In clinical practice, doctors treating patients with cirrhosis, portal hypertension and varices, I have concluded in my clinical work that there are some important things that are easily overlooked and deserve attention, partly because of clinical experience, partly because of responsibility, and partly because of theory. Now I will talk about my feelings: 1, the original screening problem In the clinic, often see “cirrhosis”, “occult cirrhosis” and other diagnoses, indicating that the cause of cirrhosis is unknown, there are also some doctors neglected to find or do not want to bother to Some doctors neglected to find out or did not want to bother to investigate the essential causes, but only palliative liver preservation, anti-yellowing and other conventional treatment, improved and discharged. In this way, the liver is not good, then hospitalized liver preservation, liver function improved, then discharged, and so on, not only cost a lot of money, and ultimately delayed the disease caused regret. Then the above diagnosis of “cirrhosis” and “occult cirrhosis” is not impossible, but it should be clear whether there is no further damage, that is, whether the current patient cirrhosis is active! If there is no more liver damage and the cirrhosis is simply left behind, the above diagnosis can be given. On the contrary, if the patient’s transaminases are still high and the disease is still progressing, you should think positively and look for the cause, then think about the liver quandary and try to find the initiating factor for targeted treatment. For example, managed an elderly man with recurrent liver injury, outside the hospital only simply liver preservation, variceal ligation, did not look further why the old man cirrhosis. After being admitted to the hospital, after several search examinations, autoimmune hepatitis was finally considered, which improved after targeted treatment was given and cirrhosis was better controlled. 2.Anti-viral treatment for hepatitis B cirrhosis: For the same reasons mentioned above, anti-viral treatment for hepatitis B cirrhosis is especially important because its already long-term liver damage, liver compensatory function is very poor or already decompensated, and there are not many stem cells left to withstand continued damage. Therefore, even if the hepatitis B virus test is lower than 103 copies, as long as the transaminases are high or the liver tissue biopsy suggests active inflammation should be antiviral treatment, and the medication should be good, more than single drug entecavir or two antiviral drugs in combination. 3, varicose vein rupture bleeding early treatment, diligent monitoring varicose vein bleeding treatment options are many, such as growth inhibitor drugs emergency hemostasis, endoscopic ligation to stop bleeding and prevent re-bleeding, transjugular portal vein shunt (TIPS) and so on. With the exception of a few large hospitals or specialties where emergency treatment is available, most hospitals follow a procedure of internal medicine to stop the bleeding and then endoscopic treatment or discharge after the bleeding has stopped. Suppose the doctor tells the patient that further treatment is needed, what is the treatment of choice? Of course, the first choice is esophageal variceal ligation treatment, which will ligate the esophageal varices and can significantly reduce the percentage of variceal rebleeding. For some large hospitals or specialized centers, emergency endoscopy can be performed at the time of bleeding, and the bleeding site is found to be directly treated by ligation or fundoplication, which increases the success rate of hemostasis, reduces the mortality rate of patients, and reduces the clinical cost with very good results. Imagine how many people can afford the cost of applying growth inhibitors and blood transfusion alone when varicose veins bleed. Varicose vein ligation treatment is a continuous process, so we should avoid the situation of not reviewing after treatment in order to achieve continuous treatment and continuous monitoring so as not to stop halfway. 4, the prevention of bleeding can be applied to the heart of the heart to reduce heart rhythm, reduce cardiac output, can effectively reduce portal hypertension, prevention of bleeding effect is significant, so patients with cirrhosis portal hypertension can be applied to the heart of the heart based on the exclusion of contraindications long-term oral. Application index is to reduce the heart rhythm to 75% of the original heart rhythm, to maintain the heart rhythm of 55-60bpm is better.