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Scope: Changes in the intestinal flora are related to autoimmune hepatitis (AIH) development. The aim of this study is to investigate the synergistic effects of probiotics and prebiotics on liver injury induced by concanavalin A (Con A). Methods and results: C57BL/6 mice are fed probiotics (Pro), prebiotics (Pre), synbiotic (Syn) for 7 days and then Con A is injected via tail veins to induce AIH. Additionally, methylprednisolone (MP) is gavaged 0.5 h after the Con A injection. It is found that both Pro, Pre, Syn, and MP decrease the levels of serum transaminase, liver F4/80+ macrophage cells, and hepatocellular apoptosis. Pro, Pre, and Syn decrease proinflammatory cytokines, elevate levels of anti-inflammatory as well as restored immune imbalance in AIH. Besides, Pro, Pre, and Syn not only reshape the perturbed gut microbiota, but also maintain intestinal barrier integrity, block the activation of lipopolysaccharide (LPS)/TLR4/NF-𝜿B pathway in the liver. Interestingly, the effects of Syn are superior to Pro or Pre alone in Con A-induced acute liver injury. Conclusions: Syn obviously facilitates AIH remission. The combined use of Pro and Pre is effective in improving Pro and Pre efficacy and can be an important tool for preventing and adjuvant treating patients for AIH.

Purpose: Children with acute lymphoblastic leukemia (ALL) are complicated with cytomegalovirus (CMV) retinitis due to the compromised immune function after chemotherapy. Here, we report a case of cytomegalovirus retinitis in a 4-year-old girl with ALL to emphasize the importance of early diagnosis and intravenous administration of antiviral medication in this group of patients. Case Report: A 4-year-old girl with ALL was diagnosed of fulminant CMV retinitis after chemotherapy. Funduscopic examination revealed perivascular sheathing in pole and peripheral retina of right eye. Large areas of yellowish-white edema, hemorrhage and exudation along the vessels were seen in the superior nasal retina. Few perivascular sheathings were found in peripheral retina without obvious hemorrhage and exudation in left eye. With early diagnosis and prompt intravenous administration of ganciclovir，the lesion of the fundus subsided and the vision was restored over 4 months of follow up period. Conclusions: In summary, CMV retinitis can occur in ALL pediatric patients who receive chemotherapy only, especially in the maintenance stage. With routine follow-up, early diagnosis and intravenous antiviral therapy, these patients may have a good prognosis.