(Disclaimer: This article is only for popularization of science, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: The patient has a history of chronic hepatitis B for many years, did not have a regular physical examination, and recently appeared to have yellow skin and eyes, as well as yellow urine, accompanied by fatigue, nausea and other symptoms, and was diagnosed as “slow plus acute liver failure”, which is a manifestation of an acute exacerbation of chronic liver disease. After examination, he was diagnosed as “slow plus acute liver failure”, which is an acute exacerbation of chronic liver disease. The patient’s condition improved after comprehensive internal medicine treatment and artificial liver treatment, and his liver function recovered, his appetite improved, and his fatigue and abdominal distension improved. Basic information] Male, 43 years old [Disease type] Chronic plus acute liver failure [Hospital] Huangshi Hospital of Traditional Chinese Medicine (City Infectious Diseases Hospital) [Time of consultation] December 2020 [Treatment plan] Medication (magnesium isoglycyrrhizinate injection, reduced glutathione for injection, enteric capsule of hepatocyte growth promoter, ursodeoxycholic acid capsule, adenosylmethionine butanedisulfonate for injection, entegravir dispersible tablets) + artificial liver therapy (plasma, adenosine, and entebasic acid). Treatment cycle] 23 days of hospitalization, outpatient follow-up every 1-2 weeks for a total of 6 months 【Treatment effect】 The patient’s liver function recovered, appetite improved, fatigue, abdominal distension improved I. Initial Consultation Mr. Feng has a history of Hepatitis B minor triple Yang for more than 20 years without systematic diagnosis and treatment, 1 week ago due to work fatigue, yellow skin and eyes and yellow urine, accompanied by fatigue, nausea, anorexia and oil. Mr. Feng had yellow skin and eyes and yellow urine, accompanied by fatigue, nausea, anorexia, and poor appetite. 3 days ago, he developed cough and chills with fever (38℃), and was treated with clindamycin hydrochloride infusion, but his symptoms did not improve. In other hospitals after the examination of liver function, suggesting serious liver function damage, for further diagnosis and treatment, to our hospital, preliminary diagnosis of slow plus acute liver failure, admitted to the hospital for treatment. After admission to the hospital, the auxiliary examination was perfected, and the antibodies against hepatitis A, C, D and E were negative, the antibodies against cytomegalovirus and EB virus were negative, serum ferritin and serum copper blue protein were normal, and the blood routine, fecal routine, renal function, blood lipids, blood glucose, and cardiac enzyme profiles were all normal. Coagulation tetralogy, renal function, blood lipids, and blood glucose were normal. Explaining to the patient that he had a history of hepatitis B minor triple Yang, that other causes of liver injury were currently excluded, and that HBV-DNA was significantly elevated, it could be clearly defined as slow plus acute liver failure caused by hepatitis B virus reactivation, requiring hospitalization for antiviral, hepatoprotective, and enzyme-lowering treatments. The patient was given magnesium isoglycyrrhizinate injection, reduced glutathione for injection, hepatocyte growth promoter enteric capsule, ursodeoxycholic acid capsule, adenosylmethionine butanedisulfonate for injection, and entecavir dispersible tablets for treatment, but the effect was not very good, and then he was treated with artificial liver therapy including plasma replacement + bilirubin adsorption, and the patient got better, and he was discharged after 23 days of hospitalization. The patient was instructed to follow up every 1-2 weeks in outpatient clinic for a total of 6 months. Third, treatment effect The patient was given comprehensive internal medicine treatment, including bed rest and medication, the patient’s jaundice still continued to rise, fatigue, abdominal distension did not see significant improvement, and bilirubin enzyme separation, coagulation dysfunction is difficult to correct. Subsequently, 3 times of artificial liver treatment, i.e. plasma replacement + bilirubin adsorption treatment was given, and the patient’s jaundice did not continue to rise, her appetite improved, and her fatigue and abdominal distension also improved. The patient’s liver function gradually recovered after 6 months of follow-up after continuing comprehensive internal medicine treatment. Note: We are glad that the patient’s liver function recovered after treatment. Slow plus acute liver failure is a critical disease in hepatology with high mortality rate, so the patient should be reminded to quit smoking and drinking, do some aerobic exercise, such as taijiquan, Ba Duan Jin, walking, etc., and don’t stay up late at night, but also take medication on time, and find a doctor to review the liver function regularly in 1-2 weeks, so as to avoid aggravation of the condition. V. Personal Insight The patient in this case had chronic liver disease with a long course of illness, and his condition was generally stable, but it was easy to ignore his condition, and once acute liver failure occurred, the prognosis was very poor, and it was difficult for the family to realize liver transplantation due to the economic situation and obstacles of liver source. In fact, if these patients can adhere to the standardized management of chronic liver disease, regular review of liver function, timely adjustment of treatment strategies, such as hepatitis B drug-resistant patients to change the antiviral regimen, alcoholic liver disease patients to quit alcohol, autoimmune liver disease patients to give adequate immunosuppressant therapy, etc., coupled with the maintenance of good living habits, quit smoking and alcohol, do not stay up all night toiling, keep a relaxed mood, appropriate physical exercise, it is likely to avoid similar situations.