In common parlance, we often hear descriptions like heart and liver, little heart and liver, etc. As the name implies, the heart and liver are very important and are very precious. In real life, it is also true that the liver is a very important organ of the human body, the liver is not good, it will lead to a person’s metabolism, synthesis, detoxification and other aspects of functional disorders, in short, the whole person is not good, so each of us need to understand their liver more clearly, to better care for her. First of all, the liver is located in the upper right abdomen of the body, as shown in the figure below. The liver is very soft and fragile, so its periphery is surrounded by a whole row of ribs to protect it firmly from external forces. Therefore, under normal circumstances, the liver cannot be felt below the right rib cage, because this is the only way to protect it intact. If one day you feel your liver below the rib cage, it means that something is wrong with your liver, either it is enlarged or it is growing badly and needs timely treatment. The liver is divided into the left liver and the right liver, of which the right liver accounts for 80% of the whole liver, above the liver is the diaphragm, and further up is the lung, with your breathing, the liver will also have up and down floating; immediately below the lower surface of the liver you can see the liver portal, as shown in the figure below, mainly from the intestines, the spleen collection of portal vein (purple), and two from the liver out of the left and right intrahepatic bile ducts (green), or is gallbladder. The gallbladder is prone to problems, especially those who do not like to eat breakfast; if they do not eat, the bile is not excreted, and a large amount of bile gathers in the gallbladder for a long time, which in turn is prone to stones and inflammation. When the stone attack or infection inflammation, there will be obvious abdominal pain, in serious cases involving the bile ducts will appear biliary colic, chills and high fever and jaundice, which is often referred to as the charcot triad of acute septic cholangitis, and sometimes even lead to coma, requiring emergency surgery, should not be underestimated! After understanding the structure of the liver, some people may ask, how do I know if my liver is good? Or how will I feel if my liver is not good? Generally speaking, the liver function is slightly damaged, people may not have any feeling, for example, many obese fatty liver people, liver function is obviously always bad, but he himself is not a little bad feeling, but also feel the spirit, appetite is quite good, should eat big meat eat big meat, should drink old wine drink old wine. And some people with acute hepatitis, especially some acute hepatitis E elderly patients, liver function can soar hundreds of times, even jaundice are out, bilirubin increased dozens of times, people are yellow like anything, they still do not feel anything, but also can eat and sleep, and finally can not survive the family’s concern, was escorted to the hospital to see a doctor. This is to show that the feeling of this thing, sometimes may not necessarily accurate, and varies from person to person, individual differences are very large, not sure when, it is best to go to the hospital to check to rest assured. There are some people who are very sensitive and show symptoms of minor abnormalities in liver function. The most common clinical symptom of liver damage is weakness and poor circulation. In layman’s terms, most people will describe it this way: they feel tired easily, they feel sore when they move around a little bit more, their legs are sore, and their appetite is not good, their meal quantity has dropped significantly, and they don’t want to dip in greasy things. Of course, these symptoms are not specific, not to say that these symptoms are necessarily bad liver, there may also be other diseases. In some people, poor liver function is followed by gastrointestinal disorders, bloating, nausea and vomiting, and even diarrhea. Severe liver damage can lead to an increase in bilirubin levels, which in turn can lead to yellowing of the skin and eyes, also known as jaundice. Because of the toxicity of bilirubin, some patients with jaundice may also develop itchy skin. In advanced liver diseases such as cirrhosis and hepatocellular carcinoma, there is a large amount of water that cannot be excreted and is retained in the abdomen and lower extremities, which means liver ascites and swelling of the lower extremities. In some cases, due to impaired blood flow after cirrhosis or liver cancer, the pressure in the esophagogastric vein or rectal vein network increases, resulting in severe varices and sudden rupture, leading to massive vomiting or pulling of blood, and in severe cases, death due to excessive blood loss. After hemorrhage, liver coma and secondary bacterial infections are particularly likely to occur. In short, end-stage liver disease is poorly treated with medication and the risk of death is very high. In addition to subjective feelings and clinical symptoms, some clinical tests are also important indicators to reflect liver function. 1, hepatocellular injury The main response indicators are glutathione ALT and glutathione AST. ALT and AST exist in hepatocytes, and when hepatocytes are injured, both are excreted in large quantities and subsequently enter the blood, leading to a significant increase in the level of ALT and AST in the blood, which is responsive, and the level of ALT and AST in the blood rises rapidly after liver damage. It should also be noted that ALT and AST are also present in other organ cells, for example, if ALT is not significantly elevated, but AST is significantly elevated, it is necessary to first consider the possibility of muscle and cardiac muscle damage, or the possibility of alcoholic liver disease, or damage to other organs, in short, it is necessary to combine with other indicators for comprehensive consideration. 2, bile duct cell damage, biliary tract problems The main reaction indicators are total bilirubin TB, alkaline phosphatase ALP, glutamate transpeptidase GGT, etc. Total bilirubin is divided into direct bilirubin DB and indirect bilirubin. Indirect bilirubin comes from aging and destroyed red blood cells, which are metabolized into direct bilirubin after entering the liver; when bile duct cells and bile ducts are damaged, bilirubin cannot be eliminated from the body through the bile ducts, and then enters the blood to cause an increase in bilirubin concentration; for patients with biliary obstruction caused by tumors and other reasons, as the conversion function of the liver is normal, the level of indirect bilirubin can be normal or slightly increased, while direct bilirubin is significantly increased due to The direct bilirubin is significantly higher due to obstruction. ALP and GGT are also increased when the biliary tract is damaged, especially when the biliary tract is infected or alcoholic liver disease, both of which are increased more significantly. Albumin, cholesterol, and fat-soluble vitamins A/D/E/K are mainly synthesized by the liver. In patients with chronic end-stage liver disease or acute subacute liver failure, liver synthesis is extremely poor, usually manifested as a significant decrease in albumin and total cholesterol levels. Vitamin K, also known as the coagulation vitamin, is significantly reduced in patients with end-stage liver disease (as well as other related causes), resulting in decreased coagulation and a significant prolongation of prothrombin time PT (normal is within 14s). A PT>20s is usually indicative of extreme liver damage and a high risk of death. 4, liver metabolic function sodium-potassium pump (Na+-K+ pump), end-stage liver disease patients with sodium-potassium pump function decline, resulting in decreased sodium levels, hyponatremia, intractable ascites. The presence of hyponatremia is a sign of further deterioration and aggravation in patients with end-stage liver disease. 5, liver detoxification function Cholinesterase level, the liver is an important detoxification organ, in clinical practice, the determination of serum cholinesterase activity is an important tool to assist in the diagnosis of organophosphorus, toxicity and assessment of liver parenchymal cell damage, reduced: seen in organophosphorus poisoning, hepatitis, cirrhosis, pernicious anemia, and the intake of morphine, codeine, barbiturates and other drugs. Serum cholinesterase levels can be significantly reduced in patients with organophosphorus poisoning. 6. Regeneration of liver cells Alpha-fetoprotein AFP, AFP is a tumor indicator, and the possibility of liver cancer increases when AFP is significantly increased. However, when liver cells are regenerated after liver damage, AFP may also increase, but the increase is generally not significant, and as hepatitis recovers, the AFP level gradually decreases to normal. In patients with acute liver failure, high levels of AFP often indicate active hepatocyte regeneration, which is a sign of good prognosis. Also AFP levels are elevated in pregnant women because it is the regeneration of liver cells in the young baby. What should I do to treat a bad liver now? Here I suggest that if the liver is really bad, it is still necessary to go to a regular hospital to take a good look, find out the specific cause of the disease, liver preservation treatment at the same time, for the cause of treatment to really cure the disease. As liver disease and treatment medication is relatively more professional and in-depth, this article will not make in-depth explanation, interested friends can check my other articles, which have involved some related drug treatment.