Clinical diagnostic criteria for alcoholic liver disease 1. A history of chronic alcohol consumption, usually more than 5 years, with a folded alcohol amount >40g/d, slightly lower in women; or a history of binge drinking within 2 weeks. 2.Serum ALT and AST decrease significantly after alcohol abstinence, and basically return to normal within 4 weeks, i.e., below 2 times the upper limit of normal (ULN). If ALT and AST are <2.5 ULN before alcohol abstinence, they should be reduced to less than 1.25 ULN after alcohol abstinence. Wang Yan, Department of Infectious Diseases, Peking University First Hospital 3. At least one of the following two items is positive: the enlarged liver shrinks significantly within 1 week and returns to normal within 4 weeks after alcohol abstinence; the GGT activity decreases significantly after alcohol abstinence, and then decreases to less than 1.5 ULN or less than 40% of the pre-prohibition value after 4 weeks. 4.Excluding liver injury caused by viral infection, metabolic abnormalities and drugs. Treatment of Alcoholic Liver Disease The main principles of treatment of alcoholic liver disease are: 1, to reduce the severity of alcoholic liver disease; 2, to stop or reverse hepatic fibrosis; 3, to improve the existing secondary malnutrition; 4, to the treatment of alcoholic cirrhosis. Abstinence from alcohol is the primary method, and its efficacy is related to the severity of liver disease. For common alcoholic liver disease, it can lead to significant improvement in clinical and pathological manifestations; for severe alcoholic liver disease, it is not necessarily effective; for alcoholic fatty liver disease, abstinence from alcohol is the only effective treatment. Lipid-lowering treatment: patients with elevated lipids should be treated with lipid-lowering drugs. Hepatoprotective, enzyme-lowering and choleretic drug treatment: some hepatoprotective, enzyme-lowering and choleretic drugs can be used appropriately, which can help the liver function to return to normal; for patients with high gamma-glutamyltranspeptidase, it is effective to choose glutathione. Anti-hepatic fibrosis treatment: Generally, the main herbal treatment is to activate blood circulation and remove blood stasis, and light diet and easy-to-digest food are the mainstay. Clinical evidence shows that the above treatments are effective in anti-hepatic fibrosis and preventing the progression of cirrhosis. Supportive therapy: due to long-term unbalanced dietary intake, patients with alcoholic fatty liver are mostly accompanied by vitamin deficiency and negative nitrogen balance, so the diet should be calorie-restricted, low-fat and high-protein diet is the mainstay, and enough vitamins and minerals, such as vitamin B1, B6, B12, folic acid, zinc, choline, methionine and so on should be supplemented. Hormones: Hormones have no significant effect in mild to moderate cases, while only severe cases can benefit from hormones. Hormones reduce acute and chronic inflammation in the liver, but have no definite effect on early or established fibrosis. Therefore, hormones in alcoholic liver disease may be indicated only in a few severe cases without cirrhosis. Others: therapies such as colchicine, propylthiouracil, insulin-glucagon, antioxidants, polyunsaturated lecithin/phosphatidylcholine lipid-lowering agents, anti-endotoxins, liver transplantation, and traditional Chinese medicine (TCM) have shown some efficacy, but are not effective in every case, or only in one aspect such as improvement of hepatic function, reduction of mortality, and reduction of cirrhosis. Liver transplantation. Alcohol withdrawal syndrome Alcohol withdrawal syndrome (AWS) is a clinical syndrome of predominantly neurologic changes caused by the sudden cessation of chronic alcohol consumption. The mechanism is that the central nervous system becomes dependent on ethanol after prolonged heavy drinking. If there is no dependence, physiological dysfunction will occur, therefore, dependence is a disturbed state at the biological level. However, its occurrence is often unrecognized by family members, colleagues and even healthcare professionals, and it is abandoned and not treated in time. Its treatment mainly consists of abstinence from alcohol, maintaining water, electrolyte and acid-base balance, sedation, and taking alcohol sulfur. 1.Mild withdrawal symptoms occur in 6-36 hours of withdrawal, manifested as: tremor; mild anxiety; headache; excessive sweating; palpitations; anorexia; gastrointestinal discomfort; normal mental status. 2.Seizures: occur 6-48 hours after the stage. Manifestations: transient generalized seizures, tonic clonic seizures. Sustained seizures are rare. 3.Alcoholic hallucinations: occur 12-48 hours after withdrawal. Manifestations: hallucinations, auditory hallucinations, tactile hallucinations. Orientation is intact and vital signs are normal. 4.Delirium tremens: the most serious symptom, occurring 48-96 hours after withdrawal. Manifestations: delirium, agitation, tachycardia, hypertension, fever, profuse sweating. Zieve syndrome Zieve syndrome refers to the triad of jaundice, hyperlipidemia and hemolytic jaundice in patients with chronic alcoholism, so it is also known as alcohol intoxication, hyperlipidemia, hemolytic syndrome.The pathogenesis of Zieve syndrome has not been fully elucidated. Jaundice may be related to the liver damage caused by alcohol poisoning and different degrees of jaundice, hyperlipidemia may be due to the increase of triacylglycerol, hemolysis may be due to hyperlipidemia so that the erythrocyte membrane cholesterol and phospholipids increased deposition of increased erythrocyte surface area, and become stiff, brittle, through the splenic blood sinusoids easy to be damaged by the obstruction caused by some people may be related to the alcoholism caused by vitamin E deficiency. It is also suggested that it may be related to vitamin E deficiency caused by alcoholism. Clinical manifestations: in addition to gangrene and hemolytic anemia, it is accompanied by nausea, vomiting, loss of appetite, epigastric pain, sharp increase in liver pressure and pain, and the spleen is not enlarged. 2.Treatment: no special treatment, lifelong abstinence from alcohol, nutritional support therapy, including amino acid and glucose infusion.