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SHENYANG, China (Reuters) - As the hospital treating Liu Xiaobao says his organs and breathing have begun to fail from cancer, few in China outside a small circle of dissidents know about the Nobel Peace Prize laureate and his lifetime pursuit of liberal democratic reform.

Even other patients at the First Hospital of China Medical University in the northeastern city of Shenyang, where Liu is being treated, seem not to know they are sharing the facilities with a world famous dissident.

When Reuters visited the floor where friends say Liu is being treated, visitors for other patients on the same ward seemed confused and asked why there were new procedures when security questioned them and checked their IDs.

Nothing has appeared in Chinese-language official media since Liu was diagnosed with cancer in late May. Searches for "Liu Xiaobo" on Chinese social media show no results.

China's foreign ministry answers questions from international media at its daily briefing with the standard line: China is a country ruled by law and the case is an internal affair; other countries should not meddle. Even that line is missing from the official transcripts of the briefings on the ministry's website.

The Global Times, a nationalist tabloid published by the official paper of the ruling Communist Party, is the only publication that regularly writes articles about Liu, in English, and usually to rebuff international criticism.

The paper has cast Liu as an outsider marginalized from society whose cause has failed inside China.

It was overseas dissidents" who are the most active in "hyping the issue and are trying to boost their image by deifying Liu, the Global Times said in a Monday editorial. Western mainstream society is much less enthusiastic than before in interfering with China's sovereign affairs, it said.

Liu was the co-author of a pro-democracy manifesto called Charter 08, which attracted more than 10,000 signatures online before the authorities deleted the document from internet pages and chatrooms. He was awarded the Nobel Peace Prize in 2010, a year after he was sentenced to 11 years in prison for inciting subversion.

Charter '08, issued in 2008, reflected an apparent shift in China at the time toward becoming more open to liberal ideals, said Beijing-based historian and political commentator Zhang Lifan. That changed when Xi Jinping came to power in 2013.

"Since (Liu) was sentenced, peaceful transformation as a route for change has essentially been blocked off by the party. Since the new administration came into office, the party is moving in the opposite direction," he said.

Hu Jia, a well-known Beijing-based dissident and friend of Liu's, says few people in China know anything about him or his work.

"The reality is that if you are on the streets of Beijing and you stop a hundred people, to have one know who Liu Xiaobo is would be a great result," he said.

"Chinese society, due to internet censorship and being cut off from the rest of the world, essentially does not get to hear our (dissident) voices. Protesting voices on Weibo are almost not existent these days," Hu said.

But Xi has helped the dissident movement by locking up a peaceful protester and letting him die in detention. "The last state to do that was Nazi Germany," Hu says.

Carl von Ossietzky, a pacifist who died in 1938 in Nazi Germany's Berlin, was the last Nobel Peace Prize winner to live out his dying days under state surveillance.

While China's censorship makes it difficult to assess Liu's support, he is a "hero" for many liberals in China, even if few will speak out for him, a Chinese editor at an online publication said, declining to be named.

"I am really not sure if it's accurate to claim he is unknown to the public, (or if) people are just too scared to show their knowledge (of Liu)," the editor said.

Despite the restrictions, internet posters have written in support of Liu and his cause, using variations on his name to avoid the censors.

"When it comes to freedom, comes to constitutional government, we have talked too much, now we need to act," read one comment on the micro-blogging platform Weibo. "Situations like Liu Xiaobo's are still a worry, but we nevertheless need people to act, bravely face the risk of death and act."

The post echoed something Liu wrote in April 1989 when he returned from studying in the United States to take part in the pro-democracy movement in Tiananmen Square: intellectuals often "just talk", they "do not do".

"He's leaving, but we cannot see, cannot speak, cannot act" said the headline of an article shared as an image on the popular messaging platform, WeChat, a method that can slow down the censors. In the article, three people born in the 1980s were interviewed about Liu.

"I will see him as a very important symbol, (but) people like him fail to get attention from common folk, and given his plight as an unknown prisoner of conscience, there is little to say," one person identified as L said in the article.

Albert Ho, who heads the Hong Kong Alliance organizing protests in Liu's support, said China's efforts to erase Liu from people's memory will fail.

"Don't underestimate the power of the internet ... And don't underestimate the people. I have seen many episodes where suddenly the hero gets degraded into the devil and the devil becomes the hero," he said, referring to previous shifts in China's political system.

"People are not living in an open society in China so you never know," he said.

Additional reporting by Venus Wu in HONG KONG and Beijing news room; Editing by Bill Tarrant

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China's liberals quietly fight efforts to erase Liu Xiaobo legacy - Reuters