SV1 led to more advanced tumor grade, consistent with findings of higher-grade tumors associated with an increased SV1/KLF6 ratio in both ovarian9 and pancreatic19 cancers. The increased tumorigenesis after DEN resulted in a higher tumor burden, with both larger and more numerous tumors in mice

with hepatocyte-specific Wnt mutation Klf6 depletion and SV1 overexpression 9 months after DEN treatment, supporting a role of increased KLF6 splicing in hepatocarcinogenesis. The proliferative effect of an increased SV1/KLF6 ratio was directly validated in freshly isolated primary hepatocytes from four different mouse lines and in Klf6fl(+/+) hepatocytes in which Klf6 was depleted or SV1 was overexpressed check details in culture. Here, Klf6 depletion was associated with significantly increased DNA synthesis and cell number, MCE公司 and was further enhanced by additional SV1 overexpression. However, hepatocyte-specific SV1 overexpression alone was not sufficient to significantly affect cell count. Together, these findings suggest that the loss of KLF6 and increased SV1 confer separate, complementary effects on tumor propensity, with hepatocyte-specific Klf6 depletion driving enhanced proliferation, whereas hepatocyte-specific SV1 overexpression largely provokes an increased tumor grade. Of equal importance, the ratio of SV1/KLF6, and not just Klf6 depletion or SV1 overexpression alone, is additive in promoting tumorigenesis. Additionally, whereas KLF6 mRNA levels

in HCV-associated liver disease decreased progressively and significantly from noncirrhotic to cirrhotic liver tissue, with a further significant decrease in dysplastic liver tissue,2 the ratio of SV1/KLF6 mRNA did not change between normal, cirrhotic, and dysplastic liver tissue. It increased significantly from dysplastic to very early HCC, with a further significant increase in advanced and very advanced HCC. This finding suggests that a decrease of KLF6 precedes onset of splicing, and that splicing coincides with malignant transformation. This finding is consistent with evidence of increased KLF6 splicing only in malignant tissues from gastric18 and pancreatic19 cancers. In aggregate, the findings indicate that reduction in KLF6 mRNA and increased SV1 expression occur independently and sequentially, ultimately accelerating the development of HCC when both are present.

Hepatocellular carcinoma was diagnosed in 20 patients, but only seven had early-stage disease in which curative treatment, such as surgical hepatectomy or percutaneous ablation, was indicated. Conclusion:  The prevalence of HCV infection in the Airin district is extremely higher than that in the Japanese general Ensartinib in vivo population. Patient education and strict action against illegal drug use are indispensable to prevent the spread of HCV infection from the district. “
“Renal dysfunction is frequent in liver cirrhosis and is

a strong prognostic predictor of orthotopic liver transplantation (OLT) outcome. Therefore, an accurate evaluation of the glomerular filtration rate (GFR) is crucial in pre-OLT patients. However, in these patients plasma creatinine (Pcr) is inaccurate and the place of serum cystatine C (CystC) is still debated. New GFR-predicting equations, based on standardized assays

of Pcr and/or CystC, have been recently recommended in the general population but their performance in cirrhosis patients has been rarely studied. We evaluated the performance of the recently published Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI-Pcr, CKD-EPI-CystC, and CKD-EPI-Pcr-CystC) and the more classical ones (4- and 6-variable MDRD and Hoek formulas) in cirrhosis patients referred for renal evaluation before OLT. Inulin clearance was performed in 202 consecutive patients together www.selleckchem.com/products/ch5424802.html with the determination of Pcr and CystC with assays traceable to primary reference materials. The performance of the GFR-predicting equations was evaluated according to ascites severity (no, moderate, or refractory) and to hepatic and renal dysfunctions (MELD score ≤ or >15 and KDOQI stages, respectively). In the whole population, CystC-based equations showed a better performance than Pcr-based ones (lower bias and higher 10% and 30% accuracies). CKD-EPI-CystC

上海皓元 equation showed the best performance whatever the ascites severity and in presence of a significant renal dysfunction (GFR <60 mL/min/1.73 m2). Conclusion: Pcr-based GFR predicting equations are not reliable in pre-OLT patients even when an IDMS-traceable enzymatic Pcr assay is used. Whenever a CystC-assay traceable to primary reference materials is performed and when a true measurement of GFR is not possible, CystC-based equations, especially CKD-EPI-CystC, may be recommended to evaluate renal function and for KDOQI staging. (Hepatology 2014;59:1522-1531) "
“Natural killer (NK) cells exhibit a polarized phenotype with increased cytotoxicity and decreased interferon gamma (IFN-γ) production in chronic hepatitis C virus (HCV) infection.

Hepatocellular carcinoma was diagnosed in 20 patients, but only seven had early-stage disease in which curative treatment, such as surgical hepatectomy or percutaneous ablation, was indicated. Conclusion:  The prevalence of HCV infection in the Airin district is extremely higher than that in the Japanese general Y-27632 in vivo population. Patient education and strict action against illegal drug use are indispensable to prevent the spread of HCV infection from the district. “
“Renal dysfunction is frequent in liver cirrhosis and is

a strong prognostic predictor of orthotopic liver transplantation (OLT) outcome. Therefore, an accurate evaluation of the glomerular filtration rate (GFR) is crucial in pre-OLT patients. However, in these patients plasma creatinine (Pcr) is inaccurate and the place of serum cystatine C (CystC) is still debated. New GFR-predicting equations, based on standardized assays

of Pcr and/or CystC, have been recently recommended in the general population but their performance in cirrhosis patients has been rarely studied. We evaluated the performance of the recently published Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI-Pcr, CKD-EPI-CystC, and CKD-EPI-Pcr-CystC) and the more classical ones (4- and 6-variable MDRD and Hoek formulas) in cirrhosis patients referred for renal evaluation before OLT. Inulin clearance was performed in 202 consecutive patients together Roxadustat research buy with the determination of Pcr and CystC with assays traceable to primary reference materials. The performance of the GFR-predicting equations was evaluated according to ascites severity (no, moderate, or refractory) and to hepatic and renal dysfunctions (MELD score ≤ or >15 and KDOQI stages, respectively). In the whole population, CystC-based equations showed a better performance than Pcr-based ones (lower bias and higher 10% and 30% accuracies). CKD-EPI-CystC

MCE公司 equation showed the best performance whatever the ascites severity and in presence of a significant renal dysfunction (GFR <60 mL/min/1.73 m2). Conclusion: Pcr-based GFR predicting equations are not reliable in pre-OLT patients even when an IDMS-traceable enzymatic Pcr assay is used. Whenever a CystC-assay traceable to primary reference materials is performed and when a true measurement of GFR is not possible, CystC-based equations, especially CKD-EPI-CystC, may be recommended to evaluate renal function and for KDOQI staging. (Hepatology 2014;59:1522-1531) "
“Natural killer (NK) cells exhibit a polarized phenotype with increased cytotoxicity and decreased interferon gamma (IFN-γ) production in chronic hepatitis C virus (HCV) infection.

Hepatocellular carcinoma was diagnosed in 20 patients, but only seven had early-stage disease in which curative treatment, such as surgical hepatectomy or percutaneous ablation, was indicated. Conclusion:  The prevalence of HCV infection in the Airin district is extremely higher than that in the Japanese general Ku0059436 population. Patient education and strict action against illegal drug use are indispensable to prevent the spread of HCV infection from the district. “
“Renal dysfunction is frequent in liver cirrhosis and is

a strong prognostic predictor of orthotopic liver transplantation (OLT) outcome. Therefore, an accurate evaluation of the glomerular filtration rate (GFR) is crucial in pre-OLT patients. However, in these patients plasma creatinine (Pcr) is inaccurate and the place of serum cystatine C (CystC) is still debated. New GFR-predicting equations, based on standardized assays

of Pcr and/or CystC, have been recently recommended in the general population but their performance in cirrhosis patients has been rarely studied. We evaluated the performance of the recently published Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPI-Pcr, CKD-EPI-CystC, and CKD-EPI-Pcr-CystC) and the more classical ones (4- and 6-variable MDRD and Hoek formulas) in cirrhosis patients referred for renal evaluation before OLT. Inulin clearance was performed in 202 consecutive patients together click here with the determination of Pcr and CystC with assays traceable to primary reference materials. The performance of the GFR-predicting equations was evaluated according to ascites severity (no, moderate, or refractory) and to hepatic and renal dysfunctions (MELD score ≤ or >15 and KDOQI stages, respectively). In the whole population, CystC-based equations showed a better performance than Pcr-based ones (lower bias and higher 10% and 30% accuracies). CKD-EPI-CystC

上海皓元医药股份有限公司 equation showed the best performance whatever the ascites severity and in presence of a significant renal dysfunction (GFR <60 mL/min/1.73 m2). Conclusion: Pcr-based GFR predicting equations are not reliable in pre-OLT patients even when an IDMS-traceable enzymatic Pcr assay is used. Whenever a CystC-assay traceable to primary reference materials is performed and when a true measurement of GFR is not possible, CystC-based equations, especially CKD-EPI-CystC, may be recommended to evaluate renal function and for KDOQI staging. (Hepatology 2014;59:1522-1531) "
“Natural killer (NK) cells exhibit a polarized phenotype with increased cytotoxicity and decreased interferon gamma (IFN-γ) production in chronic hepatitis C virus (HCV) infection.

The aim of this study was to assess the usefulness of drinking oolong tea before conventional premedication for improving endoscopic visibility. Methods: From www.selleckchem.com/products/Erlotinib-Hydrochloride.html May to June 2014, a total of 59 patients were received EGD and treated in two groups: group A (n = 30): conventional premedication using dimethicone, pronase, and sodium bicarbonate; group B (n = 29): drinking 150 mL of oolong tea before conventional

premedication. One endoscopist assesses the mucosal visibility score (from score 0: no adherent mucus; to score 5: adherent mucus in spite of using more than 60 mL of water including dimethicone during EGD). Visibility score and procedure time was compared between group A and B. Questionnaire was carried out for the patients of group B after EGD. Results: The mucosal visibility click here score showed significantly lower in the patients of group B (1.86 ± 1.09) than in those of group A (3.43 ± 1.17) (p < 0.05). Procedure time was not extended in spite of drinking immediately before EGD in comparison with group A (311.6 ± 75.5 seconds) and group B (311.0 ± 82.6 seconds) (n.s.). According to the questionnaire, drinking oolong tea before EGD has a high

satisfaction level, and contributes to the relaxation. Conclusion: Premedication using 150 mL of oolong tea before conventional premedication improves visualization during EGD. Moreover, oolong tea to drink just before EGD does not interfere with the procedure. Key Word(s): 1. Oolong tea; 2. premedication Presenting Author: RAVINDRA L SATARASINGHE Additional Authors: SACHITH C WIJESIRIWARDENA, CHAMPIKA GAMAKARANAGE, NARMATHEY THAMBIRAJAH, KUSHLANI JAYATILLAKE, GAYANA GUNARATNA, SUBASHINI SAMARAWEERA, CHAMPA JAYASUNDARA, A EPA Corresponding Author: RAVINDRA L SATHARASINGHE Affiliations: Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital, Sri Jayawardenepura General Hospital Objective: To highlight the significance of splenic abscesses in PUO. Methods: Case notes of two patients with PUO, who presented to the

two medical units of the authors, were retrospectively analyzed. Results: Case 1 A 36 year 上海皓元 old adult Sri Lankan male engineer having type2 DM and HTN and secondary polycythemia presented with a PUO of 1 month duration. LFT and renal profile were normal. There was a neutrophil leucocytosis with toxic granulations suggestive of bacterial sepsis. There was no significant exposure history. Examination revealed only hepatomegaly. Ultrasound showed hepatomegaly with fatty changes. ANA was negative, CRP >100 mg/L, hepatitis and HIV screens were negative, 2D Echo and TOE were normal. CECT abdomen and pelvis showed multiple splenic and liver abscesses. Repeated blood cultures yielded Burkholderia pseudomallei and the fever responded to IV meropenem.

Nonetheless, we have some concerns with regard to indirectness. In the identified trials, virological response was the predominant measure of benefit. Many of the trials measured SVR, which is currently the commonly used surrogate outcome measure of benefit. Recent large cohort studies show correlation between the presence of viremia and mortality.31, 32 However, it is important to remember that SVR (and early virological response and end-of-treatment virological response) is still only a putative (that is, nonvalidated) surrogate outcome.33 Because RCTs need

to inform clinical practice, clinical outcomes such as the risk of liver failure, hepatocellular carcinoma, and mortality would be of greater interest to patients and clinicians. Quizartinib molecular weight Such measures nevertheless require a follow-up

of at least 5 years. Currently, no RCTs comparing the two peginterferons are of such longevity. In the meta-analysis on adverse events, there were serious discrepancies across trials. The proportions of observed adverse events differed greatly across the trials, and the direction of effect was also heterogeneous. It is noteworthy that the IDEAL trial3 included three intervention arms: one for peginterferon alpha-2a and two for peginterferon alfa-2b. The two peginterferon alfa-2b arms consisted of a regular 1.5 μg/kg/week dosage and a low 1.0 μg/kg/week dosage. PKC inhibitor The regular dosage arm yielded a similar proportion of adverse events as the peginterferon alpha-2a arm, whereas the low-dose peginterferon alfa-2b group yielded a lower proportion of adverse events. Including or excluding the low-dose peginterferon alfa-2b arm from the meta-analysis had no visible impact on the estimated effect. Furthermore, the meta-analysis on adverse events had low precision. A post hoc OIS calculation that was geared to detect a minimally

important difference of 10% relative risk reduction, based on the 上海皓元 assumption of average population risk rate of 10%, and employed a 5% maximum type I error and 80% power, suggested that a minimum of 27,000 patients would need to be randomized for a conclusive adverse events meta-analysis. The current number of patients in the adverse events meta-analysis is approximately 5,000 (less than 20% of what is required). There are some concerns regarding the nonstandardization of the ribavirin dose given across trials. The weight-based dose of ribavirin ranged from 800 to 1,400 mg. However, the weight cutoff varied among trials as well as within the same trial. In the largest included trial,3 patients weiging 40-65 kg received a lower dose of ribavirin (800 mg) in the peginterferon alfa-2b arm compared with a higher dose of ribavirin (1,000 mg) in the peginterferon alpha-2a arm.

gloeosporioides isolates (n = 26) were 30.7% sensitive and 69.2% moderately

tolerant. Phylogenetic analysis with ITS sequences of a subset of 18 strains showed that strains classified as C. gloeosporioides had 100% identity to Colletotrichum kahawae, which belongs to the C. gloeosporioides species complex, whereas C. acutatum strains clustered into two different groups, with high similarity to the A2 and the A4 molecular groups. These data demonstrate for the first time the differential distribution of both species complexes in blackberry plant organs and further clarifies the taxonomy of the strains. “
“Garlic plants selleck compound are naturally infected with a mixture of viruses. Virus-free garlic plants, obtained by meristem culture, rapidly become reinfected when planted in the field. With the aim of understanding virus movement Mdm2 antagonist and fluctuations in virus concentration in leaves and cloves of garlic plants in the first year after infection, Onion yellow dwarf virus, Leek yellow stripe virus, and other viruses were analyzed by double-antibody sandwich enzyme-linked immunosorbent assay. Significant differences were detected in virus concentration in different leaves, but the distribution of the viruses

was variable. Therefore, no one type or position of leaf is preferable for detecting virus presence. Instead, sampling any leaf at the end of the crop cycle, about 200 days after planting, is advisable because virus concentration is several times higher in older plants. The analysis of virus distribution in bulbs revealed that virus concentration was higher in early-inoculated than in late-inoculated plants. In 81% of the bulbs, cloves were either all positive or all negative in serological tests. Only in 6% of the cases were positive and negative cloves found in the same bulb, and in 13% of the bulbs, negative results coexisted

with an uncertain status. The tests of virus concentration in relation to the layers of each bulb revealed important differences. Only the innermost layer showed differences with other layers, but this was poorly represented medchemexpress as it had fewer cloves. “
“The non-durable nature of hypersensitive (race-specific) resistance has stimulated scientists to search for other options such as race-non-specific resistance to provide long-lasting protection against plant diseases. Adult plant resistance gene complex Lr34/Yr18 confers a dual race-non-specific type of resistance to wheat against stripe rust (Puccinia striiformis f. sp. tritici) and leaf rust (P. triticina Eriks). This study was conducted to evaluate 59 spring bread wheat (Triticum aestivum L.) genotypes for the presence of the Lr34/Yr18-linked csLV34 allele using STS marker csLV34 and to determine the effect of this gene complex on the components of partial resistance in wheat to leaf/stripe rust.

This helps evaluate pruritus and monitor improvement and changes in severity.41 The disability domain consists of four items and the other domains consist of a five-point Likert scale. A maximum score of 25 indicates severe pruritus while the minimum score of 5 indicates no pruritus. This helps act as both a quantitative and qualitative assessment of pruritus as it addresses all aspects of pruritus on the patient’s quality of life. Although the 5-D itch scale is promising, further innovations may be needed to improve the assessment of pruritus. This should be done while keeping in mind the time

consuming burden on health providers and patients, imposed by lengthy assessments. Visual analog scale decodes pruritus into a point CHIR-99021 datasheet on a line. Several therapeutic modalities have been investigated to identify effective treatments for pruritus in patients with primary cholestatic disease. The management of pruritus associated with PBC is described by the 2009 American Association for the Study of Liver Diseases (AASLD)

guidelines42 and involves HKI-272 chemical structure use of bile salt resins as first line therapy, rifampin (150–300 mg twice daily) as second line, opiod antagonists (e.g. naltrexone up to 50 mg daily) as third line therapy and sertraline (75–100 mg/day) as fourth line therapy, followed by experimental approaches. This is demonstrated graphically in Figure 2. It is important to monitor patients for serious side effects that may occur during therapy and move to the next step in management if a contraindication to the drug or a drug to drug interaction exists (e.g. rifampin may hinder the antidepressant effects of serotonin reuptake inhibitors.) Ursodeoxycholic acid.  Despite the fact that UDCA is the most common drug used in treatment of PBC, and while administration of UDCA has been associated with histological and biochemical improvement in PBC, it shows no reliable effectiveness in the management of pruritus.1,43,44 Ursodeoxycholic acid at a total dosage of 750 mg/day was found to decrease the value of most biochemical parameters including

asparate aminotransferase, alanine aminotransferase and bile acids in MCE patients with ICP.37 One of the theories behind the amelioration of pruritus in patients with ICP, as mentioned earlier, involves the stimulation of hepatobiliary secretion of progesterone disulfates.37 The effect of UDCA (15–20 mg/kg/day) was evaluated in 24 pediatric patients with intrahepatic cholestasis (seven patients with neonatal hepatitis, seven with Byler disease and 10 with idiopathic intrahepatic cholestasis) aged 1.5 months to 15 years for a period of 12 months. This study showed amelioration of pruritus in all patients and complete resolution of pruritus in 16.7%.45 In an open label cross over study involving 13 children aged 13.1 ± 2.

5. The HOMA-IR was not calculated for individuals taking insulin. Information

regarding comorbidities, including diabetes mellitus, hypertension, and metabolic syndrome, were also collected. Diabetes mellitus was defined in individuals with fasting blood glucose >126 mg/dL or on drug treatment for diabetes. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood Pexidartinib order pressure (DBP) ≥90 mmHg. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria, which require at least three of the following: (1) WC >102 and 88 cm, for men and women, respectively; (2) fasting triglycerides ≥150 mg/dL or on drug treatment for hypertriglyceridemia; (3) HDL cholesterol <40 or < 50 mg/dL for men and women, respectively, or on drug treatment for dyslipidemia; (4) blood pressure ≥130/85 mmHg or on drug treatment for hypertension; and (5) fasting blood glucose ≥110 mg/dL or on drug treatment for diabetes mellitus. Medication Afatinib manufacturer usage was recorded in detail at the time of enrollment of each participant into a NASH CRN study. Physical

exam findings, including vital signs, acanthosis nigricans, and palmar erythema, were recorded. Data were also collected regarding self-reporting of family history of NAFLD. Dietary information was obtained using a validated dietary questionnaire (Block Food Questionnaire, version 1998), based upon self-reported typical eating habits over the past year. Estimates of total calories consumed and proportion of carbohydrate and fat

intake were generated MCE using the method previously published by Block et al. 16 At the time of enrollment, NASH CRN study participants also completed a questionnaire, which was derived from the National Health and Nutrition Examination Survey, on self-reported leisure-time physical activity. 17 In the questionnaire, participants reported the amount of time spent per week performing specific leisure-time activities, including brisk walking, jogging, running, hiking/climbing, biking on hills, biking on flat surfaces, swimming, using a treadmill or step machine, dancing, aerobics, calisthenics, weight lifting, golfing, playing singles or doubles tennis, basketball, football, and soccer. Participants were also given the opportunity to enter free text responses for their activities. 18 Using a standard reference for metabolic equivalent (MET) intensities for specific activities and the reported duration of each activity, a score for each individual’s total physical activity, expressed as metabolic hours per week (MET hours/week), was generated. 19 Continuous data are reported as mean or median values with associated 95% confidence intervals [95% CIs]. Student’s t or nonparametric tests were utilized to compare continuous variables, as appropriate.

Key Word(s): 1. Isolation; 2. Stem Cell; 3. Bone Marrow; 4. Differentiation; Presenting Author: MING BAI Additional Authors: CHUANGYE HE, ZHENGYU WANG, ZHANXIN YIN, JIELAI XIA, KAICHUN WU, DAIMING FAN, GUOHONG HAN Corresponding Author: MING BAI Affiliations: Fourth Military Medical University; Fourth Military Medical University; Fourth Military Medical University; Fourth Military Medical University; Fourth Military Medical University; Fourth

Military Medical University; Fourth Military Medical University; Fourth Military Medical University Objective: After transjugular selleck chemicals llc intrahepatic portosystemic shunt (TIPS), patients are associated with an increase of ammonia concentration and higher risk of hepatic encephalopathy (HE). L-ornithine-L-aspartate (LOLA) is effect on the reduction of ammonia concentration. Whether LOLA is effect on the increase of ammonia after TIPS is not evaluated in previous studies. The primary purpose of this pilot study was to evaluate the effect of LOLA on the increase of ammonia concentration. Methods: Consecutive

cirrhotic patients who underwent success TIPS procedure were randomized to receive LOLA (LOLA MI-503 purchase group) or no-LOLA treatment (controlled group) for seven days. Fasting venous ammonia, postprandial venous ammonia, psychometric tests (number connection test A [NCT-A], serial dotting test [SDT], and line tracing test [LTT]), incidence of overt HE, liver function, and renal function were assessed during the follow-up. Results: Of the 133 cirrhotic patients with success TIPS placement, 40 met the inclusion criteria and were randomized to the LOLA group (n = 21) or controlled group (n = 19). The changes of fasting ammonia were significantly different between the two groups at day 4 (Δfasting ammonia: -2.4 ± 22.5 vs. 24.8 ± 21.9, p = 0.001) and 7 (Δfasting ammonia: 2.6 ± 19.9 MCE公司 vs. 23.8 ± 22.2, p = 0.003). Furthermore, the two groups significantly differed (p < 0.05) in the changes of postprandial ammonia concentration and psychometric tests at

day 1, 4, and 7. During the extended follow-up, patients in the LOLA group had significantly less increase in bilirubin at six months after TIPS procedure (10.2 ± 18.0 vs. 24.0 ± 20.8, p = 0.020). One and three patients had overt HE during the treatment in the LOLA and controlled group (p = 0.331), respectively. The two groups were not different in complications, adverse events, and mortality. Conclusion: The prophylactic use of LOLA infusion after TIPS procedure is safe and effective on the increase of venous ammonia concentration and benefits patient mental status. LOLA also has potential effect on the raise of bilirubin in patients with TIPS. Key Word(s): 1. LOLA; 2. TIPS; 3. encephalopathy; 4.