Brief description of the case: The patient, Wang Moumou, female, 64 years old, developed extreme weakness, poor appetite, nausea, vomiting, yellow eyes and yellow urine like strong tea after taking oral Chinese medicine for “lung disease” for one month, and was diagnosed with severe liver function impairment at a local hospital, with glutathione transaminase 1206 U/L, glutathione transaminase 1246 U/L, total bilirubin 398?mol/L, prothrombin activity of 23%, diagnosed as “subacute liver failure”, and transferred to our hospital. The patient had obvious symptoms, progressive deterioration of liver function, the highest serum total bilirubin rose to 419?mol/L, prothrombin activity dropped to 21%, and hepatic encephalopathy, ascites and other complications appeared, our department gave active treatment of liver protection, enzyme reduction, anti-yellowness, anti-infection, deamination, etc., and enhanced plasma, albumin, gammaglobulin and other supportive treatment, as well as hormone and intermittent artificial liver Treatment. The patient’s weakness and other symptoms improved significantly, and his appetite began to return, and his condition improved significantly. The patient was discharged from the hospital after 2 weeks of hospitalization with significant recovery of liver function and normalization of coagulation function. No recurrence at follow-up. Physician’s comments: 1. What is liver failure? Liver failure is a clinical syndrome caused by a variety of factors, including massive necrosis or severe damage to liver cells, jaundice, coagulation dysfunction, hepatic encephalopathy and ascites. The overall morbidity and mortality rate is more than 50%. In China, the main causes of acute liver failure are viral hepatitis and drugs; in recent years, the incidence of liver injury and liver failure caused by traditional Chinese medicine has shown an increasing trend. 2.What are the causes of drug-induced liver failure? The pathogenesis of drug-induced liver injury includes two aspects: some drugs directly cause hepatocyte necrosis; on the other hand, it is related to the patient’s constitution, that is, metabolic abnormalities and allergic reactions occur in some patients, which is called idiosyncratic drug-induced liver injury. The former is predictable while the latter is unpredictable, so some patients taking the same drug will have liver damage or even liver failure, while others will not have any adverse reactions. 3.How to detect liver damage caused by drugs early? Generally speaking, liver injury is most likely to occur within 5 to 90 days of the start of drug application, within 24 hours in individual patients, or more than 90 days in very few patients, or even after discontinuation of the drug. During this period, if symptoms such as weakness, loss of appetite, nausea, aversion to oil, and dark yellow urine occur, you should seek medical attention at the earliest possible time. As for drugs with clear hepatotoxicity, such as anti-tuberculosis drugs, liver function should be checked regularly from the beginning of taking the drugs. 4.What is the experience of successful treatment of liver failure in this case? In this case, the patient’s liver function was damaged to the extent of liver failure, and there were complications such as hepatic encephalopathy and ascites, which made treatment very difficult. On the basis of close monitoring of changes in the condition and active liver preservation treatment, special means such as artificial liver and hormones were appropriately applied to treat the patient, which eventually led to his recovery. 5.What is the subsequent outcome of such patients? The liver has a strong regenerative capacity. After passing the dangerous period, the patient’s liver returns to normal function by regenerating new liver cells, and in the long term it can approach the level of a normal person.