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  • 中国科技核心期刊
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2025 Vol. 28, No. 3 Published:10 May 2025
Impact of circadian rhythms on pathogenesis of non-alcoholic fatty liver disease
Chen Chunru, Qi Haolong, Lu Cong, et al
2025, 28(3):  321-325.  doi:10.3969/j.issn.1672-5069.2025.03.001
Abstract ( 13 )   PDF (874KB) ( 32 )  
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Hashimoto's thyroiditis and nonalcoholic fatty liver disease:contingency or causality?
Lu Yifan, Chen Hao, Huai Jiaxian, et al
2025, 28(3):  326-329.  doi:10.3969/j.issn.1672-5069.2025.03.002
Abstract ( 8 )   PDF (842KB) ( 21 )  
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Viral hepatitis
Sequential or combined rescue antiviral therapy by tenofovir amibufenamide in entecavir-treated chronic hepatitis B patients with low-level viremia
Kong Lixia, Chen Xufeng, Xu Yan, et al
2025, 28(3):  334-337.  doi:10.3969/j.issn.1672-5069.2025.03.004
Abstract ( 10 )   PDF (835KB) ( 9 )  
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Objective The purpose of this study was to investigate sequential or combined rescue antiviral therapy by tenofovir amibufenamide (TMF) in entecavir(ETV)-treated chronic hepatitis B (CHB) patients with low-level viremia(LLV). Methods Eighty-nine patients with CHB who had ETV treatment for at least 24 months were encountered in our hospital between January 2021 and December 2023, and high-sensitive PCR detection found complete virological response (CVR) in 52 cases and LLV in 37 cases. For rescue antiviral therapy, ETV and TMF combination was given in 14 patients, switching to TMF in 12 patients and continuation on ETV in 11 patients for 48 weeks. Multivariate Logistic regression analysis was applied to find risk factors for LLV occurrence. Results Baseline serum ALT and AST levels in patients with LLV were (36.0±5.2)yr, (54.2±7.0)U/L and (43.5±7.4)U/L, all much younger or lower than [(38.9±5.8)yr, (143.0±6.8)U/L and (85.4±7.1)U/L, respectively, P<0.05], while serum HBV DNA load, HBeAg positive rate, HBsAg level and liver stiffness measurement (LSM) were (7.2±2.6)lg IU/ml, 82.7%, 6300.8(5123.9, 8912.4)IU/ml and (8.6±1.0)kPa, all much higher than [(5.4±1.4)lg IU/ml, 40.5%, 3002.0(2413.4, 4512.4)IU/ml and (7.1±0.7)kPa, respectively, P<0.05] in those with CVR; multivariate Logistic regression analysis showed that high serum HBV DNA loads, serum HBeAg positive and high serum HBsAg levels were all the independent risk factors for occurrence of LLV (P<0.05) in CHB patients receiving ETV antiviral treatment; by end of 48 week rescue therapy, serum HBV DNA transferred to negative, serum ALT and LSM were (35.1±4.7)U/L and (6.9±0.6)kPa in patients with ETV and TMF combination treatment, much superior to in other two groups (P<0.05). Conclusion LLV could occur in CHB patients receiving ETV antiviral therapy, and combination of ETV and TMF is an efficacious choice for rescue therapy, which needs long-term clinical observation.
Implication of peripheral blood mononuclear cell galectin-3 and galectin-9 in patients with chronic hepatitis B and concomitant metabolism-related fatty liver disease
Liu Qian, Yang Jie, Zhang Jing, et al
2025, 28(3):  338-341.  doi:10.3969/j.issn.1672-5069.2025.03.005
Abstract ( 9 )   PDF (846KB) ( 8 )  
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Objective The aim of this study was to investigate changes of peripheral blood mononuclear cell (PBMC) galectin-3 and galectin-9 in patients with chronic hepatitis B (CHB) and concomitant metabolism-related fatty liver disease(MAFLD). Methods 138 CHB patients with MAFLD and 95 CHB patients were admitted to Affiliated Hospital, Hebei University between January 2021 and February 2024, and PBMCs were isolated and galectin-3 messenger ribonucleic acid (mRNA) and galectin-9 mRNA was detected by real-time fluorescence quantitative PCR. The influencing factors were determined by multivariate unconditional Logistic regression analysis, and the diagnostic performance of galectin-3 mRNA and galectin-9 mRNA for CHB with MAFLD was analyzed by receiver operating characteristic curve (ROC). Results Galectin-3 mRNA and galectin-9 mRNA in PBMCs in CHB and MAFLD group were (1.6±0.3) and (1.4±0.2), both significantly higher than in CHB group [(1.3±0.1) and (1.2±0.1), respectively, P<0.05]; Logistic analysis showed that body mass index, hypertension, type 2 diabetes, hyperlipidemia, HOMA-IR, galectin-3 mRNA and galectin-9 mRNA loads were all the independent risk factors for CHB patients having MAFLD (P<0.05); the area under the curve (AUC) for PBMC galectin-3 mRNA and galectin-9 mRNA combination in predicting CHB with MAFLD was 0.888, much greater than 0.785 by galectin-3 mRNA or 0.791 by galectin-9 mRNA alone (P<0.05). Conclusion PBMC galectin-3 mRNA and galectin-9 mRNA loads are abnormally increased in patients with CHB and concomitant MAFLD, and the combination of the two parameters might help predict the existence of MAFLD in patients with CHB.
Sound touch elastography in predicting liver fibrosis in patients with chronic hepatitis B
Wang Yu, Liu Jie, Fan Jianmin, et al
2025, 28(3):  342-345.  doi:10.3969/j.issn.1672-5069.2025.03.006
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Objective The aim of this study was to investigate sound touch elastography (STE) in predicting liver fibrosis (LF) in patients with chronic hepatitis B (CHB). Methods 79 patients with CHB were recruited in our hospital between January 2021 and March 2024, and all of them underwent liver biopsy. Liver stiffness measurement (LSM) was obtained by STE. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic performance of LSM in predicting significant LF. Results Of 79 patients with CHB, liver histo-pathological examination showed S0 in 17 cases, S1 in 30 cases, S2 in 15 cases, S3 in 10 cases and S4 in 7 cases; serum ALT and AST levels in patients with S2/S3 were much higher than in patients with S0/S1 (P<0.05); LSM in patients with SO, S1, S2, S3 and S4 were (6.3±0.5)kPa, (7.7±1.2)kPa, (8.9±1.4)kPa, (11.3±1.0)kPa and (15.7±1.2)kPa, suggesting gradually increasing trend; the AUC was 0.974 (95%CI:0.912-0.996), with sensitivity of 97.1%, specificity of 85.1% and accuracy of 94.6%, when LSM=8.3 kPa was set as cut-off-value in predicting significant LF (defined as >=S2). Conclusion STE technique could be used in predicting LF in patients with CHB, which might add more measures for early diagnosis.
Satisfactory response to pegylated interferon α-2a and albavir/granrivir combination therapy in patients with chronic hepatitis C
Wang Hao, Wang Qingyuan, Shen Qiong, et al
2025, 28(3):  346-349.  doi:10.3969/j.issn.1672-5069.2025.03.007
Abstract ( 7 )   PDF (835KB) ( 1 )  
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Objective This study was conducted to investigate efficacy of pegylated interferon α-2a (peg-IFNα-2a) and albavir/granrivir combination in the treatment of patients with chronic hepatitis C (CHC). Methods 74 patients with CHC were encountered in our hospital between January 2018 and January 2022, and we assigned them to receive peg-IFNα-2a and albavir/granrivir combination therapy (observation, n=37) for 12 weeks, or to receive peg-IFNα-2a and ribavirin combination therapy (control, n=37) for 24 weeks. Serum HCV RNA loads and other laboratory tests were recorded. Results Rapid virological response rate, end of treatment virological response rate and sustained virological response rate in observation group were 70.3%, 97.3% and 94.6%, all significantly higher than 37.8%, 62.2% and 54.1% in the control (P<0.05); by week 4, week 12 and week 24 of follow-up, serum HCV RNA loads in the observation were (1.6±0.8)lg u/ml, (1.5±0.9)lg u/ml and (1.2±0.3)lg u/ml, all significantly lower than [(4.3±0.9)lg u/ml, (4.5±0.8)lg u/ml and (3.2±0.5)lg u/ml, respectively, P<0.05] in the control; by end of antiviral treatment, peripheral blood WBC, RBC, PLT counts and Hb concentration in the observation were (5.1±1.0)×109/L, (4.9±0.6)×1012/L, (101.8±17.5)×109/L and (120.5±19.5)g/L, all significantly higher than [(3.3±0.9)×109/L, (4.3±0.5)×1012/L, (85.8±17.3)×109/L and (100.3±16.3)g/L, respectively, P<0.05] in the control, and serum ALT and AST levels were (34.6±5.8)U/L and (36.4±6.9)U/L, both much lower than [(46.3±6.9)U/L and (49.1±7.5)U/L, respectively, P<0.05] in the control group. Conclusion Combination of peg-IFN α-2a and albavir/graniclovir in treatment of patients with CHC could obtain a satisfactory antiviral efficacy, improve liver function recovery.
Non-alcoholic fatty liver diseases
Correlation of serum volatile organic compounds to body inflammatory index in patients with metabolism-related fatty liver disease: an analysis based on 2017-2020 National Health and Nutrition Examination Survey database
Dai Zixing, Yuan Hui, Chen Qingling, et al
2025, 28(3):  350-353.  doi:10.3969/j.issn.1672-5069.2025.03.008
Abstract ( 7 )   PDF (955KB) ( 0 )  
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Objective The aim of this study was to investigate correlation of serum volatile organic compounds (VOCs) to and body inflammatory index in patients with metabolism-related fatty liver disease(MAFLD): an analysis based on 2017-2020 National Health and Nutrition Examination Survey database (NHANES). Methods Data from NHANES database from 2017 to 2020 were retrieved, patients who met diagnosis of MAFLD were enrolled and their laboratory tests, including serum VOCs levels and results of questionnaires were collected. Systemic inflammatory response index (SIRI) and systemic iImmunoinflammatory index (SII) were calculated. Multivariate Logistic regression modeling was applied to analyze correlation of the two inflammatory indicators to serum VOC content. Results SII in 2991 patients with MAFLD was (531±325), SIRI was (1.8±1.01), serum 1,4-dichlorobenzene level was (1.2±8.2) ng/mL, and serum 2,5-dimethylfuran level was (0.1±0.1) ng/mL; serum 2,5-dimethylfuran level was positively correlated with SIRI (r=0.3, P<0.05) and with SII (r=0.3, P<0.05) in patients with MAFLD; by multivariate Logistic regression modeling analysis, serum 2,5-dimethylfuran level was found to be associated with SIRI (β=1.8±0.3, P<0.05) and with SII (β=696.7±122.4, P<0.05) in unadjusted model; the model adjusted by age found that SIRI (β=2.0±0.3, P<0.05) and SII (β=709.1±123.9, P<0.05) were positively correlated to serum 2,5-dimethylfuran level; serum 2,5-dimethylfuran level was found to be still correlated to SIRI (β=1.7±0.3, P<0.05) or to SII (β=655.8±129.7, P<0.05) by adjusting the model for age, gender, body mass index (BMI), waist circumference (WC), smoking, hypertension, diabetes, total triglycerides (TG), alanine Aminotransferase (ALT), high-density lipoprotein (HDL) and high sensitivity C-reactive protein (hsCRP). Conclusion Exposure of individuals to higher levels of 2,5-dimethylfuran could exacerbate body systemic inflammatory response, which might trigger MAFLD occurrence.
Characterization of ileal microbiome in patients with metabolic-associated fatty liver disease
Wei Taotao, Liu Tianye, Dai Gaozhong
2025, 28(3):  354-357.  doi:10.3969/j.issn.1672-5069.2025.03.009
Abstract ( 11 )   PDF (1284KB) ( 21 )  
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Objective The aim of this study was to investigate characteristics of ileal microbiota in patients with metabolic associated fatty liver disease (MAFLD). Methods 54 patients with MAFLD and 18 individuals for physical examination were recruited in our hospital between January 2024 and November 2024, all underwent FibroScan scan for controlled attenuation parameter (CAP) and endoscopy with special device for ileal specimen collection. 16S rDNA sequencing was performed. Results Patients with MAFLD in our series were divided into mild, moderate and severe liver steatosis, with 18 cases in each; patients with MAFLD had an elevated Alpha diversity of ileal flora, with a gradual decrease in percentage of Turicibacter, a reduction in abundance of Lactobacillus and Veillonella, while having an increase in the abundance of Prevotella, Leptotrichia and Porphyromonas. Conclusion The diversity and abundance of ileal microbiota in patients with MAFLD change, which is related to the severity of the entity. The reduction of Turicibacter and the migration of oral colonizing bacteria might be characteristics of the ileal microbiota in patients with MAFLD.
Improvement of liver function tests by oral bicyclol in patients with type 2 diabetes mellitus and nonalcoholic steatohepatitis
Xu Lingling, Lu Yuan, Zheng Yanchai, et al
2025, 28(3):  358-361.  doi:10.3969/j.issn.1672-5069.2025.03.010
Abstract ( 9 )   PDF (836KB) ( 11 )  
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Objective The aim of this study was to investigate oral bicyclol administration in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic steatohepatitis (NASH). Methods A total of 102 patients with T2DM and nonalcoholic fatty liver disease (NAFLD) were enrolled in our hospital between January 2021 and October 2023, and out of them, NASH was diagnosed in 48 cases. Patients with NASH were randomly assigned to receive metformin in 24 cases (control) or receive metformin and bicyclol combination in another 24 cases (observation) for six months. Fasting blood glucose (FPG) and glycosylated hemoglobin (HbA1C) were routinely detected, fasting insulin (FINS) level was determined by radioimmunoassay, and homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Results By end of six month treatment, serum AST and ALT levels in the observation group were (51.3±7.3)U/L and (49.6±9.4)U/L, both much lower than [(82.8±7.6)U/L and(98.7±11.1)U/L, respectively, P<0.05] in the control; serum total cholesterol, triacylglycerol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels in the observation were(5.5±0.7)mmol/L, (2.7±0.4)mmol/L, (3.2±0.4)mmol/L and (1.1±0.4)mmol/L, all not significantly different compared to [(5.5±0.6)mmol/L, (2.6±0.5)mmol/L, (3.2±0.5)mmol/L and (1.1±0.3)mmol/L] in the control (P>0.05); HbA1c, FPG, FINS and HOMA-IR were (6.9±0.8)%, (5.4±1.2)mmol/L, (5.4±0.7)μU/ml and (1.2±0.3), all not significantly different as compared to [(6.7±0.7)%, (5.2±1.1)mmol/L, (5.3±1.1)μU/ml and (1.2±0.5)] in the control group (P<0.05). Conclusion Oral bicyclol could short-termly reduce serum liver function test parameters in patients with NASH and underlying T2DM, which is worthy of further study.
Efficacy of estimated glucose disposal rate in predicting risk of metabolism-associated fatty liver disease in individuals without diabetes
Dong Xu, Wang Chaoqun, Chen Yi, et al
2025, 28(3):  362-365.  doi:10.3969/j.issn.1672-5069.2025.03.011
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Objective The aim of this study was to investigate efficacy of estimated glucose disposal rate (eGDR) in predicting risk of metabolism-associated fatty liver disease (MAFLD) in individuals without type 2 diabetes mellitus (T2DM). Methods 468 non-diabetic individuals with MAFLD and 100 non-diabetic healthy persons were encountered in the First Affiliated Hospital, Naval Medical University between July and December 2023, clinical materials were routinely obtained, and eGDR were calculated. Multivariate Logistic regression analysis was applied to reveal risk factors of MAFLD in non-diabetic population. All subjects were divided into Q1 to Q4 groups based on the eGDR quartiles, and the prevalence of MAFLD in each group was compared. ROC curve was plotted to evaluate the efficacy of eGDR in predicting MAFLD. Results Of individuals without diabetes in our series, MAFLD patients were older and more male than in healthy controls; BMI, systolic blood pressure, diastolic blood pressure, serum triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, glycated hemoglobin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, creatinine, urea nitrogen and uric acid levels were all higher (all P<0.001) , while serum high density lipoprotein-cholesterol and eGDR were lower (all P<0.001) than in control persons; multivariate Logistic regression analysis showed that age and BMI were independent risk factors for the occurrence of MAFLD, while diastolic blood pressure and eGDR were independent protective factors (P<0.05) in persons without diabetes; ROC analysis showed that the AUC of eGDR reduction in predicting the risk of MAFLD existence was 0.939 (95% CI:0.910 to 0.969, P<0.001), with a maximum Yoden index of 0.775, corresponding to an optimal cut-off value of 10.85 mg/kg/min, with a sensitivity of 89.5% and a specificity of 88.0%; Q4 group had the lowest prevalence of MAFLD (38.0%) compared to other three groups. Conclusions eGDR is a non-invasive and easily available indicator of insulin resistance. The decrease of eGDR is associated with the increased risk of MAFLD in non-diabetic individuals, and it has a good predictive efficacy for MAFLD.
Comparison of diagnostic performance of six non-invasive evaluation scores for type 2 diabetes mellitus with metabolic associated fatty liver disease
Qin Hao, Fang Chunhua, He Jing, et al
2025, 28(3):  366-369.  doi:10.3969/j.issn.1672-5069.2025.03.012
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Objective The aim of this study was to evaluate diagnostic performance of six non-invasive evaluation scores for type 2 diabetes mellitus (T2DM) with metabolic associated fatty liver disease (MAFLD). Methods A total of 282 patients T2DM, of them MAFLD was diagnosed in 158 cases, were enrolled in our hospital between January and December 2023, and from conventional clinical materials, metabolic score for insulin resistance (METS-IR), triglyceride-glucose index(TyG), triglyceride glucose-body mass index (TyG-BMI), hepatic steatosis index (HSI), Framingham steatosis index (FSI) and Zhejiang University index (ZJUI) were calculated. The diagnostic efficacy of these scores was assessed by using receiver operating characteristic (ROC) curve analysis. Results All the six non-invasive evaluation scores were significantly greater in patients with T2DM and MAFLD than in those with T2DM (P<0.05); the predicting AUC by TyG-BMI was 0.857(95% CI:0.814-0.900), and the AUC by ZJUI was 0.852(95% CI:0.808-0.896), suggesting both having a satisfactory diagnostic performance. Conclusion Both TyG-BMI and ZJU index have an excellent predictive value for identifying MAFLD from patients with T2DM, offering potential tools for clinical screening and monitoring.
Short-term observation of acupoint application and exercise in the treatment of patients with non-alcoholic fatty liver disease
Wen Dachao, Zhang Qiuping, Shi Ling
2025, 28(3):  370-373.  doi:10.3969/j.issn.1672-5069.2025.03.013
Abstract ( 7 )   PDF (835KB) ( 0 )  
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Objective The aim of this study was to investigate acupoint application and exercise prescription in the treatment of patients with non-alcoholic fatty liver disease (NAFLD). Methods 81 patients with NAFLD were encountered in our hospitalbetween June 2022 and June 2024, and were randomly divided into control group (n=40) and observation group (n=41). Patients in the control group received lipid-lowering therapy with dietary intervention, and those in the observation received acupoint application and exercise prescription. The intervention lasted for three months in the two groups. Serumtumor necrosis factor-α(TNF-α), interleukin 6 (IL-6), irisin and adiponectin (APN) levels were detected by ELISA, controlled attenuation parameter (CAP) was determined byFibrotouch, and generic quality of life inventory 74 (GQOLI-74) and health promoting lifestyle profile (HPLP)were evaluated. Results By end of three month intervention, body mass index, waist-to-hip ratio and ,WHR and percentage of body fat in the observation group were(24.3±2.6)kg/m2, (0.6±0.2)and (27.3±2.8)%, all much lower than [(26.1±2.7)kg/m2, (0.7±0.1)and (29.6±3.1)%,P<0.05] in the control; serum total cholesterol,triacylglycerol and low-density lipoprotein cholesterol levels were(5.5±0.7)mmol/L, (1.7±0.3)mmol/Land (3.2±0.5)mmol/L, all much lower than[(5.9±0.7)mmol/L, (2.6±0.4)mmol/L and (4.2±0.5)mmol/L, respectively, P<0.05], while serum high-density lipoprotein cholesterol level was(1.3±0.4)mmol/L, much higher than [(1.0±0.3) mmol/L,P<0.05] in the control; serumalanine aminotransferase,aspartate aminotransferase and CAP were(40.3±4.5)IU/L, (42.1±4.6)IU/L and (267.8±7.8)dB/m, all significantly lower than[(93.4±5.6)IU/L, (61.7±5.9)IU/Land (288.3±10.9)dB/m, respectively, P<0.05] in the control; serum TNF-α and IL-6 levels were(401.5±42.3)pg/mL and (18.6±2.8)mg/L, both significantly lower than [(461.2±48.6)pg/mLand (28.7±3.1)mg/L, respectively, P<0.05], while serum irisin and APN levels were (9.4±1.2)ng/mL and (19.3±2.1)μg/mL, both significantly higher than[(7.6±0.9)ng/mLand (13.4±1.8)μg/mL, respectively,P<0.05] in the control group; GQOLI-74 score, and regular exercise, scientific dietand adequate sleep rates were(81.2±8.5)points, and 87.8%, 85.4%and 82.9%, all much higher than [(76.3±7.6)points, 62.5%, 60.0%and 62.5%, respectively, P<0.05] in the control. Conclusion Acupoint application and exercise prescription is efficacious in the treatment ofpatients with NAFLD,which might improve body fat metabolism and alleviate inflammatory reactions.
Ultrasound attenuation coefficient and serumALT/AST ratio in evaluating liver steatosis in patients with nonalcoholic fatty liver disease
Ma Chengxi, Xu Jing, Wang Yanqiu
2025, 28(3):  374-377.  doi:10.3969/j.issn.1672-5069.2025.03.014
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Objective The aim of this study was to investigate diagnostic performance of ultrasound attenuation coefficient (AC) and serum alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio in evaluating liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods 70 patients with NAFLD and 30 volunteers for healthy physical examination were admitted to our hospital between May 2021 and May 2024, and all patients with NAFLD received liver biopsies. Ultrasonic attenuation imaging (ATI) was performed to measure AC, and serum ALT and AST levels were routinely detected. Receiver operating characteristic (ROC) curves were applied to analyze predicting efficacy of AC and serum ALT/AST ratio combination for liver steatosis in patients with NAFLD. Results Of 70 patients with NAFLD in our series, liver histo-pathological examination showed liver steatosis of mild degree in 20 cases, moderate in 28 cases and severe in 22 cases; AC in patients with severe liver steatosis was (1.1±0.4)dB·cm-1·MHz-1, much higher than [(0.8±0.3)dB·cm-1·MHz-1, P<0.05] in moderate or [(0.6±0.2)dB·cm-1·MHz-1, P<0.05] in mild and [(0.5±0.1)dB·cm-1·MHz-1, P<0.05] in healthy persons, and serum ALT/AST ratio was (1.0±0.1), much lower than [(1.3±0.2), P<0.05] in moderate or [(1.7±0.4), P<0.05] in mild and [(1.8±0.5), P<0.05] in healthy control; ROC analysis showed that the AUC was 0.882(95%CI:0.745-0.961), with sensitivity (Se) of 92.9% and specificity (Sp) of 75.0%, when AC and ALT/AST ratio combination in predicting moderate liver steatosis (P<0.05), and the AUC was 0.902(95%CI:0.804-0.978), with Se of 95.5% and Sp of 85.0%, when the two parameters combined in predicting severe liver steatosis, much superior to any parameter doing alone (P<0.05). Conclusion Combination of AC and serum ALT/AST ratio might help clinicians for early liver steatosis screening, which needs further clinical investigation.
Changes of serum osteocalcin,β-I type collagen carboxy-terminal peptide and angiotensin levels in patients with non-alcoholic fatty liver diseases
Wang Xintian, Kang Xiaobo, Wu Xia, et al
2025, 28(3):  378-381.  doi:10.3969/j.issn.1672-5069.2025.03.015
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Objective The aim of this study was to explore implication of serum osteocalcin (OCN), β-I type collagen carboxy-terminal peptide (β-CTX) and angiotensin-II(Ang-II) levels in patients with non-alcoholic fatty liver diseases(NAFLD). Methods 101 patients with NAFLD, including simple fatty liver (SFL) in 32 cases, nonalcoholic steatohepatitis (NASH) in 50 cases and fatty-related liver cirrhosis (LC) in 19 cases, and 53 healthy individuals who underwent for physical examinations were enrolled in our hospital between June 2022 and December 2023, and all received Fibroscan scan for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). Serum OCN level was detected by ELISA, serum β-CTX level was determined by electrochemiluminescence immunoassay, and serum Ang-II level was measured by using fully automated chemiluminescence instrument. Results CAP in patients with SFL was much higher than in healthy control(P<0.05), serum ALT and AST levels, as well as LSM and CAP in patients with NASH and with LC were much higher than in patients with SFL or healthy individuals (P<0.05), and LSM in patients with LC was much higher than in with NASH(P<0.05); serum OCN and β-CTX levels in patients with NASH were (17.3±6.3)ng/mL and (0.3±0.1)ng/mL, both significantly lower than [ (22.8±6.4)ng/mL and (0.4±0.2)ng/mL, respectively, P<0.05] in patients with SFL, while serum Ang-Ⅱ level was (2.7±0.5)μg/L, significantly higher than [(2.4±0.4)μg/L, P<0.05] in patients with SFL; serum Ang-Ⅱ level in patients with LC was (3.0±0.6)μg/L, much higher than in with NASH(P<0.05); serum OCN and β-CTX levels in 19 patients with advanced liver fibrosis were(16.0±6.9)ng/mL and (0.2±0.1)ng/mL, both significantly lower than [(19.6±6.0)ng/mL and (0.4±0.1)ng/mL, respectively, P<0.05], while serum Ang-Ⅱ level was (3.1±1.5)μg/L, much higher than [(2.5±0.7)μg/L, P<0.05] in 31 patients with significant liver fibrosis. Conclusion Abnormal changes of serum OCN, β-CTX and Ang-II levels in patients with NAFLD is common, which might help assess steatosis and fibrosis.
Diagnostic performance of shear wave elastography and APRI combination in predicting significant liver fibrosis in patients with type 2 diabetes mellitus and NAFLD
Zeng Ai, Wang Cong, Li Min, et al
2025, 28(3):  382-385.  doi:10.3969/j.issn.1672-5069.2025.03.016
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Objective The aim of this study was to explore diagnostic performance of shear wave elastography and aspartate aminotransferase/platelet ratio index (APRI) combination in predicting significant liver fibrosis (SLF) in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Methods 73 patients with T2DM and NAFLD were enrolled in our hospital between January 2021 and December 2023, and all underwent transient elastography (TE) to obtain liver stiffness measurement (LSM), underwent shear wave elastography to obtain Yang’s modulus, and routine blood detection for APRI. Receiver operating characteristic (ROC) curves were drawn for assess diagnostic efficacy, and the consistency between shear wave elastography and APRI combination, and LSM in the diagnosis of SLF was analyzed by Kappa test. Results SLF was found in 19 cases (26.0%) based on LSM>7.4 kPa; body mass index, percentage of concomitant renal injury, serum AST, ALT level, LSM, APRI and Yang’s modulus in patients with SLF were (30.7±2.8)kg/m2, 42.1%, (92.3±10.5)U/L, (120.5±9.6)U/L, (12.7±3.1)kPam (1.2±0.4) and (10.7±3.1)kPa, all much higher than [(25.2±2.4)kg/m2, 20.4%, (49.8±8.1)U/L, (47.8±7.3)U/L, (6.1±1.6)kPa, (0.8±0.3) and ((5.1±1.6))kPa, respectively, P<0.05] in patients without SLF; the ROC analysis showed that the AUC was 0.891, with sensitivity of 94.7% and specificity of 74.1%, when Yang’s modulus and APRI combination in predicting SLF in patients with T2DM and with underlying NAFLD, much superior to any parameters doing alone (P<0.05); Kappa value between shear wave elastography and APRI combination, and TE in the diagnosis of SLF was 0.563 (P<0.05), suggesting moderate result. Conclusion Shear wave elastography and APRI combination in predicting SLF in patients with T2DM and NAFLD is efficacious, which might guide clinicians for further management.
Drug-induced liver injuries
Serum miR-122, IL-1β and IL-10 level Changes in patients with drug-induced liver injury
Xiong Zuan, Cheng Feng, Liu Qing, et al
2025, 28(3):  386-389.  doi:10.3969/j.issn.1672-5069.2025.03.017
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Objective The aim of this study was to explore clinical implication of serum microRNA-122 (miR-122), interleukin-1beta (IL-1β) and IL-10 levels in patients with drug-induced liver injury (DILI). Methods 139 patients with DILI and 75 individuals for physical examination were admitted to our hospital between January 2023 and June 2024, and thecatalogue of patients with DILI included cholestatic type in 39 cases, hepatocyteinjury type in 86 cases and mixed type in 14cases, and grade 1 in 43 cases, grade 2 in 60 cases and grade 3 in 36 cases based on liver injury severity. Serum miR-122 level was detected by real-time reverse transcription polymerase chain reaction (RT-PCR), and serum IL-1β and IL-10 levels were assayed by ELISA. Results Serum bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transferase levels in patients with DILI were(48.6±7.9)μmol/L, (117.9±35.8)U/L,(112.8±42.3)U/L, (193.2±46.5)U/L and (377.6±88.8)U/L, all significantly higher than [(10.3±3.2)μmol/L, (24.8±5.4)U/L, (23.1±4.0)U/L, (49.7±17.8)U/L and (50.4±4.2)U/L, respectively, P<0.05] in the control; serum miR-122 level in patients with mixed type was(11.5±2.6)and in those with hepatocyteinjury typewas(10.9±1.6), both much higher than [(9.0±1.5),P<0.05] in those with cholestatic type, serum IL-1β level in patients with mixed type was (105.3±3.8)pg/mL and in those with hepatocyte injury type was (101.8±3.2)pg/mL, both much higher than [(90.6±13.0)pg/mL, P<0.05] in those with cholestatic type, while there were no significant differences as respect to serum IL-10 levels among the three groups (P>0.05); serum miR-122 level in patients with grade 3 was (12.5±1.2), and in those with grade 2was (10.3±1.4), both much higher than [((8.6±1.5),P<0.05] in patients with grade 1 liver injury, serum IL-1β level in patients with grade 3 was (105.1±13.2)pg/mL, and in those with grade 2 was (100.7±13.4)pg/mL, both significantly higher than [(88.8±13.1)pg/mL, P<0.05] in those with grade 1, while serum IL-10 level in patients with grade 3 was (1.9±0.8)pg/mL, and in those with grade 2 was (2.1±0.9)pg/mL, both significantly lower than [(2.8±1.1)pg/mL, P<0.05]in those with grade 1 liver injury. Conclusion Serum miR-122,IL-1β and IL-10 level changes in patients with DILI might hint severity of liver injuries, and warrant further clinical investigation.
Clinical feature of patients with drug-induced autoimmune-like hepatitis: An analysis of 73 cases
Ma Dantong, Yang Shuang, Gao Lili, et al
2025, 28(3):  390-393.  doi:10.3969/j.issn.1672-5069.2025.03.018
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Objective The purpose of this study was to summarize clinical feature of patients with drug-induced autoimmune-like hepatitis(DI-ALH). Method A retrospective analysis was conducted on clinical data of patients with drug-induced liver injury (DILI) in our hospital between January 2018 and January 2023, and all patients underwent liver biopsies. Immunosuppressant was given to those with autoimmune phenomenon. Result Of 312 patients with DILI, DI-ALH was found in 73 patients who presented as persistent liver injury after discontinuation of suspected medicine, elevated serum globulin level, and positive autoantibodies; percentage of herbal medicine-induced liver injury (HILI) in patients with DI-ALH was much higher than in patients with DILI(P<0.05), serum cholinesterase level was much lower, while total serum bile acid (TBA), bilirubin, globumin and IgG levels were much higher than in patients with DILI (P<0.05); liver histo-pathological injuries were more severe in patients with DI-ALH; of 70 patients with DI-ALH receiving immunosuppressant, disease remission (DR) rate was found as 48.6% and incomplete response (ICR) was 51.4% after three month treatment; baseline serum IgG levels in patients with ICR was much higher than in those with DR (P<0.05), and liver injuries in ICR group were more severe (P<0.05). Conclusion Autoimmune reaction might be involved in patients with DILI, especially in those who take herbal medicine, immunosuppressant might be tentatively given and the long-term efficacy still need observation.
Liver failure
Efficacy of plasma exchange and hemofiltration in the treatment of patients with acute-on-chronic hepatitis B liver failure
Li Yongfei, Xu Zhengju, Ye Qiaoxia, et al
2025, 28(3):  394-397.  doi:10.3969/j.issn.1672-5069.2025.03.019
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Objective The aim of this study was to compare the efficacy of plasma exchange (PE) and hemofiltration (HF) at different start-up time in the treatment of patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF). Methods 126 patients with HBV-ACLF were enrolled in our hospital between March 2021 and March 2024, and all patients underwent PE/HF therapy. Artificial liver supporting system (ALSS) treatment started early (less than 72 hours after admission) in 89 cases (observation), and started lately (72 hours thereafter) in 37 cases (control). Results ALSS carried out repeatedly for (3.4±1.4)times in the observation group, much less than [(4.6±1.1)times, P<0.05] in the control, while 28-day and 90 day survivals were 84.2% and 67.4%, much higher than 67.6% and 48.6%(P<0.05) in the control; by three months after treatment, serum HBV DNA went to negative in all the patients in the two groups; there were no significant differences as respect to serum potassium, sodium and chlorine levels before and after ALSS treatment in the two groups(P>0.05); after treatment, total serum bilirubin level, prothrombin time activity and serum albumin level in 60 survivals in the observation group were (25.8±7.6)μmol/L, (68.2±9.3)% and (34.7±2.8)g/L, not significantly different as compared to [(28.4±5.9)μmol/L, (63.7±8.6)% and (35.6±2.5)g/L, respectively, P<0.05] in 18 survivals in the control group. Conclusion ALSS treatment should start as early as possible after admission in patients with ACLF, and any delay and hesitancy might decrease successful rescue rate.
Comparison of nafamostat mesylate and unfractionated heparin for anticoagulation during double plasma molecular adsorption system treatment in patients with liver failure
Zhang Wenrui, Zhao Ninghui, Yao Ruoyu, et al
2025, 28(3):  398-401.  doi:10.3969/j.issn.1672-5069.2025.03.020
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Objective This clinical trial was conducted to compare anticoagulational effect of nafamostat mesylate (NM) and unfractionated heparin (UFH) during double plasma molecular adsorption system (DPMAS) treatment in patients with liver failure(LF). Methods We retrospectively analyzed clinical materials of LF patients underwent DPMAS treatment in Department of Gastroenterology, Shanxi Bethune Hospital between May 2023 and May 2024. During the procedure, NM as an anticoagulant was given at dose of 60 mg for piping with thereafter 35 mg.h-1 maintaining. Prothrombin time activity(PTA), international normalized ratio (INR), activated partial thromboplastin time (APTT) and blood platelet counts were routinely detected. Results 27 patients with LF were enrolled and received 62 times of DPMAS treatments, of which UFH was used in 21 times and NM was used in 41 times; after DPMAS treatment, elongation APTT and INR in NM group were 1.3(-3.6, 9.0)% and 2.5(-8.5, 16.6)%, both significantly less than [271.1(49.0, 816.5)% and 68.9(44.8, 118.8)%, respectively, P<0.05] in UFH group, and reduction rates of PTA and PLT counts were (4.2±23.7)% and 4.6(1.3, 7.6)%, both significantly lower than [(46.5±24.3)% and (13.0±12.6)%, respectively, P<0.05] in UFH group; there was no significant difference as respect to incidences of hypotension (9.8% vs. 14.3%, P>0.05), and no bleeding was found between the two groups. Conclusion Impact of nafamostat mesylate on coagulation function tests and platelet counts in patients with LF during DPMAS treatment is relatively small, and needs further clinical investigation as a limited cases observed.
Liver cirrhosis
Diagnostic performance of sound touch elastography and semi-quantitative ultrasound scoring in assessing early liver cirrhosisin patients with chronic hepatitis B
Zhai Feifei, Wang Cai, Wang Junling, et al
2025, 28(3):  402-405.  doi:10.3969/j.issn.1672-5069.2025.03.021
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Objective The aim of this study was to investigate the diagnostic performance of sound touch elastography (STE) and semi-quantitative ultrasound scoring in assessing early liver cirrhosis (LC) in patients with chronic hepatitis B(CHB). Methods A total of 103 patients with CHB were enrolled in our hospital between January 2022 and June 2024, and all underwent liver biopsies and Color Doppler ultrasonography for semi-quantitative ultrasound scores and elasticity modulus (E) values. Fibrosis index based on 4 factors (FIB-4) was routinely calculated. The diagnostic efficacy of ultrasonic indexeswas analyzed by receiver operating characteristic (ROC) curves. Results Of 103 patients with CHB, liver histo-pathological examination found early LC in 37 cases (35.9%); total score of semi-quantitative ultrasound in patients with LC was (13.9±1.7)points, much higher than [(8.6±1.2)points, P<0.05] in patients with CHB; E value in LC group was (11.5±2.9)kPa, significantly greater than [(7.4±1.6)kPa, P<0.05] in CHB group; peripheral blood platelet count in LC group was (112.7±41.9)×109/L, much lower than [(159.6±58.3)×109/L, P<0.05], while FIB-4 score was (2.4±0.3)points, much greater than [(1.5±0.6),P<0.05] in CHB group; the AUC was 0.963(95%CI:0.906-0.990), with sensitivity of 89.2% and specificity of 94.5%, when the E value with combination of semi-quantitative ultrasound score in predicting early LC in patients with CHB, much superior to that by any one of the parameters(P<0.05). Conclusion STE and semi-quantitative ultrasound score have a very satisfactory diagnostic efficacy in predictingearly LC in patients with CHB, which warrant further clinical investigation.
Prevalence and risk factors of overt hepatic encephalopathy in hepatitis B-induced liver cirrhosis
Yao Yu, Xu Chunyang, Ren Jiangwu
2025, 28(3):  406-409.  doi:10.3969/j.issn.1672-5069.2025.03.022
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Objective The purpose of this study was to investigate prevalence and risk factors of overt hepatic encephalopathy (HE) in hepatitis B-induced liver cirrhosis (LC). Methods 60 patients with hepatitis B-induced LC were recruited in our hospital between March 2019 and March 2021, and consecutively followed-up for two years. Third lumbar skeletal muscle index (L3-SMI) was obtained by abdominal CT scan, esophageal varices (EV) was determined by gastroscopy, and HE was diagnosed by West Haven score. Multivariate Logistic regression analysis was applied to find risk factors. Results HE was found in 25 cases during the two-year follow-up period; baseline serum bilirubin, INR, EV incidence, hepatorenal syndrome, Child-Pugh score, MELD score and sarcopenia incidence in patients with HE were (35.3±8.5)μmol/L, (1.4±0.5), 68.0%, 72.0%, (15.6±2.3) points, (21.6±2.5)points and 80.0%, all much higher than [(20.6±9.3)μmol/L, (1.2±0.3), 25.7%, 17.1%, (9.2±1.6)points, (15.5±3.2)points and 34.3%, respectively, P<0.05], while serum albumin level, peripheral blood platelet count and L3-SMI were (29.3±5.6)g/L, (62.3±13.5)×109/L and (43.1±8.9)cm2/m2, all much lower than [(33.2±5.9)g/L, (85.2±15.6)×109/L and (46.3±8.5)cm2/m2, respectively, P<0.05] in cirrhotics without HE; multivariate Logistic regression analysis showed that PLT(OR=3.442, INR(OR=3.677), EV (OR=3.647, Child-Pugh class (OR=4.191), MELD score (OR=4.614), sarcopenia (OR=4.651) and L3-SMI (OR=4.468) were all the independent risk factors for occurrence of HE in patients with LC (P<0.05). Conclusion Clinicians should take common risk factors of complications, such as HE, into consideration as dealing with patients with LC, which might improve the prognosis.
Efficacy of endoscopic variceal ligation and somatostatin and esomeprazole combination in the treatment of patients with liver cirrhosis with complicated esophagogastric variceal bleeding
Xu Rongbo, Wang Yan, Wang Xiaosong, et al
2025, 28(3):  410-413.  doi:10.3969/j.issn.1672-5069.2025.03.023
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Objective The aim of this study was to investigate clinical efficacy of endoscopic variceal ligation (EVL) and somatostatin and esomeprazole combination in the treatment of patients with liver cirrhosis (LC) with complicated esophagogastric variceal bleeding(EVB). Methods Consecutive 77 patients with LC and complicated EVB were encountered in our hospital between April 2022 and April 2024, and were randomly divided into control (n=38) and observation (n=39) group, receiving intravenous infusion of somatostatin and esomeprazole, or receiving EVL plus intravenous infusion of the two medicines. Portal vein diameter (Dpv), portal vein blood flow velocity (Vpv) and portal vein blood flow volume (Qpv) were detected by Doppler ultrasonography. Results For hemostasis, blood transfusion, bleeding-stopping time, supplemented albumin and hospital stay in the observation group were (240.3±131.4)mL,(3.7±0.5)h,(10.4±2.9)g and (5.7±0.8)d, all much less or shorter than [(596.2±238.9)mL, (44.3±4.1)h, (44.2±12.5)g and (11.6±1.4)d, respectively, P<0.05]in the control; 14 days after treatment, Vpv and Qpv in the observation were (15.8±2.2)cm/s and (944.2±245.5)mL/min, both significantly faster or greater than [(13.4±2.3)cm/s and (776.7±170.6)mL/min, respectively, P<0.05] in the control; serum fibrinogen level was(2.9±0.5)g/L, much higher than [(2.2±0.6)g/L, P<0.05] in the control; the emergent hemostasis rate in the observation was 97.4%, much higher than 84.2%(P<0.05)in the control; by end of six month follow-up, re-bleeding rate was 2.6% and esophagogastric varices relapse was 7.9%, both much lower than 18.8% and 25.0%(P<0.05)in the control group. Conclusion EVL at base of intravenous infusion of somatostatin and esomeprazole in the treatment of patients with LC and EVB is efficacious with high emergent hemostasis, and less rebleeding and low EV relapse.
Prediction of esophageal varices bleeding by liver ultrasound blood flow parameters and liver and spleen stiffness measurement in patients with liver cirrhosis
Liu Yuhua, Zhang Yuan, Guo Jiating
2025, 28(3):  414-417.  doi:10.3969/j.issn.1672-5069.2025.03.024
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Objective The aim of this study was to explore prediction of esophageal varices bleeding (EVB) by liver ultrasound blood flow parameters and liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) in patients with liver cirrhosis (LC). Methods 89 patients with hepatitis B-induced LC were enrolled in our hospital between January 2022 and February 2023, all underwent gastroscopy and EV was recorded and classified. All patients underwent Doppler ultrasonography to detect portal vein diameter (PVD), congestion index of portal vein (PV-CI), portal vein velocity (PVV) and damping index of hepatic vein (HV-DI). LSM and SSM were detected by FibroTouch. The sensitivity (Se) and specificity (Sp) of different indexes in predicting EVB were analyzed by area under the receiver operating characteristic (ROC) curve (AUC). Results Gastroscopy showed EV in 57 cases(64.1%)in our series; HV-DI, PVD, PV-CI as well as LSM and SSM in patients with EV were (0.9±0.2), (1.7±0.4)cm, (0.4±0.1)cm/s, (19.3±3.6)kPa and (46.1±11.6)kPa, all significantly higher than [(0.7±0.1), (1.4±0.2)cm, (0.2±0.1)cm/s, (12.3±3.1)kPa and (34.5±7.9)kPa, respectively, P<0.05], while PVV was (15.8±3.3)cm/s, significantly lower than [(19.2±2.5)cm/s, P<0.05] in those without EV; HV-DI, PVD, PV-CI, LSM and SSM in 16 patients with severe EV were significantly higher than in 20 patients with moderate EV or in 21 patients with mild EV, while PVV was much lower than in with moderate or mild EV (P<0.05); during one year of follow-up, EVB occurred in 34 cases (59.7%) of 57 patients with EV; ROC analysis showed that HV-DI, PVV, PVD, PV-CI, LSM and SSM could predict EVB occurrence, and combination of them had a satisfactory efficacy, with the AUC of 0.885(95%CI:0.757-0.916), Se of 97.1% and Sp of 80.0%, much superior to mono-parameter(P<0.05). Conclusion Liver ultrasonic blood flow parameters and LSM and SSM combination has a high efficacy in predicting EVB occurrence in patients with LC, which warrants further clinical investigation.
CT portography quantitative parameters in predicting portal hypertension and esophagogastric variceal bleeding in patients with decompensated liver cirrhosis
Gao Jianjun, Zhang Huaxi, Fan Renbao, et al
2025, 28(3):  418-421.  doi:10.3969/j.issn.1672-5069.2025.03.025
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Objective The aim of this study was to explore CT portography (CTP) quantitative parameters in predicting portal hypertension and esophagogastric variceal bleeding (EVB) in patients with decompensated liver cirrhosis (DLC). Methods A total of 98 patients with decompensated hepatitis B-induced liver cirrhosis were encountered in our hospital between January 2021 and March 2023, and all underwent CTP, gastroscopy and portal pressure gradient (PPG) determination. Patients were followed-up for 12 months, and receiver operating characteristic (ROC) curve was applied to evaluate predictive performance. Results Of 98 patients with liver cirrhosis in our series, esophagogastric varices (EV) was found in 47 cases(48.0%) and significant portal hypertension (SPH) in 45 cases (45.9%); diameters of main portal vein, splenic vein, left gastric vein, left branch and right branch of intrahepatic portal vein in patients with SPH were (17.6±1.8)mm, (15.9±1.9)mm, (6.1±1.3)mm, (13.0±1.3)mm and (12.6±1.7)mm, all significantly greater than [(14.9±2.0)mm, (14.0±2.0)mm, (4.6±1.6)mm, (11.3±1.4)mm and (11.3±1.6)mm, respectively, P<0.05] in those with non-SPH(NSPH); during 12-month follow-up, EVB occurred in 22 cases (22.5%), and baseline diameters of five portal veins mentioned above in patients with EVB were all much greater than in those without EVB(P<0.05); the AUC was 0.830(P<0.05), with sensitivity (Se) of greater than 75.6% and specificity (Sp) of greater than 79.3%, or the AUC was 0.755(P<0.05, with Se of greater than 68.2% and Sp of greater than 71.1% in predicting SPH or EVB when any combination of three parameters from the five was met. Conclusion CTP quantitative parameters have certain clinical diagnostic efficacy in predicting SPH and EVB in cirrhotic patients, and needs further investigation.
Efficacy of endoscopic variceal ligation with combination of intravenous administration of somatostatin and omeprazole in the treatment of liver cirrhosis patients with esophagogastric variceal bleeding
Jiang Zhaoqin, Song Jie, Mu Yongfang
2025, 28(3):  422-425.  doi:10.3969/j.issn.1672-5069.2025.03.026
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Objective The aim of this study was to investigate the efficacy of endoscopic variceal ligation (EVL) with intravenously administered somatostatin and omeprazole in the treatment of liver cirrhosispatients complicated withesophagogastric variceal bleeding (EVB). Methods 103 patients with liver cirrhosisand EVB were encountered in our hospital between January 2020 and January 2023, and were randomly divided into control (n=51) and observation (n=52) group. All patients in the two groups underwent EVL, and those in the observation were given intravenously omeprazole and somatostatin for 3 to 5 days until hemostasis, and all were followed-up for six months. Diameter and venous flow of portal vein and splenic vein were measured by color Doppler ultrasonography. Results Three patients (5.8%) in the observation group and eight patients (15.7%) in the control group died of emergent bleeding; blood transfusion volume, hemostasis time and hospitalization days in 49 survivals in the observation were (406.5±138.1)mL, (1.6±0.7)d and (5.8±1.5)d, much less or shorter than [(615.7±240.3)mL, (4.1±0.5)d and (9.1±1.7)d, respectively, P<0.05] in 43 survivals in the control; after treatment, serum albumin level in the observation was (33.4±5.3)g/L, much higher than [(31.3±4.6)g/L, P<0.05], and serum fibrinogen level was (4.2±0.5)g/L, much higher than [(3.8±0.4)g/L, P<0.05] in the control; peripheral blood platelet count, hematocrit and hemoglobin levels in the observation group were(219.3±20.1)×109/L, (36.4±4.2)% and (109.6±6.1)g/L, all much higher than [(176.2±19.5)×109/L, (31.7±4.3)% and (91.2±7.0)g/L, respectively, P<0.05] in the control; there were no significant differences as respect to diameters and blood flow of portal vein and splenic vein in the two groups (P>0.05); by end of six month follow-up, re-bleeding occurred in one patient (2.0%)in the observation group and survived, and it occurred in three patients (7.0%)in the control, and one (2.3%)of them died. Conclusion EVL and intravenous administration of somatostatin and omeprazole in dealing with patients with EVB is efficacious, which could stop intragastric bleeding definitely and effectively, and warrants further clinical investigation.
Hepatoma
FOLFOX in hepatic artery infusion chemotherapy with combination of lenvatinib and PD-1 inhibitors in treatment of patients with advanced primary liver cancer
Yang Yijin, Hong Han, Chen Bin, et al
2025, 28(3):  426-429.  doi:10.3969/j.issn.1672-5069.2025.03.027
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Objective The aim of this study was to investigate therapeutic efficacy of FOLFOX in hepatic artery infusion chemotherapy (HAIC) with combination of lenvatinib and PD-1 inhibitors in treatment of patients with advanced primary liver cancer(PLC). Methods 86 patients with advanced, unresectable PLC were encountered in our hospital between January 2020 and December 2022, and were randomly assigned to receive FOLFOX through HAIC chemotherapy plus lenvatinib in 43 patients (control), or to receive sintilimab at base of regimen mentioned above in another 43 patients (observation) for three months, and followed-up for two years. Peripheral blood lymphocyte subsets were detected by FCM, and serum alpha-fetoprotein (AFP) level was assayed by ELISA. Results Complete remission rate and partial remission rate in the observation group were 11.6% and 74.4%, with total effective rate of 86.1%, both significantly higher than 4.7% and 60.5%, with total effective rate of 65.1%(P<0.05) in the control; after treatment, percentages of peripheral blood CD3+ and CD4+ cells were (46.9±5.3)% and (40.4±5.2)%, both much higher than [(40.4±4.8)% and (34.1±4.3)%, respectively, P<0.05], while percentage of CD8+ cells was (16.1±2.4)%, much lower than [(22.3±3.5)%, P<0.05) in the control; serum AFP level was (102.6±11.2)ng/mL, much lower than [(143.0±15.4)ng/mL, P<0.05]in the control group; serum ALT and AST levels were (49.0±4.0)U/L and (44.4±5.0)U/L, both much higher than [(41.8±4.8)U/L and (38.2±5.3)U/L, respectively, P<0.05]in the control; by end of two-year follow-up, the survival rate in the observation group was 67.4%, with progression-free survival (PFS) of (16.2±2.8)m, significantly higher than 39.5%, with PFS of (11.8±3.2)m in the control (P<0.05). Conclusion The combination of FOLFOX through HAIC and Lenvatinib plus sintilimab in dealing with patients with advanced PLC could elevate short-term remission rate and prolong survival, and warrants further clinical investigation.
Clinical feature of gastrointestinal perforation in patients with hepatocellular carcinoma: Analysis of 15 cases
Liu Songtao, Li Juan, Liu Mei, et al
2025, 28(3):  430-433.  doi:10.3969/j.issn.1672-5069.2025.03.028
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Objective The aim of this study was to summarize clinical feature of gastrointestinal perforation (GIP) in patients with hepatocellular carcinoma (hcc). Methods 15 patients with GIP and underlying HCC were encountered in our hospital between January 2017 and July 2024, and all patients were carefully dealt with conventionally or surgically. Results Of the 15 patients with GIP and HCC, 11 were male and 4 female, with average age of (9.4±9.8) year old; 12 patients were infected with hepatitis B virus, 1 had alcoholic liver disease and 2 were cryptogenic; all the 15 patients had abdominal pain with a median duration of 2 d(1 hour,10 d); blood WBC count was (8.3±4.9×109/L) with neutrophil percentage of(82.5±9.8%), serum albumin level was (29.3±5.6 g/L), and prothrombin time activity was (59.5±10.3%); the perforated sites in stomach, duodenum, jejunum, ileum and colon were 6 cases (40.0%), 2 cases (13.3%), 1 case (6.7%), 2 cases (13.3%) and 4 cases (26.7%), respectively; three patients died after supporting treatment, with an average survival of 15 days, the remaining 12 patients underwent surgical repairment, with 3 died and 9 survived; of the 9 survivals, 2 underwent liver transplantation, 4 underwent hepatic artery embolization and/or targeted and/or immune therapy, 2 underwent internal supporting treatment and 1 had regular monitoring, the outcomes were 7 died and 2 survived, with mean survival time of (22.2±19.3) months. Conclusion The patients with HCC have the risk of GIP during invasive and systemic treatment, and an appropriate surgical repairment should be done in time once it occur.
MRI evaluation of intrahepatic residual lesions in patients with primary liver cancer after transcatheter arterial chemoembolization
Dong Yanhong, Jiang Kun, Huang Hui, et al
2025, 28(3):  434-437.  doi:10.3969/j.issn.1672-5069.2025.03.029
Abstract ( 7 )   PDF (962KB) ( 5 )  
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Objective The aim of this study was to investigate evaluation of intrahepatic residual lesions by magnetic resonance imaging (MRI) scan in patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE). Methods 116 patients with PLC were encountered in our hospital between June 2020 and August 2022, and all underwent TACE therapy for one to three times at interval of one month. Patients were followed-up and had digital subtraction angiography (DSA), MRI and CT scan by end of three months. Diagnostic performance of MRI and CT scan was evaluated based on DSA golden criteria. Results Of 146 lesions in 116 patients with PLC, there were 103 residual tumor lesions and 43 lesions at complete remission states showed by DSA by end of three months after TACE; sensitivity, accuracy and negative predictive value by MRI scan in determining residual tumors were 92.2%, 94.5% and 84.3%, all significantly higher than 73.8%, 81.5% and 61.4% (P<0.05) by CT scan; of 103 residual tumors after TACE, DSA found iodine oil deposition type Ⅰ in 10 cases, type Ⅱ in 51 cases, type Ⅲ in 35 cases and type Ⅳ in 7 cases; the positive rates of type Ⅰ and Ⅱ showed by MRI scan were 70.0% and 90.2%, both much higher than 10.0% and 64.7%, respectively (P<0.05) by CT scan; after TACE therapy, MRI scan showed enveloped tumors in 54 cases (37.0%), much higher than 16 cases (11.0%) by CT scan (P<0.05). Conclusion MRI scan has a satisfactory diagnostic efficacy in assessing residual tumor lesions after TACE therapy, which might play a pivotal role in making strategy for further treatment in this setting.
Diagnosis of benign and malignant liver tumors by magnetic resonance imaging enhancement scanning and diffusion-weighted imaging
Sha Xinjie, Xia Xiaoliang
2025, 28(3):  438-441.  doi:10.3969/j.issn.1672-5069.2025.03.030
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Objective This study was conducted to evaluate diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)and diffusion-weighted imaging(DWI)in patients with intrahepatic space-occupying lesions (SOL). Methods 96 patients with SOL were encountered in our hospital between January 2022 and December 2023, and all patients underwent DCE-MRI scan to record constant (Kep), volume transfer constant (Ktrans), extracellular extravascular space volume ratio (Ve) and initial enhancement curve area (iAUC) as well as apparent diffusion coefficient (ADC). Diagnosis was based on post-operational histo-pathological examination as gold standard. Diagnostic efficacy was assessed by receiver operating characteristic curve (ROC). Results Post-operational histo-pathological examination proved benign lesions in 55 cases, including hepatic adenoma in 27 cases, cirrhotic nodules in 13 and focal nodular hyperplasia of the liver in 15 cases, and malignant lesions in 41 cases, including hepatocellular carcinoma in 31 cases and intrahepatic cholangiocarcinoma in 10 cases; percentages of tumors withirregular shapes, rough edgesand uneven internal enhancement in malignant tumors were 68.3%, 65.9% and 68.3%, all much higher than 36.4%, 34.6%and 38.2%(all P<0.05) in benign lesions; Kep, Ktrans ,Ve and iAUC in malignant lesions were (0.8±0.3)min-1, (0.4±0.1)min-1, (0.4±0.2) and (1.0±0.3), all significantly greater than [(0.4±0.1)min-1, (0.2±0.1)min-1, (0.3±0.1) and (0.7±0.2), respectively, P<0.05], while ADC was (1.0±0.4), significantly smaller than [(1.7±0.6),P<0.05] in benign lesions; ROC analysis showed that the specificity reached to 94.5%, with sensitivity of 70.2%, when parameters of DCE-MRI and ADC combination in determining malignant lesions. Conclusion DCE-MRI is helpful in judging the quality of intrahepatic SOL, which warrants further clinical investigation.
Poor prognosis of patients with intrahepatic cholangiocarcinoma with high serum CEA, CA125, CYFRA21-1 and VEGF levels
Huang Yan, Yang Zhiyong, Huang Qian, et al
2025, 28(3):  442-445.  doi:10.3969/j.issn.1672-5069.2025.03.031
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Objective The aim of this study was to explore implication of serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin fragment antigen( CYFRA ) 21-1 and vascular endothelial growth factor (VEGF) level changes in patients with intrahepatic cholangiocarcinoma (ICC). Methods 81 patients with ICC were admitted to our hospital between February 2020 and February 2023, and all received GEMOX chemotherapy and carelizumab treatment for 4 cycles with one cycle of 21 days. Serum CEA, CA125, CYFRA21-1 and VEGF levels were routinely detected by electrochemiluminescence immunoassay. The influencing factors of prognosis in ICC patients were analyzed by multivariate Cox regression model. Results Serum CEA, CA125, CYFRA21-1 and VEGF levels in 26 patients with multiple ICC were (18.9±3.4)ng/mL, (110.3±9.5)ng/mL, (22.1±3.8)U/mL and (268.8±12.6)pg/mL, all significantly higher than [(11.8±3.3)ng/mL, (66.8±18.0)ng/mL, (10.8±3.7)U/mL and (199.6±37.1)pg/mL, respectively, P<0.05] in 55 patients with single ICC, serum CEA, CA125, CYFRA21-1 and VEGF levels in 52 ICC patients with lymph node metastasis were (16.5±3.4)ng/mL, (93.7±23.1)ng/mL, (17.6±5.6)U/mL and (249.6±24.5)pg/mL, all significantly higher than [[(10.4±3.6)ng/mL, (59.6±14.8)ng/mL, (9.1±3.7)U/mL and (173.6±29.5)pg/mL, respectively, P<0.05] in 29 ICC patients without lymph node metastasis, serum CEA, CA125, CYFRA21-1 and VEGF levels in 38 patients with tumor diameter greater than 5 cm were (17.5±4.2)ng/mL, (106.5±11.0)ng/mL, (19.0±5.8)U/mL and 259.8±17.9)pg/mL, all significantly higher than [(11.2±3.1)ng/mL, (58.5±9.7)ng/mL, (10.4±3.8)U/mL and (187.9±33.6)pg/mL, respectively, P<0.05] in 43 patients with tumor less than 5 cm, serum CEA, CA125, CYFRA21-1 and VEGF levels in 39 patients with TNM phase Ⅳ were(17.5±4.2)ng/mL, (105.5±12.1)ng/mL, (18.8±5.8)U/mL and (258.1±20.6)pg/mL, all significantly higher than [(11.1±3.0)ng/mL, (58.1±9.5)ng/mL, (10.4±3.8)U/mL and (187.8±34.0)pg/mL, respectively, P<0.05] in 42 patients with phase Ⅱ/Ⅲ; one-year survival in 81 patients with ICC in our series was 71.6%, and multivariate Cox regression analysis showed that TNMphase Ⅲ/Ⅳ, high serum CEA, CA125 and VEGF levels were all the independent risk factors impacting prognosis of patients with ICC (P<0.05). Conclusion High serum CEA, CA125, CYFRA21-1 and VEGF levels in patients with ICC might be related to poor prognosis, which warrants further clinical investigation.
Serum alpha-fetoprotein levels in predicting prognosis of children with hepatoblastoma after hepatectomy
Song Rui, Yang Jiangong, Luo Liqin, et al
2025, 28(3):  446-449.  doi:10.3969/j.issn.1672-5069.2025.03.032
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Objective The aim of this study was to investigate serum alpha fetoprotein (AFP) level changes in predicting prognosis of children with hepatoblastoma (HB) after radical resection of tumor. Method 105 pediatric patients with HB were encountered in our hospital between January 2018 and December 2020, all underwent radical tumor resection, and were followed-up for five years. Kaplan-Meier was applied for survival analysis, and event-free survival (EFS) and overall survival (OS) were documented. Result Based on PRETEXT staging, there were stage I in 18 cases, stage II in 39 cases, stage III in 41 cases and stage IV in 7 cases in our series; at presentation, serum AFP levels in stage I, stage II, stage III and stage IV were (43261.3±17236.9)μg/L, (47823.4±16921.3)μg/L, (60489.2±18638.3)μg/L and (73482.1±20496.5)μg/L, which decreased to(11.4±0.3)μg/L, (16.5±0.9)μg/L, (28.4±4.6)μg/L and (416.3±12.1)μg/L, respectively, six months after operation; during follow-up, incidences of tumor relapse, metastasis, EFS and OS in stage I were 16.7%, 5.6%, 77.8% and 94. 4%, in stage II were 20.5%, 7.7%, 71.8% and 92.3%, in stage III were 34.1%, 12.2%, 53.7% and 78.0%, and in stage IV were 42.9%, 57.1%, 0.0% and 57.1%. Conclusion Serum AFP levels in pediatric patients with HB is correlated to tumor stages, and those with stage III and stage IV might have even high serum AFP levels, which decreases hard to normal, and indicating poor prognosis.
Different ultrasound manifestations in children with different pathological types of hepatoblastoma
Tang Qiqiong, Jia Chunyang, Huo Yaling, et al
2025, 28(3):  450-453.  doi:10.3969/j.issn.1672-5069.2025.03.033
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Objective The aim of this study was to investigate ultrasound manifestations in children with different pathological types hepatoblastoma (HB). Methods 64 children with HB were encountered in our hospital between October 2021 and October 2024, and all of them underwent abdominal color Doppler ultrasonography and surgery or biopsy for pathological examination. Expression of alpha fetoprotein, glycoprotein CD34, cytokeratin 7, CK19, integrase interactor-1, hepatocyte paraffin-1 and beta-catenin were detected immunohistochemistry. Results Liver histo-pathological examination diagnosed complete epithelial type in 43 cases, including fetal type in 14 cases and embryonic type in 29 cases, and mixed epithelial mesenchymal type in 21 cases, including teratoma-like in 13 cases and without teratoma-like in 8 cases; diameter of tumor in fetal type was (8.5±2.4)cm, much less than [(11.4±2.1)cm, P<0.05] in tumor in embryonic type or [(10.7±2.2)cm, P<0.05] in tumor in mixed epithelial mesenchymal type or [(10.5±2.0)cm, P<0.05] in tumor in without teratoma-like type; percentage of hyperechoic in fetal type was 92.9%, and in embryonic type was 93.1%, both much greater than 23.1%(P<0.05) in mixed teratoma-like or 37.5%(P<0.05) in without teratoma-like; percentage of calcification in fetal type was 21.4% and in embryonic type was 27.6%, both much lower than 76.9%(P<0.05)in mixed tumors with teratoma-like features or 62.5%(P<0.05)in mixed tumors without teratoma-like features; percentage of intratumoral necrotic cystic changes in fetal tumors was 35.7%, significantly lower than 79.3% (P<0.05)in embryonic tumors or 76.9%(P<0.05)in mixed tumors with teratoma-like features or 75.0%(P<0.05)in mixed tumors without teratoma-like features. Conclusion Different pathological features of HB in children could have different ultrasound manifestations, which might provide hints for pathological subtyping preliminarily.
Liver abscess
Intrapurulent catheter drainage under ultrasound guidance in the treatment of patients with bacterial liver abscess
Li Hongjian, Xu Zhiwen, Xia Fei, et al
2025, 28(3):  454-457.  doi:10.3969/j.issn.1672-5069.2025.03.034
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Objective The aim of this study was to investigate intrapurulent catheter drainage under ultrasound guidance in the treatment of patients with bacterial liver abscess (BLA). Method A total of 96 patients with BLA were encountered in our hospital between October 2020 and October 2023, and were randomly divided into observation group (n=48) and control group (n=48), received intrapurulent catheter drainage or puncture drainage under ultrasound guidance. Supporting management was given in the two groups. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and cortisol (COR) levels were assayed by ELISA, and serum interleukin-6 (IL-6),IL-8 and IL-12 levels were also detected by ELISA. Result All patients with BLA recovered in our series after one to three week treatment, presenting with disappeared purulent cavity, and no relapse was found by end of three month follow-up; after treatment, serum bilirubin, ALT and GGT levels in the observation group were(15.3±2.4)μmol /L, (72.4±7.5)U/L, (39.3±2.8)g/L and (79.3±19.4)U/L, all not significantly different compared to [(16.5±2.3)μmol /L, (73.2±10.3)U/L, (36.6±2.9)g/L and (73.1±22.3)U/L, respectively] in the control (P>0.05); serum SOD, COR and MDA levels in the observation were (73.3±7.5)U/mL, (117.8±8.4)nmol/L and (5.1±0.8)μmol/mL, all not significantly different as compared to [(75.4±7.1)U/mL, (118.8±8.5)nmol/L and (5.5±0.9)μmol/mL, respectively] in the control group (P>0.05); serum IL-6, IL-8and IL-12 levels in the observation were (0.2±0.1)ng/mL, (0.3±0.1)ng/mL and (81.3±16.5)ng/mL, all much lower than [(0.3±0.1)ng/mL, 0.4±0.1)ng/mL and (95.2±17.1)ng/mL, respectively, P<0.05] in the control group. Conclusion We recommend intrapurulent catheter drainage under ultrasound guidance in dealing with patients with BLA, which might need less puncture and less antibiotic administration, with relatively quick recovery.
Cholelithiasis
Ultrasound-guided percutaneous transhepatic gallbladder puncture drainage and subsequent selective laparoscopic cholecystectomy in treatment of patients with acute calculous obstructive cholecystitis
Yan Huajun, Chen Xingyun, Ma Bing, et al
2025, 28(3):  458-461.  doi:10.3969/j.issn.1672-5069.2025.03.035
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Objective The aim of this study was to investigate selective laparoscopic cholecystectomy (LC) after ultrasound-guided percutaneous transhepatic gallbladder puncture drainage (UG-PTGD) in treatment of patients with acute calculous obstructive cholecystitis (ACOC). Methods A total of 109 patients with ACOC were encountered in our hospital between May 2020 and May 2024, and were randomly assigned to receive LC (control, n=54) or selective LC after UG-PTGD (observation, n=55). Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) levels were detected by ELISA. Results Operation time, intraoperative blood loss, postoperative drainage volume, anal exhaust time, extubation time and hospital stay in the observation group were (54.5±8.1)min, (33.8±7.9)mL,(18.5±2.9)mL,(21.5±4.2)h, (3.3±0.6)d and (4.5±1.5)d, all much less or shorter than [(72.6±11.4)min,(44.1±6.7)mL,(26.9±4.2)mL,(27.4±3.9)h,(4.8±0.7)d and (10.6±2.9)d, respectively, P<0.05] in the control; post-operationally, serum AST and ALT levels were much lower than in the control (P<0.05); serum TNF-α, IL-6 and CRP levels were (32.2±11.4)ng/mL, (116.7±12.3)pg/mL and (25.8±5.2)mg/L, all significantly lower than [(39.6±12.7)ng/mL, (127.1±19.2)pg/mL and (46.7±8.1)mg/L, respectively, P<0.05] in the control; incidence of complications was 9.1%, much lower than 24.1%(P<0.05) in the control group. Conclusion Emergent management by UG-PTGD, and thereafter selective LC in the treatment of patients with ACOC were safe, efficacious, which might be an alternative option in this clinical scenario.
Percutaneous transhepatic gallbladder drainage and sequential laparoscopic cholecystectomy with preservation of main cystic artery in the treatment of patients with acute cholecystitis
Feng Song, Li lianjie, Cheng Bo
2025, 28(3):  462-465.  doi:10.3969/j.issn.1672-5069.2025.03.036
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Objective The purpose of this study was to observe the efficacy of percutaneous transhepatic gallbladder drainage (PTGD) and sequential laparoscopic cholecystectomy (LC) with preservation of main cystic artery in the treatment of patients with acute cholecystitis (AC). Methods 206 patients with AC were encountered in our hospital between October 2020 and September 2023, and were randomly divided into control (n=103) and observation group (n=103). The patients in the control group underwent PTGD and sequential conventional LC, and those in the observation group underwent PTGD and sequential LC with preservation of main cystic artery. Serum C-reactive protein (CRP), interleukin-6 (IL-6) , tumor necrosis factor (TNF-α), plasma cortisol (Cor) and norepinephrine (NE) levels were measured by ELISA. Results The operation time in the observation group was (56.5±7.2)min, much longer than [(44.3±10.4)min,P<0.05], while the intraoperative blood loss was (16.5±3.2)ml, much less than [(67.4±14.5)ml, P<0.05] in the control; there were no significant differences as respect to serum liver function tests before and after the operation between the two groups (P>0.05); five days after operation, serum CRP, IL-6, TNF-α and Cor levels in the observation were (18.5±2.3)mg/L, (14.5±12.3)mmol/L, (12.1±6.1)mmol/L and (56.5±17.1)ng/mL, all significantly lower than [(27.4±25.4)mg/L, (29.6±18.5)mmol/L, (25.1±8.1)m mol/L and (79.4±30.2)ng/mL, respectively, P<0.05] in the control group; post-operationally, there was no significant difference respect to complications, such as incision infection, bile leakage and biliary injuries, between the two groups (4.9% vs. 5.8%, P>0.05). Conclusion The PTGD and sequential LC with preservation of main cystic artery could effectively reduce the intraoperative blood loss, and warrants further clinical investigation.
Comparison of endoscopic retrograde cholangiopancreatography and laparoscopic choledochotomy and exploration in the treatment of patients with post-cholecystectomy choledocholithiasis
Ke Junjie, Xing Jieyu, Zhang Mingying
2025, 28(3):  466-469.  doi:10.3969/j.issn.1672-5069.2025.03.037
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Objective The aim of this study was to compare the efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic choledochotomy and exploration (LCE) in the treatment of patients with post-cholecystectomy choledocholithiasis. Methods Sixty patients with choledochal stones who had cholecystectomy were recruited in our hospital between February 2020 and February 2022, and we randomly assigned patients to receive LCE (observation, n=30) or ERCP (control, n=30). Serum C-peptide, cortisol (Cor), norepinephrine (Ne) and adrenocorticotrophic hormone (ACTH) levels were determined. Results The surgical successful rate and stone clearance rate in the observation group were 96.7% and 93.3%, both significantly higher than66.7% and 66.7% (P<0.05) in the control group; the operational time and medical cost in the observation group were (62.4±6.5)min and (20000.4±5000.0)yuan RMB, both much shorter or less than(106.3±8.7)min and (30000.0±8000.0)yuan RMB, P<0.05], while postoperative exhaustion time, ambulation time and hospital stay were much longer than in the control(P<0.05); five days after operation, serum Cor and Ne levels in the observation were (211.2±32.1)nmoL/mL and (5.0±0.6)nmoL/mL, significantly higher than [(152.1±41.2)nmoL/mL and (3.1±0.8)nmoL/mL, respectively, P<0.05] in the control; there were no significant differences in post-operational complications, such as bile leakage, infection, bleeding and pancreatitis between the two groups (20.0% vs. 16.7%, P>0.05). Conclusion The surgery by LCE in dealing with patients with choledocholithiasis who have gall bladder removed is promising, with high surgery success and stone clearance.
Gallbladder polyps
Multimodal nalbuphine hydrochloride analgesia in patients with gallbladder polyps after laparoscopic cholecystectomy
Dong Wenyue, An Bin, Mu Dan, et al
2025, 28(3):  470-473.  doi:10.3969/j.issn.1672-5069.2025.03.038
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Objective The aim of this study was to investigate multimodal nalbuphine hydrochloride analgesia in patients with gallbladder polyps (GP) after laparoscopic cholecystectomy(LC). Methods 78 patients with GP were encountered in our hospital between November 2020 and March 2024, and all underwent LC surgery. For post-operational analgesia, patients were randomly divided into control and observation groups, 39 cases in each. Bilateral transversus abdominis plane block (TAP) and patient-controlled intravenous analgesia (PCIA) were conducted, nalbuphine were given in observation, and flurbiprofen ester were administered in the control. Visual analogue scale (VAS) and Ramsay sedation scale (RSS) were evaluated, and serum substance P (SP) and prostaglandin E2 (PGE2) levels were assayed by RIA. Results By 1, 4 and 12 hours after surgery, VAS scores in the observation group were(3.7±0.7)points, (4.0±0.8)points and (4.3±0.9)points, all much lower than [(4.3±0.7)points, (4.6±0.9)points and (4.9±1.0)points, P<0.05] in the control; by 1, 4, 12 and 24 hours, RSS scores were (2.4±0.5)points, (2.6±0.6)points, (2.9±0.6)points and (2.5±0.6)points, all not significantly different compared to [(2.5±0.6)points, (2.7±0.6)points, (3.0±0.7)points and (2.6±0.5)points, P>0.05]; by 1, 4 and 12 hours, serum SP levels were (0.9±0.2)μg/mL, (2.7±0.6)μg/mL and (4.3±1.0)μg/mL, all much lower than [(1.3±0.3)μg/mL, (4.4±1.1)μg/mL and (6.5±1.3)μg/mL, respectively, P<0.05], and serum PEG2 levels were (91.9±11.5)pg/mL, (265.3±29.6)pg/mL and (168.3±18.7)pg/mL, all much lower than [(108.8±12.7)pg/mL, (304.2±32.8)pg/mL and (183.2±20.6)pg/mL, respectively, P<0.05] in the control group; post-operationally, first exhaust time, food intake and removal of drainage tube in the observation were(40.7±4.2)h, (41.6±3.9)h and (90.6±8.4)h, all much shorter than [(49.8±5.3)h, (50.4±21.5)h and (103.7±4.1)h, respectively, P<0.05] in the control. Conclusion Application of nalbuphine hydrochloride in multimodal analgesia after LC is beneficial to relieve pain, which might be related to inhibition of pain-related substance release.
Non-invasive assessment of liver fibrosis in patients with non-alcoholic fatty liver disease
Liu Qianqian, Duan Zhijiao, Chen Ping
2025, 28(3):  477-480.  doi:10.3969/j.issn.1672-5069.2025.03.040
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Liver fibrosis (LF) is closely related to poor outcomes in patients with non-alcoholic fatty liver disease (NAFLD), and early intervention is expected to improve prognosis of the disease. Percutaneous liver biopsy is the primary method for the diagnosis and staging of LF, but its wide application is limited as its invasiveness, sampling inconsistency and subjective evaluation. Recently, a lot of new non-invasive techniques have emerged for LF assessment, with advantage of convenience and repeatability. In this article, we provides a review on this topic.
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    Comparative study on the clinical efficacy of lorazepam and oxazepam in treatment of patients with alcoholic liver diseases and alcohol withdrawal syndrome
    Liu Lixia, Lin Yingyuan, Li Huamin, et al
    Journal of Practical Hepatology    2021, 24 (5): 709-712.   DOI: 10.3969/j.issn.1672-5069.2021.05.026
    Abstract1725)      PDF(pc) (850KB)(417)      
    Objective This clinical trial aimed to compare the efficacy of lorazepam and oxazepam in treatment of patients with alcoholic liver diseases (ALD) and alcohol withdrawal syndrome (AWS). Methods A total of 127 patients with ALD and AWS were enrolled in our hospital between November 2017 and November 2020, and were randomly divided into control (n=63) and observation group (n=64), receiving lorazepam and oxazepam, respectively, for seven days. The scores of alcohol withdrawal syndrome scale (AWSS) and self-rating anxiety scale (SAS) score were evaluated. Serum hyaluronic acid (HA), laminin (LN), type III procollagen N-terminal peptide (PC-III) and type-IV collagen (IV-C) were detected by ELISA. Results At the end of 7 day treatment, the efficient rate in observation group was 96.9%, significantly higher than 81.0% in the control (P<0.05); at presentation, the AWSS and SAS, serum alanine transaminase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT),total bilirubin (TBIL) and alkaline phosphatase (ALP) as well as HA, LN, PC-Ⅲ and IV-C levels were not significantly different between the two groups(P>0.05); after treatment, the AWSS and SAS in observation were (9.5±2.4) and (30.8±6.4), significantly different as compared to in the control; serum ALT, AST, GGT, TBIL and ALP levels were (30.5±8.1)U/L, (71.6±15.3)U/L, (466.1±22.7)U/L, (23.5±6.5)μmol/L and (82.3±12.4)U/L, all much lower than in the control; serum HA, PC-Ⅲ and IV-C levels were (116.8±18.3)μg/L,(123.1±12.3)μg /L and (80.2±11.6)μg /L, significantly lower than in the control. Conclusion The clinical efficacy of oxazepam is good in treatment of ALD patients with complicated AWS, which could improve clinical symptom and anxiety relieving.
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    Improvement of liver function tests by silibinin and polyene phosphatidylcholine combination therapy in patients with anti-tuberculosis drugs-induced liver injury
    Mo Junqiao, Lin Jing, Yang Li
    Journal of Practical Hepatology    2023, 26 (5): 666-669.   DOI: 10.3969/j.issn.1672-5069.2023.05.016
    Abstract1168)      PDF(pc) (851KB)(349)      
    Objective The aim of this study was to observe the efficacy of silibinin and polyene phosphatidylcholine combination therapy in patients with anti-tuberculosis drugs-induced liver injury (DILI). Methods 118 patients with pulmonary tuberculosis were encountered in our hospital between June 2018 and June 2021, and all received standardized anti-tuberculosis treatment by 2HRS( E) Z /4HR for six months. During the process, 63 patients were found having DILI, and were randomly divided into control (n=30) and observation (n=33) groups, receiving polyene phosphatidylcholine or silibinin capsule and polyene phosphatidylcholine combination therapy until the anti-tuberculosis regimen ended. Serum interleukin-2 (IL-2), IL-6, IL-1β and tumor necrosis factor-α (TNF-α) levels were detected by ELISA, serum superoxide dismutase (SOD) was detected by radioimmunoassay and serum reduced glutathione (GSH) and malondialdehyde (MDA) levels were assayed by biochemical colorimetry. Results After treatment, serum ALT, AST and GGT levels in the observation group were (32.8±6.1)U/L, (41.2±8.3)U/L and (36.1±6.5)U/L, all significantly lower than [(48.6±8.4)U/L, (53.8±9.2)U/L and (53.8±9.6)U/L, respectively, P<0.05] in the control; serum IL-6, IL-1β and TNF-α levels in the observation were (6.3±1.0)ng/L, (11.0±2.3)μg/L and (6.8±1.5)ng/L, all much lower than [(9.5±1.2)ng/L, (19.2±3.6)μg/L and (9.9±1.3)ng/L, respectively, P<0.05] in the control, while there was no significant difference respect to serum IL-2 levels in the two groups (P>0.05); serum SOD and GSH levels in the observation group were (597.3±71.6)U/L and(7.6±1.5)μmol/L, both significantly higher than [(542.8±68.2)U/L and (6.2±1.3)μmol/L, P<0.05], while serum MDA level was (4.0±0.7)nmol/L, much lower than [(5.8±0.9)nmol/L, P<0.05] in the control. Conclusion The administration of silibinin capsule and polyene phosphatidylcholine combination in treatment of patients with pulmonary tuberculosis during anti-tuberculosis therapy could protect the liver function test normal, and maintain the accomplishment of anti-tuberculosis treatment, which might be related to the relieving inflammation and oxidative stress response.
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    Short-term observation of entecavir and magnesium isoglycyrrhizinate in treatment of patients with chronic hepatitis B
    Huang Junrong, Wu Changru, Wu Jianlin
    Journal of Practical Hepatology    2022, 25 (3): 327-330.   DOI: 10.3969/j.issn.1672-5069.2022.03.006
    Abstract1002)      PDF(pc) (839KB)(260)      
    Objective The purpose of this study was to observe the application of entecavir and magnesium isoglycyrrhizinate combination in the treatment of patients with chronic hepatitis B (CHB). Methods A total of 98 patients with CHB were enrolled in our hospital between January 2019 and February 2020, and were randomly divided into control (n=49) and observation group (n=49), receiving entecavir or entecavir and magnesium isoglycyrrhizinate combination therapy for 48 weeks. Serum hyaluronan (HA), laminin (LN), type-IV collagen (CIV) and type-III procollagen (PIIIP) levels were detected by radioimmunoassay. Serum interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 10 (IL-10) and tumor necrosis factor α (TNF-α) levels were detected by ELISA. The peripheral blood T lymphocyte subsets were detected by flow cytometry. Results At the end of 48 week observation, serum ALT normalization rate in the observation group was 87.8%, significantly higher than 71.4%(P<0.05) in the control; serum ALT and AST levels in the combination group were (32.3±6.9)U/L and (38.3±4.7)U/L, both significantly lower than [(47.5±7.6)U/L and (52.9±5.1)U/L, respectively, P<0.05] in the control; serum HA and PⅢP levels were (90.6±9.5)ng/mL and (141.6±32.6)ng/mL, both significantly lower than [(126.8±14.6)ng/mL and (168.2±29.9)ng/mL, respectively, P<0.05] in the control; serum IL-4 and TNF-α levels were (48.8±7.9)ng/L and (11.3±1.9)ng/L, significantly lower than [(62.6±8.8)ng/L and (18.5±1.7)ng/L, respectively, P<0.05], while serum IL-10 level was (19.2±2.5)ng/L, significantly higher than [(12.7±3.4)ng/L, P<0.05] in the control; the percentage of peripheral blood CD4+ cells and the ratio of CD4+/CD8+ cells were (43.5±5.5)% and (1.6±0.2), both significantly higher than [(38.4±4.7)% and(1.4±0.4), respectively, P<0.05] in the control group. Conclusion The application of entecavir and magnesium isoglycyrrhizinate combination in the treatment of patients with CHB could effectively improve liver function test normal, inhibit the process of liver fibrosis, which might be related to the inhibition of inflammatory reaction and modulation of immune system.
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    Guidelines for the prevention and treatment of metabolic dysfunction-associated (non-alcoholic) fatty liver disease(Version 2024)
    Chinese Society of Hepatology, Chinese Medical Association
    Journal of Practical Hepatology    2024, 27 (4): 494-510.  
    Abstract988)      PDF(pc) (3936KB)(1109)      
    The Chinese Society of Hepatology of the Chinese Medical Association invited relevantexperts to revise and update the Guideline of Prevention and Treatment of Nonalcoholic Fatty Liver Disease(2018Version) and renamed it as (Version 2024) Guideline for the Prevention and Treatment of MetabolicDysfunction-associated (non-alcoholic) Fatty Liver Disease. Herein, the guiding recommendations on clinicalissues such as screening and monitoring, diagnosis and evaluation, treatment and follow-up of metabolicdysfunction-associated fatty liver disease are put forward.
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    Auxiliary treatment of a herbal compound, Ganshuang granule, with entecavir for patients with chronic hepatitis B
    Guo Xiaoling, Zhang Yaowu, Li Mengtao, et al.
    Journal of Practical Hepatology    2023, 26 (3): 340-343.   DOI: 10.3969/j.issn.1672-5069.2023.03.010
    Abstract965)      PDF(pc) (819KB)(344)      
    Objective The purpose of this clinical trial was to investigate the auxiliary treatment of a herbal compound, Ganshuang granule, with entecavir for patients with chronic hepatitis B (CHB). Methods 60 patients with CHB were enrolled in our hospital between January 2019 and January 2021, and were randomly divided into control and observation groups, with 30 cases in each. The patients in the control group received entecavir, and those in the observation were treated with entecavir and a herbal compound, Ganshuang granule, for 48 weeks. The AST to platelet ratio index (APRI), fibrosis 4 score (FIB-4) were obtained, and the liver stiffness measurement (LSM) was determined by FibroTouch scan. Serum interleukin-6(IL-6), transforming growth factor-beta (TGF-β), platelet-derived growth factor (PDGF) and C-reactive protein (CRP) levels were assayed by ELISA. Results At the end of 48 week treatment, serum ALT and AST levels in the observation group were significantly lower than in the control group (P<0.05); serum HBV DNA loss in the two groups were both 100.0%, and serum HBeAg negative rates were both 0.0% (P>0.05); the APRI, FIB-4 and LSM in the observation group were (1.02±0.23), (4.38±0.77) and (7.73±1.53), all significantly lower than [(1.30±0.33), (5.26±0.85) and (9.68±2.02), respectively, P<0.05] in the control; serum IL-6, TGF-β, PDGF and CRP levels in the observation were much lower than in the control (P<0.05). Conclusion The auxiliary treatment of Ganshuang granule at base of entecavir antiviral therapy could significantly improve biochemical response in patients with CHB, which might be related to the anti-fibrotic effect and inhibition of body inflammatory reaction of the herbal compound.
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    Short-term efficacy of dapagliflozin and liraglutide combination in treatment of patients with non-alcoholic fatty liver disease and diabetes mellitus type 2
    Sun Zheng, Wang Xiaoye, Yuan Jing, et al.
    Journal of Practical Hepatology    2022, 25 (6): 796-799.   DOI: 10.3969/j.issn.1672-5069.2022.06.010
    Abstract907)      PDF(pc) (827KB)(854)      
    Objective The aim of this study was to investigate the short-term efficacy of dapagliflozin and liraglutide combination in treatment of patients with non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus type 2(T2MD). Methods 60 patients with NAFLD and T2MD were admitted to our hospital between September 2017 and October 2020, and were randomly divided into control and observation group, with 30 cases in each group. All the patients were supervised for routine lifestyle intervention and oral metformin administration for blood glucose control. In addition, the patients in the control group were treated with liraglutide intravenouly, and those in the observation group were treated with dapagliflozin and liraglutide combination. The regimen lasted for 3 months. The fasting plasma glucose (FPG), 2 hour-postprandial plasma glucose (2h PG) and glycated hemoglobin (HbA1c) as well as serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) levels were routinely obtained. Serum fasting insulin(Fins) and 2 h Ins levels were assayed, and the HOMA-IR was calculated. The controlled attenuation parameter (CAP) of livers was detected by FibroTouch. Results At the end of 3 month observation, the FPG, 2hPG and HbA1 levels in the observation group were(5.8±0.7)mmol/L, (6.9±0.8)mmol/L and (6.3±0.9)%, all significantly lower than [(6.6±0.6)mmol/L,(7.7±0.7)mmol/L and (7.2±1.0)%, respectively, P<0.05] in the control group; serum Fins, 2hIns and HOMA-IR levels were (9.8±1.2)mIU/L, (20.2±1.7)mIU/L and (2.6±0.4)%, significantly lower than [(11.9±1.1)mmol/L, (24.8±1.6) mmol/L and (3.2±0.5)%, respectively, P<0.05] in the control; serum TG level was (2.6±0.4) mmol/L, significantly lower than [(3.0±0.3)mmol/L, P<0.05], while serum HDL-C level was (1.6±0.2) mmol/L, significantly higher than [(1.2±0.3)mmol/L, P<0.05] in the control; the CAP was (249.2±7.5)dB/m, also significantly lower than [(264.7±8.6)dB/m, P<0.05] in the control; serum AST level was (39.9±3.8)U/L, significantly lower than [(44.9±4.2)U/L, P<0.05] in the control. Conclusion The application of dapagliflozin and liraglutide combination is efficacious in the treatment of patients with NAFLD and T2MD, which could effectively reduce blood glucose and lipid levels, improve liver function tests back to normal, with the ability of alleviation of insulin resistance.
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    Clinical features of patients with benign recurrent intrahepatic cholestasis: a report of three cases
    Wang Fu, Wang Haoqi, Zhou Yi, et al
    Journal of Practical Hepatology    2023, 26 (1): 47-50.   DOI: 10.3969/j.issn.1672-5069.2023.01.013
    Abstract833)      PDF(pc) (841KB)(233)      
    Objective The aim of this study was to summarize the clinical features of patients with benign recurrent intrahepatic cholestasis (BRIC). Methods The clinical manifestations, laboratory tests, imaging, pathological examinations, and genetic analysis in three patients with BRIC in Zhongshan Hospital, Fudan University, were retrospectively reviewed. Results The three patients were all male and their initial onset ages were below 20 year old; the common symptoms of the patients were jaundice and pruritus, and two of them also experienced abdominal distension, irregular defecation, and appetite loss; serum total bilirubin, direct bilirubin, ALP and TBA levels increased significantly, while serum GGT, ALT and AST levels stayed normal or increased slightly during the disease attack duration; no abnormal intrahepatic and extrahepatic bile ducts were found in magnetic resonance cholangiopancreatography (MRCP) examination, but obvious cholestasis of hepatocytes and capillary bile duct embolism were observed in liver histopathology; the ATP8B1 gene mutation sites with functional prediction of "potentially harmful" or "likely pathogenic" in pathogenic classification were all detected in three patients; all patients were excluded from other known causes of cholestasis, and the disease was recurrent, but with self-limiting. Conclusion The BRIC is rarely reported and its pathogenesis remains unclear currently. The clinical diagnosis might be made based on clinical manifestations, ancillary tests, and pathological findings after excluding other common causes of liver damage. For patients with high suspicion of BRIC, the genetic tests should be performed as early as possible to clarify the diagnosis and guide the management.
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    Serum CA125,CA199,AFP,CEA in patients with cirrhosis and primary liver cancer
    Dai Weiwei, Liu Zhengxin, Xu Baohong
    JOURNAL OF PRACTICAL HEPATOLOGY    2017, 20 (1): 81-84.   DOI: 10.3969/j.issn.1672-5069.2017.01.021
    Abstract797)      PDF(pc) (715KB)(939)      
    Objective To investigate the changes of serum carbohydrate antigen(CA)125,CA199, alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in patients with live cirrhosis and primary liver cancer(PLC). Methods Serum levels of CA125,CA199,AFP and CEA in 440 individuals were detected by ELISA,including 223 patients with liver cirrhosis,97 patients with PLC and 120 healthy persons. Results The levels of CA125 in patients with liver cirrhosis and PLC were (261.64±32.47) U/ml and (265.80±30.44 ) U/ml, CA199 were (25.73±3.39) U/ml and (30.54±3.29) U/ml,CEA were (4.03±0.36) ng/ml and (3.87±0.21) ng/ml,much higher than those[(21.25±7.66) U/ml,(18.57±8.11) U/ml and (3.08±1.05) ng/ml,P<0.05] in healthy persons;serum AFP levels in patients with PLC were(20000.00±453.07) ng/ml,much higher than[(7.52±2.01) ng/ml,P<0.05] in patients with liver cirrhosis;The levels of CA125(474.52±59.80) U/ml],CA199 [(27.80±5.94) U/ml] and CEA [(5.80±0.63) ng/ml] in patients with liver cirrhosis of class C were significantly higher than those of class A [(55.65±8.82) U/ml,(18.81±0.46) U/ml and (3.20±0.10) ng/ml,respectively,P<0.05];The levels of CA125[(385.16±36.09) U/ml],CA199[(26.55±2.87) U/ml],AFP[(13.63±1.82) ng/ml] and CEA [(4.85±0.39) ng/ml] in patients with cirrhotic ascites were higher than those without ascites[(62.75±15.45) U/ml,(19.58±0.75) U/ml,(9.39±1.26) ng/ml and (3.54±0.16) ng/ml,P<0.05];The levels of CA125 [(318.48±48.80)U/ml] and CA199 [(26.63±3.22)U/ml] in patients with alcoholic liver cirrhosis were higher than those in patients with viral cirrhosis [(215.77±26.26)U/ml and(19.06±0.64)U/ml,P<0.05] or in patients with primary biliary cirrhosis [(129.73±28.55)U/ml and(18.00±0.00) U/ml,P<0.05];The level of AFP [(56.41±26.75)ng/ml] in patients with viral cirrhosis was higher than[(5.44±0.30) ng/ml or(7.35±1.47) ng/ml,respectively,P<0.05],while the CEA level[(3.53±0.17) ng/ml] was lower than [(5.19±0.35) ng/ml or(5.73±0.98) ng/ml,P<0.05] in patients with alcoholic liver cirrhosis or primary biliary cirrhosis. Conclusion The serum levels of CA125,CA199,AFP and CEA in patients with liver cirrhosis and PLC were different. The serum levels of CA125,CA199,AFP and CEA in patients with liver cirrhosis were associated with Child-Pugh scores,ascites and etiology.
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    Role of bile acids in cholestatic liver injury
    He Shengfu, Wang Yuqin
    Journal of Practical Hepatology    2020, 23 (6): 919-922.   DOI: 10.3969/j.issn.1672-5069.2020.06.041
    Abstract751)      PDF(pc) (865KB)(962)      
    Objective Bile acid(BA) is synthesized in the liver and is the major component of bile. BAs accumulates in serum and liver when BAs secretion is impaired, which is followed by liver injury. The molecular mechanism of cholestasis has been extensively studied, however, it remains controversial. Recent studies showed that BAs might induce hepatocyte injury under pathological conditions, and the mechanism involved inflammatory response induced by stressed hepatocytes. In this article, we reviewed recent advances in the pathogenesis of liver injury induced by BAs and we focused on how BAs induce the activation of inflammatory cytokines that further induce the aggregation of immune cells. Based on these pathogenesis, we tentatively point out a number of novel treatments for cholestatic liver damage.
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    Clinical efficacy of PD-1 inhibitor and lenvatinib in the treatment of elderly patients with advanced primary liver cancer
    Peng Yu, Li Haitao, Yang Wenli, et al
    Journal of Practical Hepatology    2023, 26 (1): 112-115.   DOI: 10.3969/j.issn.1672-5069.2023.01.029
    Abstract751)      PDF(pc) (913KB)(419)      
    Objective The aim of this study was to explore the clinical efficacy of programmed cell death protein-1 (PD-1) inhibitor and lenvatinib in the treatment of elderly patients with advanced primary liver(PLC). Methods 56 patients with advanced PLC were admitted to our hospital between February, 2017 and February, 2020, and were divided into control (n=28) and observation group (n=28), receiving lenvatinib or PD-1 inhibitor, tirelizhu, and lenvatinib combination therapy. The peripheral blood lymphocyte subsets, CD4+ cell surface PD-1 and cytotoxic T-lymphocyte antigen 4 (CTLA-4) were detected by FCA. Serum acidic fibroblast growth factor (aFGF), basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) levels were detected by ELISA. Results At the end of three month treatment, there were no significant differences as respect to the objective remission rate (42.9% vs. 25.0%) and local control rate(78.6% vs. 64.3%, P>0.05); the percentages of CD3+, CD4+ and CD8+ cells in the combination treatment group were much higher than, while the CD4+/CD8+ cell ratio, as well as the cell PD-1 and CTLA-4 expression were much lower than in the control (P<0.05); serum aFGF, bFGF and VEGF levels in the observation group were (4.1±0.8)pg/L, (5.1±1.0)pg/L and (13.5±2.7)ng/ml, all significantly lower than [(5.3±0.9)pg/L, (6.1±0.8)pg/L and (18.6±3.1)ng/ml, respectively, P<0.05] in the control; at the end of two-year follow-up, there was no significant difference respect to the progression free survival (10.7% vs. 21.4%, P>0.05) between the two groups, while the overall survival in the observation group was 60.7%, much higher than 25.0% (P<0.05) in the control. Conclusion The strategy of PD-1 inhibitor and lenvatinib combination in the treatment of elderly patients with advanced PLC could improve immune functions and prognosis, which needs further investigation.
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    Guidelines of prevention and treatment for nonalcoholic fatty liver disease:a 2018 update
    National Workshop on Fatty Liver, Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (2): 177-186.   DOI: 10.3969/j.issn.1672-5069.2018.02.007
    Abstract740)      PDF(pc) (841KB)(2634)      
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    Early antiviral efficacy of tenofovir amibufenamide in treatment of naïve patients with chronic hepatitis B
    Zhang Danlei, Xu Jing
    Journal of Practical Hepatology    2023, 26 (3): 336-339.   DOI: 10.3969/j.issn.1672-5069.2023.03.009
    Abstract735)      PDF(pc) (821KB)(197)      
    Objective The aim of this study was to investigate the early efficacy of tenofovir amibufenamide (TMF) in the treatment of naïve patients with chronic hepatitis B (CHB). Methods A total of 90 naïve patients with CHB were recruited in the First Affiliated Hospital, China University of Science and Technology between January 2020 and March 2022, and were divided into observation (n=50) and control group (n=40), receiving TMF or tenofovir disoproxil fumarate (TDF) treatment for 48 weeks. Serum alanine transaminase (ALT), HBV DNA loads, HBeAg and HBsAg levels were detected routinely. Results At 12, 24, 36 and 48 weeks of treatment, serum ALT levels in the observation group were 38.0(25.0,55.0)U/L, 31.5(23.8,35.0)U/L, 29.5(22.8,35.0) U/L and 26.0(21.8,34.0)U/L, all not significantly different compared to 38.5(25.0,60.0)U/L, 30.0(22.0,44.0)U/L, 31.0(22.8,44.5)U/L and 28.0(19.8,42.0)U/L (P>0. 05), serum HBV DNA loads were 0(0, 3)lgIU/ml, 0(0, 0.5)lgIU/ml, 0(0, 0)lgIU/ml and 0(0, 0)lgIU/ml, not significantly different compared to 2(0, 3)lgIU/ml, 0(0, 2)lgIU/ml, 0(0, 1.5)lgIU/ml and 0(0,0)lgIU/ml (P >0.05) in the control; serum HBV DNA loss were 58%, 76%, 78% and 88%, not significantly different compared to 45%, 65%, 75% and 85%(P >0.05) in the control; at 12, 24 and 36 week treatment, serum ALT normalization rates in the observation group were 56%, 80% and 92%, all not significantly different compared to 55%, 70% and 65%(P >0.05) , while at the end of treatment 48 week, serum ALT normalization rate in the observation group was 100.0%, much higher than 72.5%(P<0.01) in the control; during the period of antiviral regimen, there was no obvious untoward effects in the two groups. Conclusion The antiviral performance of TMF in the treatment of naïve patients with CHB is as efficacious as of TDF, while the long-term efficacy and its impact on renal functions needs further clinical investigation.
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    Multi-slice spiral CT features of patients with gallbladder adenomyosis different from with gallbladder cancer
    Yang Fan, Wang Jian, Wen Zhi
    Journal of Practical Hepatology    2022, 25 (1): 140-143.   DOI: 10.3969/j.issn.1672-5069.2022.01.035
    Abstract716)      PDF(pc) (3720KB)(226)      
    Objective The aim of this study was to summarize the imaging features of multi-slice spiral CT (MSCT) in patients with gallbladder adenomyosis and in patients with gallbladder carcinoma. Methods 113 patients with gallbladder adenomyosis and 78 with gallbladder carcinoma were enrolled in our hospital between September 2015 and September 2020, and all patients underwent MSCT and ultrasonography. The histophthological examination was performed after surgery. Results The consistency of diagnosis by MSCT based on postoperative histopathological examination (Kappa=0.749) was stronger than that by ultrasonography (Kappa=0.577); the accuracy rate by MSCT scan in the diagnosis of patients with gallbladder adenomyosis was higher than that by ultrasonography(88.0% vs. 79.6%, P<0.05); the diagnosis of special, local gallbladder adenomyosis, by MSCT was also higher than that by ultrasonography (97.1% vs. 82.9%, P<0.05); the CT scan showed that the percentages of smooth gallbladder walls, RAS sinus display and clear boundary between liver and gallbladder in patients with gallbladder adenomyosis were 36.3%, 36.3% and 69.0%, all significantly higher than 9.0%, 6.4% and 38.5% in patients with gallbladder carcinoma (P<0.05). Conclusion The diagnostic accuracy of patients with gallbladder adenomyosis by MSCT is relatively high, and its imaging feature might help discriminate gallbladder adenomyosis from cancer.
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    Guidelines of prevention and treatment for alcoholic liver disease:a 2018 update
    National Workshop on Fatty Liver, Alcoholic Liver Disease, Chinese Society of Hepatology, Chinese Medical Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (2): 170-176.   DOI: 10.3969/j.issn.1672-5069.2018.02.006
    Abstract690)      PDF(pc) (735KB)(757)      
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    Clinical characteristics of patients with Dengue fever: A report of 70 cases
    Wang Qian, Li Wenli, Wang Bing, et al.
    Journal of Practical Hepatology    2022, 25 (5): 645-648.   DOI: 10.3969/j.issn.1672-5069.2022.05.010
    Abstract682)      PDF(pc) (816KB)(239)      
    Objective The aim of this study was to summarize the clinical features of patients with Dengue fever (DF), especially in those with liver injuries. Methods 70 patients with DF were encountered in our hospital from January to December 2020, and were carefully managed by supporting treatment. The patients with liver injuries were dealt with liver-protecting medicines. The clinical feature, including blood and biochemical parameters was collected. Results Out of 70 patients with DF, the main symptoms included fever, arthralgia, rash, abdominal pain, diarrhea, respiratory and urinary tract infections, and the leukopenia in 34 cases, thrombocytopenia in 35 cases and abnormal liver function tests in 33 cases; the hospital stay in 33 patients with liver injuries was (7.1±2.2) d, significantly longer than [(5.8±2.0), P<0.05] in 37 patients without liver injuries; all the 70 patients recovered; there was no significant difference as respect to peripheral white blood cell counts between patients with and without liver injuries (P>0.05), while the platelet counts in patients with liver injuries was (105.0±48.6)×109/L, significantly lower than [(156.2±88.7)×109/L, P<0.05] in those without liver injuries; serum ALT, AST, GGT, C-reactive protein and MB isoenzyme of creatine kinase levels slightly increased in patients with liver injuries and the outcomes was good. Conclusions The patients with Dengue fever could have complicated slight liver injuries, and the liver-protecting management could improve the recovery.
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    Report of serious liver injury induced by acitretin in a patient with psoriasis and literature review
    Li Chen, Liu Hongling, Liu Wanshu
    JOURNAL OF PRACTICAL HEPATOLOGY    2014, 17 (4): 416-418.   DOI: 10.3969/j.issn.1672-5069.2014.04.023
    Abstract672)      PDF(pc) (670KB)(1242)      
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    Intestinal flora changes in patients with hepatitis B-induced liver cirrhosis after entecavir and glycyrrhizin combination treatment
    Ji Minyou, Li Chao, Zhao Xingzhong, et al
    Journal of Practical Hepatology    2021, 24 (5): 641-644.   DOI: 10.3969/j.issn.1672-5069.2021.05.009
    Abstract664)      PDF(pc) (852KB)(276)      
    Objective The aim of this study was to investigate the clinical predicting value of serum ascites albumin gradient (SAAG) on esophageal variceal bleeding (EVB) risk in patients with decompensated hepatitis B cirrhosis. Methods 84 patients with decompensated hepatitis B cirrhosis were admitted to our hospital between April 2017 and October 2019, and the SAAG and modified SAAG werecalculated. The Logistic multivariate analysis was used to analyze the independent impacting factors on EVB in patients with decompensatedhepatitis B cirrhosis. The receiver operating characteristic curve (ROC) was drawn and the area under the ROC (AUROC) was calculated to predict the EVB risk. Results 18 out of our series had, and 66 patients had not EVB during six-month followed-up period; the percentage of male cases older than 65 yr in patients with EBV was 72.2%,greatly older than in patients without EBV (43.9%,P<0.05); serum albumin level in patients with EVB was (35.8±2.7)g/L, significantly lower than , blood platelet count was (52.3±10.7)×109/L, significantly lower than , the APTT was (45.8±5.9)s, significantly longer than ,the SAAG was (18.7±5.1), significantly higher than , and the modified SAAG was (9.2±2.4), significantly higher than in patients without EVB; the spleen thickness was (5.2±1.3)cm, significantly higher than , and the portal vein blood flow velocity was (15.2±2.9) cm/s, significantly slower than in patients without EVB; the multivariate Logistic analysis showed that serum albumin level (OR=0.435, 95%CI=0.287-0.659), ascites albumin level(OR=1.845, 95%CI=1.063-3.202), the APTT(OR=1.469,95%CI=1.272-1.697), the MELD score (OR=3.285, 95%CI=1.697-6.359) and the modified SAAG(OR=2.917, 95%CI=1.337-6.364) were the independent impacting factors for EVB in patients with decompensated hepatitis B cirrhosis(P<0.05); the AUCs of modified SAAG and MELD score for predicting EVB were 0.827 and 0.791, respectively, and theirsensitivities were 0.889 and 0.787, and the specificities were 0.636 and 0.612, respectively. Conclusion The application of SAAG is helpful to predict the risk of EVB in patients with decompensated hepatitis B cirrhosis, and worth further clinical investigation.
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    Evaluation of reliability and validity of self-rating anxiety scale and self-rating depression scale in patients with liver cirrhosis
    Tian Yindi, Wang Yikai, Li Jing, et al.
    JOURNAL OF PRACTICAL HEPATOLOGY    2019, 22 (1): 105-108.   DOI: 10.3969/j.issn.1672-5069.2019.01.028
    Abstract633)      PDF(pc) (932KB)(1317)      
    Objective This study was designed to evaluate of reliability and validity of self-rating anxiety scale(SAS) and self-rating depression scale(SDS) in patients with liver cirrhosis. Methods A total of 138 patients with liver cirrhosis were enrolled in this study. The reliability and validity of the two scales was evaluated by Cronbach’s α co-efficient,intraclass correlation co-efficient (ICC),Kaiser-Meyer-Olkin (KMO) score and Bartlett’s test of sphericity(BTS). Results The prevalence of anxiety and depression in this series were 38.2% and 63.1%,respectively;SAS scale’ Cronbach's α coefficient was 0.777 and SDS scale’ was 0.782, indicating better homogeneity reliability; Twenty items of SAS and SDS scales were analyzed by exploratory factors to construct validity and four main factors were extracted from the SAS scale that showed the variances ratio were 15.4%,14.9%,10.6% and 10.2%,respectively,and four factors accounted for 51.1% of the total variance of accumulated explanation;Five main factors were extracted from SDS scales that showed the variance ratio were 14.0%,12.6%,11.9%,10.3% and 8.4%,respectively,with 57.4% of the total variance;The re-measurement analysis of SAS and SDS scale’s items found that the two measurements were highly correlated with each other (P<0.001). Conclusion SAS and SDS scales have a better reliability and validity in the investigation of psychological and mental impairment in patients with liver cirrhosis.
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    Very short-term efficacy of silybin meglumine and Danning tablet combination in treatment of patients with alcoholic hepatitis
    Lu Yongyu, Liu Changjiang, Huang Shuai.
    Journal of Practical Hepatology    2020, 23 (5): 662-665.   DOI: 10.3969/j.issn.1672-5069.2020.05.015
    Abstract629)      PDF(pc) (847KB)(596)      
    Objective The aim of this study was to investigate the short-term efficacy of silybin meglumine and Danning tablet, a herbal medicine, combination in treatment of patients with alcoholic hepatitis (AH). Methods 146 consecutive patients with AH were recruited in our hospital between March 2017 and June 2019, and were randomly divided into control group (n=73) and observation group (n=73). The patients in the control group were given Danning tablets, and those in the observation group were treated with silybin meglumine and Danning combination for 3 months. Serum superoxide dismutase (SOD), alondialdehyde (MDA) and free fatty acid (FFA) were detected. Results Serum total cholesterol (TC) level in the combination group was (4.9±0.7)mmol/L, significantly lower than 【(5.5±1.2)mmol/L, P<0.05】, and high density lipoprotein cholesterol (HDL-C) was (1.3±0.9)mmol/L, much higher than 【(1.0±0.5)mmol/L, P<0.05】 in the control, and serum triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) levels in the two groups were not significantly different 【(1.7±0.3)mmol/L vs. (1.7±0.7)mmol/L and (3.2±0.4)mmol/L vs. (3.4±0.7)mmol/L, respectively, P>0.05】; serum alanine aminotransferase level was (35.9±7.7)U/L, serum aspartate aminotransferase level was (39.5±6.3)U/L, serum glutamyl transpeptidase level was (123.8±6.6)U/L, and serum alkaline phosphatase level was (57.3±12.5)U/L, all significantly lower than those in the control [(63.5±9.2)U/L,(65.5±7.8)U/L,(145.7±7.2)U/L and (78.4±13.1)U/L, respectively, P<0.05】; serum SOD level was (132.9±19.3)nmol/L, much higher than 【(105.5±12.6)nmol/L, P<0.05】, serum MDA level was (9.5±2.3)nmol/L, significantly lower than 【(14.4±3.6)nmol/L, P<0.05】, and serum FFA level was (24.3±3.1)nmol/L, much lower than 【(30.2±3.3)nmol/L, P<0.05】 in the control. Conclusion The administration of silybin meglumine and a herbal medicine combination in treatment of patients with AH might in short-term ameliorate blood lipid metabolism, inhibit oxidative stress and improve liver functions, which needs further multi-central investigations.
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    Preliminary study on the efficacy of combination of tenofovir and Anluo Huaxian pill in the treatment of patients with HBeAg-negative chronic hepatitis B
    Zhao Xieshan, Wu Chunrong, Wang Chunfeng, et al
    Journal of Practical Hepatology    2019, 22 (5): 644-647.   DOI: 10.3969/j.issn.1672-5069.2019.05.008
    Abstract620)      PDF(pc) (817KB)(247)      
    Objective The aim of this study was to investigate the efficacy of of combination of tenofovir and Anluo Huaxian pill,a herbal medicine,in the treatment of patients with HBeAg-negative chronic hepatitis B (CHB). Methods A total of 68 patients with HBeAg-negative CHB were recruited in our hospital bwtween March 2015 and May 2017,and were divided randomly into two groups,with 34 patients in each. The patients in the control group were treated with tenofovir orally and those in the observation were treated with combination of tenofovir and Anluo Huaxian pill for 48 weeks. Serum interleukin(IL)-6,IL-2,and tumor necrosis factor-α(TNF-α) by enzyme-linked immunosorbent assay,and serum type III procollagen(PC-III),hyaluronic acid (HA),laminin (LN) and type IV collagen (IV-C) were detected by radioimmunoassay. Results At the end of 48 w treatment,serum HA,LN,IV-C,and PC-III levels in the combination group were(94.5±31.5) ng/ml,(113.2±51.6) ng/ml, (72.4±20.3) g/L and (102.4±19.6) g/L,significantly lower than [(121.6±37.5) ng/ml,(132.5±53.8) ng/ml,(94.6 ±22.1) μg/L and(134.7±21.5) g/L,respectively,P<0.05] in the control;serum IL-2 level was (173.6±28.3) ng/L, significantly higher than [(145.7±26.4) ng/L,P<0.05], while serum IL- 6 and TNF-α levels were (94.5±16.2) pg/ml and(26.6±6.8) pg/ml,significantly lower than [(112.6±17.8) pg/ml and(35.7±8.3) pg/ml,respectively,P<0.05] in the control;serum HBV DNA loss were 91.2% and 88.2% in the two groups(P<0.05) and serum ALT normalization rates in the two groups were 94.1% and 94.1%. Conclusion The administration of tenofovir and Anluo Huaxian pills is effective in the treatment of patients with HBeAg-negative CHB, which might alleviate liver fibrosis and reduce intrahepatic inflammation.
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    Comparison of response toPEG-IFNα-2a or PEG-IFNα-2b in patients with chronic hepatitis B
    Lin Jinxiang, Yang Keli
    Journal of Practical Hepatology    2021, 24 (1): 27-30.   DOI: 10.3969/j.issn.1672-5069.2021.01.008
    Abstract612)      PDF(pc) (812KB)(903)      
    Objective The aim of this study was to compare the antiviral response to pegylated interferon-α (PEG-IFNα-2a) or PEG-IFNα-2b in patients with chronic hepatitis B (CHB). Methods 74 patients with CHB were enrolled in our hospital between July 2016 and May 2018, and were randomly divided into group A (n=37) and group B (n=37). The patients in group A were treated with PEG-IFNα-2a, and those in group B were treated with PEG-IFNα-2b. The antiviral therapy lasted for 48 w, and all patients were followed-up for 24 weeks. Results At the end of 12 w, 24 w and 48 w treatment and 24 w followed-up, serum alanine aminotransaminase (ALT) normalization rates in goup A were 29.7%, 35.1%, 83.8% and 75.7%, all not significantly different as compared to 27.0%, 29.7%, 86.5% and 78.4%, respectively, (P>0.05) in group B; serum HBV DNA loss were 59.5%, 73.0%, 78.4% and 75.7%, all not significantly different as compared to 45.9%, 51.4%, 81.1% and 75.7%, respectively, (P>0.05) in group B; serum HBeAg negative rates were 33.3%, 36.7%, 36.7% and 40.5%, all not significantly different as compared to 29.2%, 29.2%, 33.3% and 35.1%, respectively, (P>0.05) in group B; during the treatment, the incidences of flu-like symptoms and abnormal thyroid functions in the two groups were the same, and the incidences of thrombocytopenia and granulocytopenia in group A were 40.0% and 76.6%, both notsignificantly different as compared to 37.8% and 75.7% in group B (P>0.05).Conclusion At present, both PEG-IFNα-2a and PEG-IFNα-2b could be selected for the treatment of patients with CHB, and the surveillance of untoward effects is pivotally important for the regimen going and the achievement of antiviral therapy.
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    Diagnosis and treatment of hepatocellular jaundice
    Yang Min, Lu Mingqin
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (2): 160-162.   DOI: 10.3969/j.issn.1672-5069.2018.02.003
    Abstract607)      PDF(pc) (439KB)(1313)      
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    Clinical efficacy of tenofovir and Fuzhenghuayu capsule in treatment of patients with chronic hepatitis B liver cirrhosis
    Ye Xiaoting,Sun Qingfeng,Fu Rongquan, et al
    Journal of Practical Hepatology    2021, 24 (1): 143-144.   DOI: 10.3969/j.issn.1672-5069.2021.01.037
    Abstract597)      PDF(pc) (764KB)(219)      
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    Prevention and treatment of cirrhotics with esophagus and gastric varices bleeding
    Sun Ruonan, Zhang Chunqing
    Journal of Practical Hepatology    2021, 24 (4): 607-610.   DOI: 10.3969/j.issn.1672-5069.2021.04.039
    Abstract596)      PDF(pc) (854KB)(773)      
    Objective Esophageal and gastric varices bleeding (EGVB) is a common complications of liver cirrhosis, with a high mortality rate. Therefore, the prevention and treatment of EGVB is very important for patients with liver cirrhosis. Internal medicine, endoscopic management, interventional and surgical operation are all important approaches for the prevention and treatment of EGVB, which greatly improves the survival rate of cirrhotic patients. In this paper, we reviewed the current progress of primary prevention, emergent hemostasis and secondary prevention of patients with different types of esophageal and gastric varices.
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    Effect and underlying mechanism of curcumin on oleic acid-induced steatosis of HepG2 cells in vitro
    Wu Pengbo, Song Qi, Yu Yuanjie, et al.
    Journal of Practical Hepatology    2020, 23 (3): 324-327.   DOI: 10.3969/j.issn.1672-5069.2020.03.006
    Abstract585)      PDF(pc) (2483KB)(1061)      
    Objective The aim of this experiment was to explore the effect and underlying mechanism of curcumin on oleic acid-induced steatosis of HepG2 cells in vitro. Methods HepG2 cells were treated with or without 1 mmol/L oleic acid (OA) to establish nonalcoholic fatty liver disease (NAFLD) cell model. The HepG2 cells were divided into four groups, e.g. control (con), steatosis model (OA) , curcumin control and curcumin-intervened groups. Bodipy493/503 staining was used to detect the distribution of lipid droplets in the HepG2 cells. The ultrastructure of mitochondria was examined by transmission electron microscopy. Reactive oxygen species (ROS) levels were detected by DCFH-DA. The TNF-α and IL-6 levels in the supernatants were measured by a commercial kit. The apoptosis was determined by Hoechst 33258 staining. Western blott was applied to determine the expression of Bcl-2, Bax, mCytc, NF-κB, and Caspase-3/9 proteins. Results Compared with in the control cells, the cells treated with OA showed significantly increased lipid droplets accumulation, while the cells treated with curcumin showed reduced lipid droplets accumulation; the mitochondrial damage including mitochondrial swelling and vesiculation in OA group was more obvious than that in control group, while the mitochondrial damage treated by curcumin was significantly improved; the TNF-α and IL-6 levels in OA group were much higher than that in the control group , while they decreased greatly in curcumin-inervened group ; the ROS levels was (52.24±5.11)% in OA group, significantly higher than (6.71±2.31)% in the control group, while it decreased to (37.44±7.21)% in curcumin-treated group (P<0.05); the apoptosis rate in OA group was (12.12±0.72)%, significantly higher than (2.04±0.57)% in the control group, while it decreased significantly in curcumin-treated group ; the expressions of Bax, NF-κB and cleaved-Caspase-3/9 intensified, and Bcl-2 and mCytc decreased greatly in OA group as compare to those in the control, while the expressions of Bax, NF-κB and Caspase-3/9 decreased, and Cytc and Bcl-2 increased (P<0.05) in curcumin-intervened group. Conclusion Curcumin effectively prevent oleic acid-induced steatosis in HepG2 cells, which might be related to the alleviation of inflammatory reaction, oxidative stress and inhibition of apoptosis.
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    Up-regulation of lipid metabolism related genes in liver tissues of mice with nonalcoholic fatty liver diseases
    Zhang Meng, Chen Yi, Liu Jiao, et al
    Journal of Practical Hepatology    2020, 23 (2): 163-166.   DOI: 10.3969/j.issn.1672-5069.2020.02.004
    Abstract581)      PDF(pc) (1674KB)(940)      
    Objective The aim of this experiment was to investigate the changes of lipid metabolism related genes in liver tissues of mice with nonalcoholic fatty liver diseases (NAFLD). Methods A NAFLD model was established in ten mice by feeding high-fat diet. The histopathological changes of the liver tissues were observed. Blood total cholesterol (TCH) and triglycerides (TG) levels were detected, and sterol regulatory element-binding proteins (SREBPs), acetyl coenzyme carboxylase (ACC) and fatty acid synthase (FAS) mRNA were detected by reverse transcription-polymerase chain reaction. Results The steatosis of liver cells was found in mice in NAFLD model group; blood TG and TCH levels in NAFLD model group were (0.63±0.13) mmol/L and (7.23±0.7) mmol/L, significantly higher than [(0.28± 0.06) mmol/L and (2.78±0.6) mmol/L, P<0.001] in ten mice in the control; at the end of 24 w experiment, hepatic FAS and SREBP-1 mRNA in NAFLD mice were (3.9±1.1) and (1.8±0.7), significantly higher than 【(1.0±0.3) and (1.0±0.4), FAS: t = 6.231, P<0.001; SREBP-1: t = 2.431, P =0.035】, while the ACC mRNA was (1.2±0.5), not significantly different as compared to 【(1.0±0.4), t = 0.765, P =0.462】 in the control. Conclusion The lipid metabolism related genes in liver tissue of mice with NAFLD are significantly up-regulated, which might play a pivotal role in the pathogenesis of NAFLD.
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    Models of nonalcoholic fatty liver disease
    Zhang Yizhi, Zhang Xiaohui, Chen Yu
    Journal of Practical Hepatology    2021, 24 (5): 761-764.   DOI: 10.3969/j.issn.1672-5069.2021.05.039
    Abstract562)      PDF(pc) (860KB)(1150)      
    Objective The incidence rate of nonalcoholic fatty liver disease (NAFLD) is increasing. It might progress to the end-stage liver disease. However, there is still no specific treatment for this entity. Therefore, the establishment of representative animal models reflecting disease characteristics has become especially important. Although there are many different disease models, there is still a lack of NAFLD model which could cover the whole spectrum of this entity in human. In this paper, we reviewed the current progress on NAFLD model, focusing on animal model, 2D cell model, 3D liver model and their advantages and disadvantages.
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    Committee of Hepatology, Chinese Research Hospital Association; Fatty Liver Expert Committee, Chinese Medical Doctor Association
    National Workshop on Fatty Liver, Alcoholic Liver Disease, Chinese Society of Hepatology; National Workshop on Liver, Metabolism, Chinese Society of Endocrinology, Chinese Medical Association
    Journal of Practical Hepatology    2019, 22 (6): 787-792.   DOI: 10.3760/cma.j.issn.1007-3418.2019.10.005
    Abstract556)      PDF(pc) (737KB)(997)      
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    Combination of ursodeoxycholic acid and prednisone and azathioprine in the treatment of patients with autoimmune hepatitis
    Nie Liu, Peng Hanming, Liao Dongliang
    Journal of Practical Hepatology    2021, 24 (2): 224-227.   DOI: 10.3969/j.issn.1672-5069.2021.02.019
    Abstract553)      PDF(pc) (858KB)(399)      
    Objective The aim of this study was to observe the efficacy of combination of ursodeoxycholic acid (UDCA) and prednisone and azathioprine in the treatment of patients with autoimmune hepatitis (AIH).Methods 120 AIH patients were recruited in the Department of Gastroenterology in our hospital between February 2017 and December 2019, and were randomly divided into control and observation groups with 60 cases in each group. The patients in the control received prednisone and azathioprine, while those in the observation group received UDCA at base of prednisone and azathioprine therapy. The regimen lasted for 21 months. Serum complement 3 (C3), C4, as well as immunoglobulin were detected.Results At the end of the treatment, serum alanine aminotransferase level in the observation group was (55.2±6.9)U/L, significantly lower than 【(91.2±12.8)U/L, P<0.05】, serum aspartate aminotransferase level was (59.7±7.5)U/L, significantly lower than 【(101.5±13.5)U/L, P<0.05】, serum alkaline phosphatase level was (122.4±15.7)U/L, much lower than 【(138.9±15.2)U/L, P<0.05】, and serum glutamyl transpeptidase level was (120.7±10.1)U/L, significantly lower than 【(161.5±20.7)U/L, P<0.05】 in the control; serum C3 level in the observation was (0.6±0.1)g/L, significantly lower than 【(0.8±0.2)g/L,P<0.05】, and serum C4 level was (0.1±0.1)g/L, significantly lower than 【(0.2±0.1)g/L, P<0.05】 in the control; serum IgG level in the observation group was (12.5±2.0)g/L, significantly lower than 【(20.4±2.7)g/L, P<0.05】, and serum IgM level was (2.7±0.9)g/L, significantly lower than 【(3.4±1.1)g/L, P<0.05】 in the control.Conclusion The administration of ursodeoxycholic acid at base of prednisolone and azathioprine combination in the treatment of patients with AIH could effectively reduce serum C3 and C4 levels, improve immune functions and alleviate liver injury, which needs further investigation.
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    Efficacy and safety of tauroursodeoxycholic acid and ursodeoxycholic acid combination in the treatment of patients with nonalcoholic fatty liver disease:a Meta-analysis
    Xing Xin, Wei Zhongcao, Zhou mimi, et al.
    Journal of Practical Hepatology    2019, 22 (6): 852-855.   DOI: 10.3969/j.issn.1672-5069.2019.06.019
    Abstract552)      PDF(pc) (920KB)(622)      
    Objective To systematically evaluate the efficacy and safety of tauroursodeoxycholic acid and ursodeoxycholic acid combination in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). Methods We searched CNKI,VIP,WanFang Data,CBM,PubMed,The Cochrane Library,EMbase database and retrieved randomized controlled trials (RCT) on the observation of tauro ursodesoxycholic acid and ursodeoxycholic acid combination in the treatment of patients with NAFLD since inception of database. Meta analysis was performed by using RevMan 5.3 software. Results A total of 682 NAFLD patients were included in 6 RCT studies,and 342 in the observation group were treated by tauro ursodesoxy cholic acid and polyene phosphatidyl choline,and 340 in the control group were treated by ursodeoxycholic acid and polyene phosphatidyl choline combination. The Results showed that the overall effective rate [RR=1.10,95%CI(1.03,1.18),P=0.004],serum ALT reduction [MD=13.34,95%CI(12.20,14.48),P<0.00001],AST reduction [MD=11.29,95%CI(5.85,16.72),P<0.0001], GGT reduction [MD=22.54,95%CI(20.75,24.33),P<0.00001],TG reduction[MD=0.48,95%CI(0.25,0.70),P<0.0001],LDL-C reduction [MD=0.67,95%CI(0.51,0.83),P<0.00001] and BMI reduction [MD=1.57,95%CI(1.29, 1.84),P<0.00001] as well s HDL-C elevation [MD=0.23,95%CI(0.18,0.27),P<0.00001] in the observation group in the treatment of patients with NAFLD were significantly superior to those in the control group; however,there was no significant difference between the two groups as respect to serum TC reduction [MD=0.30,95%CI(-0.03,0.64),P=0.08] and the incidence of adverse reactions [RR=1.00,95%CI(0.41, 2.47),P=1.00];the improvement of hepatic steatosis was also not significantly different between the two groups [RR=2.2,95%CI(0.97,4.98),P=0.06]. Conclusion The efficacy of tauro ursodesoxy cholic acid combined with polyene phosphatidyl choline in the treatment of patients with NAFLD is good based on the domestic studies,which might be at a low level observations.
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    Conventionaland contrast-enhanced ultrasonography manifestations of intrahepatic cholangiocarcinoma
    Chen Jiaojiao, He Nian’an, Fang Jing, et al
    Journal of Practical Hepatology    2021, 24 (2): 272-275.   DOI: 10.3969/j.issn.1672-5069.2021.02.031
    Abstract549)      PDF(pc) (3530KB)(438)      
    Objective The aim of this study was to summarize the conventional and contrast-enhanced ultrasonography (CEUS)manifestations of intrahepatic cholangiocarcinoma (ICC).Methods 52 patients with ICC were recruited in our hospital, and all underwent conventional and CEUS check-up.Results The gray-scale ultrasonography showed than the tumors presented with uniform hypoechoic in 23 cases (44.2%, uneven hypoechoic in 22 cases (42.3%), slightly hyperechoic and hyperechoic in 7(13.5%); the color Doppler flow imaging showed that the blood supply of lesions was in grade 0 in 11 cases (21.2%), in grade 1 in 9 cases (17.3%), in grade 2 in 28 cases (53.8%), and in grade 3 in 4 cases(7.7%); out of 51 eligible cases of ICC, the CEUS demonstrated that the enhancement performance in arterial phase was in typeⅠ, e.g. rapid overall uniform enhancement, in 10 cases (19.6%), and in type Ⅱ, e.g. rapid uneven enhancement, in 41 cases (80.4%), out of which, in subtype Ⅱa, the overall uneven enhancement, in 19 cases (37.3%), in subtype Ⅱb, the dendritic enhancement, in 9 (17.6%), in subtype Ⅱc, thick-walled irregular ring-like enhancement, in 6 (11.8%), and in subtype Ⅱd, ring-like and dendritic enhancement, in 7 (13.7%).Conclusion ICCs have some CEUS characteristic features, which might help for the early diagnosis.
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    Cross-talk between Notch and LPS-TLR4-NF-κB inflammatory signaling pathways in LPS-activated HepG2 cells
    Zhang Ying, Wang Hongyan, Chi Cheng, et al
    JOURNAL OF PRACTICAL HEPATOLOGY    2019, 22 (4): 470-473.   DOI: 10.3969/j.issn.1672-5069.2019.04.005
    Abstract546)      PDF(pc) (571KB)(987)      
    Objective To investigate the interaction between Notch and LPS-LPS-Toll like receptor-4(TLR4)-NF-κB inflammatory signaling pathways in HepG2 cells stimulated with lipopolysaccharide (LPS).Methods HepG2 cells were cultured with LPS and cell RNAs were extracted,and Notch signaling pathway receptors and their ligands mRNA were detected by quantitative reverse transcription polymerase chain reaction. Western blot analysis was used to detect Notch intracellular domain(NICD) and NF-κB protein expression levels after the γ-secreting enzyme inhibitor (DAPT),LPS or combination of LPS and DAPT activation,respectively.Results After LPS activation of HepG2 cells,the mRNA level of Notch 1 was 2.25 times(P<0.001),Jag 1 was 2.47 times(P<0.001),NOTCH 3 was 0.0700 times (P>0.05),Jag 2 was 0.420 times (P>0.05),and Dll 4 was 0.947 times (P<0.01) increased,while NOTCH 2 was 0.857 times(P<0.01),NOTCH 4 was 0.283 times(P>0.05),Dll 1 was 0.750 times(P<0.01),and Dll 3 was 0.393 times(P>0.05) decreased;the expression of NICD and NF-κB proteins in LPS-intervened cells increased obviously,while those in DAPT-intervened cells decreased greatly as compared to those in the control. Conclusion Our findings reveals that the interaction might be going on between Notch and TLR4-NF-κB signaling pathways in HepG2 cells stimulated by LPS. The inhibition of Notch signaling pathway could significantly alleviate the inflammatory response caused by LPS-TLR4.
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    Clinical efficacy of entecavir combined with live bifidobacterium and lactobacillus tablets in the treatment of hepatitis B patients with decompensated liver cirrhosis
    Li Bo, Deng Cunliang
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (5): 669-672.   DOI: 10.3969/j.issn.1672-5069.2018.05.004
    Abstract534)      PDF(pc) (444KB)(413)      
    Objective To investigate the clinical efficacy of entecavir combined with live bifidobacterium and lactobacillus tablets in the treatment of B patients with decompensated liver cirrhosis. Methods 120 patients with hepatitis B induced decompensated liver cirrhosis in the Affiliated Hospital of the Southwest Medical University between Jan. 2015 and Aug. 2017 were randomly divided into control and observation groups. The patients in the control group were administrated entecavir and patients in the observation group were administrated entecavir and live bifidobacterium and lactobacillus tablets. The index of liver function,hepatic fibrosis,HBV DNA and the rate of spontaneous bacterial peritonitis were compared between the two groups. Results At the end of 12 weeks,serum levels of ALT and TBIL in combination treatment group were(70.2±6.2) U/L and(16.3±4.2) μmol/L,both significantly lower than (76.2±9.6) U/L and (26.3±5.2) μmol/L in the control group(P<0.05);serum level of ALB in the treatment group was (32.5±4.2) g/L,significantly higher than(30.2±5.3)g/L in the control group(P<0.05);at the end of 24 weeks,serum levels of ALT and TBIL in the treatment group were (12.2±3.2) U/L and(6.2±1.3) μmol/L,both significantly lower than (26.4±3.2)U/L and (11.2±3.2) μmol/L in the control group (P<0.05);serum level of ALB in the treatment group was (37.8±2.3) g/L,significantly higher than (34.4±4.2) g/L in the control group (P<0.05);serum LN and C- IV were (65.2±15.1)ng/ml and (85.5±8.5)ng/ml,much lower than【(75.3±10.3)ng/ml and (96.2±10.3)ng/ml in the control,respectively,P<0.05】;serum HBV DNA level was (1.0±0.1)lg copies/ml,no significantly different as compared to (1.7±0.3) lg copies/ml in the control (P>0.05),and serum HBV DNA negativity rate was 100.0%,also no significantly different as compared to 90.0% in the control(P>0.05);at the end of 12 w and 24 w,the SBP occurred in 5(8.3%) and in 2(3.3%),significantly lower than in 10(16.7%) and in 8(13.3% in the control (P<0.05);at the end of 24 w,3(5%) died in the combination group,much lower than 10(16.7%) in the control(P<0.05). Conclusion Entecavir combined with live bifidobacterium and lactobacillus tablets has a good clinical efficacy in treatment of hepatitis B patients with decompensated liver cirrhosis,which is worth further investigation.
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    Efficacy of bifidobacterium triple viable capsuleand metformin in treatment of patients with nonalcoholic fatty liver disease
    Chen Jinyu, Guo Xiaoxia, Zhong Xiaoni
    Journal of Practical Hepatology    2021, 24 (1): 63-66.   DOI: 10.3969/j.issn.1672-5069.2021.01.017
    Abstract533)      PDF(pc) (818KB)(268)      
    Objective The aim of this study was to investigate the therapeutic efficacy of bifidobacterium triple viable capsule and metformin in the treatment of patients with nonalcoholic fatty liver disease (NAFLD) and the changes of blood dark incubation of insulin receptor substrate 1(IRS1), IRS2 and glucose transporter -4(GLUT4) mRNA. Methods 70 patients with NAFLD were enrolled in our hospital between June 2018 and December 2019,and were randomly divided into control (n=35) and observation (n=35), receiving metformin hydrochloride or bifidobacterium triple viable capsules at base of metformin for three months. Peripheral blood IRS1, IRS2 and GLUT4mRNA were assayed by RT-PCR, and serum highly sensitive c-reactive protein (hs-CRP), interleukin -6 (IL-6) and IL-10 levels were also detected. Results At the end of three month treatment, the total fatty liver improvement rate in the observation group was 91.4%, which was significantly higher than that in the control group (68.6%, P<0.05); serum aspartate aminotransferase (AST) level in the observation group was (23.9±9.7) U/L, significantly lower than that in the control group , serum alanine aminotransferase (ALT) level was (45.5±12.3) U/L, much lower than that in the control group , and serum glutamyltranspeptidase (GGT) level was (66.9±11.9) U/L, significantly lower than that in the control group ; blood IRS1 mRNA was (2.1±0.2), which was much higher than that in the control group , peripheral blood IRS2 mRNA level was (2.3±0.4), which was significantly higher than that in the control group , and peripheral blood GLUT4 mRNA level was (2.5±0.4), which was also significantly higher than that in the control group ; serum hs-CRP level was (3.4±0.7) mg/L, significantly lower than that in the control group , serum interleukin-6(IL-6) level was (26.9±7.4)ng/L, significantly lower than that in the control group , and serum IL-10 level was (46.5±12.8)ng/L, significantly lower than that in the control group .Conclusion The combination of bifidobacterium triple viable capsule and metformin in treatment of patients with NAFLD could effectively improve the hepatic steatosis, which might be related to the elevation of peripheral blood IRS1, IRS2 and GLUT4 and inhibition of serum inflammatory factors.
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    Efficacy and safety of glecaprevir/pibrentasvir therapy in the treatment of patients with chronic hepatitis C and genotype 1b infection
    Hu Chunxia, Yang Jiaonan, Zhang Fengxiao et al
    Journal of Practical Hepatology    2022, 25 (3): 359-362.   DOI: 10.3969/j.issn.1672-5069.2022.03.014
    Abstract529)      PDF(pc) (843KB)(178)      
    Objective The aim of this study was to investigate the efficacy and safety of glecaprevir/pibrentasvir therapy in the treatment of patients with chronic hepatitis C (CHC) and genotype 1b infection. Methods A total of 138 patients with CHC and genotype 1b infection were admitted to the our hospital between July 2019 and August 2020, and were randomly divided into DAA-treated group, receiving glecaprevir/pibrentasvir treatment in 69 cases, and PR-treated group, receiving pegylated interferon alpha-2b and ribavirin combination treatment in another 69 cases. The regimen lasted for 12 weeks in both groups. The biochemical, hematology and virologic parameters were routinely detected. Results At the end of the treatment, serum aspartate aminotransferase and alanine aminotransferase levels in DAA-treated patients were (35.2±6.2)U/L and (30.7±5.4)U/L, both significantly lower than [(48.4±6.9)U/L and (45.4±6.1)U/L, respectively, P<0.05] in PR-treated patients; the rapid virologic response, virologic response at end of treatment and sustained virologic response in DAA-treated patients were 78.3%, 95.7% and 95.7%, all significantly higher than 65.2%, 76.8% and 76.8%(P<0.05) in PR-treated patients; during the treatment, the white blood cell counts and platelet counts in PR-treated patients were (3.4±1.4)×109/L and (110.7±30.8)×109/L, both significantly lower than [(6.3±1.3)×109/L and (208.3±30.2)×109/L, P<0.05] in DAA-treated patients; the incidence of untoward effects in patients receiving DAA treatment was 5.8%, very significantly lower than 84.1%(P<0.001) in patients receiving PR treatment. Conclusion The administration of glecaprevir/pibrentasvir in treating patients with genotype 1b-infected CHC is efficacious and safe with promising virologic response and low side effects, which warrants further clinical investigation.
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    Short-term observation ofglicladine and insulin aspart 50 in the treatment of patients with non-alcoholic fatty liver diseases and hepatogenic diabetes
    Zhang Yan, Xia Wenfang, Jin Jin, et al
    Journal of Practical Hepatology    2021, 24 (2): 240-243.   DOI: 10.3969/j.issn.1672-5069.2021.02.023
    Abstract521)      PDF(pc) (860KB)(286)      
    Objective The aim of this study was to analyze the short-term efficacy of glicladine and insulin aspart 50 in the treatment of patients with non-alcoholic fatty liver diseases (NAFLD) and hepatogenic diabetes and to monitor the changes of homeostasis model assessment for insulin resistance (HOMA-IR) and index of β-cell function in homeostasis model assessment (HOMA-β).Methods 98 patients with NAFLD and hepatogenic diabetes were admitted to our hospital between January 2017 and December 2019 were randomly divided into control group (n=49) and observation group (n=49). The patients in the control group were treated with insulin aspart 50, while those in the observation group were treated with glicladine at the basis of insulin aspart 50. The regimen in both groups lasted for 12 weeks. The fasting blood glucose (FBG) , postprandial 2 hour blood glucose (2 h PG) and serum hemoglobin A1c (HbAlc) level were detected, and the HOMA-IR and HOMA-β were calculated. Serum liver function indexes were detected by automatic biochemical analyzer.Results At the end of 12 week treatment, the FPG level in observation group was (6.3±3.9) mmol/l, significantly lower than [ (7.8 ±1.2) mmol/l, P<0.05] in the control, the 2 h PG level was (8.4±2.6) mmol/l, significantly lower than [(11.5±2.8) mmol/l, P<0.05] in the control, and the HbAlc level was (7.1±1.6)%, significantly lower than [(8.3±1.9)%, P<0.05] in the control; the HOMA-IR in the observation group was (1.5±0.2) , significantly lower than [(2.4±03), P<0.05] in the control, while the HOMA-β was (42.9±8.7), significantly higher than [(33.5±7.2), P<0.05] in the control; serum alanine aminotransferase (ALT) level in the observation group was (53.9±13.7) U/L, significantly lower than [(72.2±19.6) U/L, P<0.05] in the control, and serum aspartate aminotransferase (AST) level was (22.1±6.3) U/L, significantly lower than [(46.4±6.9) U/L, P<0.05] in the control; Serum albumin, total bilirubin and glutamyl transpeptidase levels in the two groups were not significantly different before and after treatment (P>0.05).Conclusion The administration of glicladine and insulin aspart 50 in the treatment of patients with NAFLD and hepatogenic diabetes could significantly improve the blood sugar level recovery, which might related to the improvement of islet β cell functions and reduction of HOMA-IR.
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    Analysis of plasma exchange and continuous blood purification in treatment of patients with hepatitis B liver failure
    Yang Xiaoling, Zhou Qiang, Zheng Chunhua, et al
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (3): 469-470.   DOI: 10.3969/j.issn.1672-5069.2018.03.042
    Abstract511)      PDF(pc) (880KB)(531)      
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    Therapeutic efficacy of polyene phosphatidylcholine in patients with anti-tuberculosis agents-induced liver injury
    Liu Yunhua, Da Rongfeng, Xu Hubo, et al
    Journal of Practical Hepatology    2021, 24 (2): 228-231.   DOI: 10.3969/j.issn.1672-5069.2021.02.020
    Abstract507)      PDF(pc) (863KB)(397)      
    Objective To investigate the therapeutic efficacy of polyene phosphatidylcholine in patients with anti-tuberculosis agents-induced liver injury and its effect on serum heme oxygenase (HO-1), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels. Methods 78 patients drug-induced liver injury (DILI) during anti-tuberculosis therapy for pulmonary tuberculosis were enrolled in our hospital between March 2018 and March 2019, and were randomly divided into control and observation group with 39 in each, receiving diammonium glycyrrhizinate or polyene phosphatidylcholine orally for 12 weeks. Serum interleukin-6, IL-1β and tumor necrosis factor-α(TNF-ɑ) as well as serum HO-1, GSH-Px and SOD levels were detected.Results At the end of 12 week observation, serum level of alanine aminotransferase (ALT) in the observation group was (28.1 ± 20.5) U/L, which was significantly lower than that in the control group [(59.4 ± 22.7) U/L, P <0.05], and serum level of aspartate aminotransferase (AST) in the observation group was (345.1 ± 17.3) U/L, which was significantly lower than that in the control group [(45.1 ± 17.3) U/L, P <0.05]; serum TNF-ɑ level inthe observation group was (7.4 ± 1.5) pg/mL, which was significantly lower than that in the control group [(10.3 ± 1.8) pg/mL, P <0.05], and serum IL-1β level in the observation group was (13.7 ± 2.1) ng/mL, which was significantly lower than that in the control group [(34.2 ± 4.8) ng / mL, P <0.05]; serum HO-1 level in the observation group was (294.1 ± 16.9) U/L, which was significantly higher than that in the control group [(198.8 ± 17.2) U/L, P <0.05], and serum level of SOD was (544.2 ± 13.3) U/L, which was significantly higher than that in the control group [(421.0 ± 12.8) U/L, P <0.05]. Conclusion The administration of polyene phosphatidylcholine in the treatment of patients with DILI caused by anti-tuberculosis medicine is efficacious, which could significantly increase serum HO-1 and SOD levels, and reduce oxidative stress response, and needs further clinical investigation.
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    Prevalence of serum anti-mitochondrial antibody-M2 antibody in health check-up individuals
    Qu Ying, Cai Xiaobo, Zhang Qidi, et al
    Journal of Practical Hepatology    2022, 25 (2): 203-206.   DOI: 10.3969/j.issn.1672-5069.2022.02.013
    Abstract507)      PDF(pc) (834KB)(709)      
    Objective The purpose of this study was to investigate the prevalence of serum anti-mitochondrial antibody-M2 (AMA-M2) antibody in physical examination individuals. Methods 18515 serum samples were collected from the Physical Examination Center, Shanghai General Hospital between May 2012 and December 2014. Serum AMA-M2 was quantitatively detected by ELISA, and blood biochemical parameters were assayed. Results Among 18515 screened people, 245 persons (1.3%) were serum AMA-M2 positive, of which 97 were men and 148 were women, with the ratio of men to women of about 1∶1.5, and the highest positive rate (28.6%) was found in 46 to 55 year old age group(n=70); serum alkaline phosphatase levels increased in 12 persons with serum AMA-M2 positive, who met the diagnostic criteria of primary biliary cholangitis (PBC); serum ALP level in 54 persons with higher serum AMA-M2 (>150U/ml) was (92.8±85.6 U/L), and serum GGT level was (84.3±118.5 U/L, significantly higher than [(67.7±38.3U/L) and (39.1±61.8U/L), respectively, P<0.05] in 191 individuals with low serum AMA-M2. Conclusion It is not uncommon that serum AMA-M2 antibody is positive in healthy people, and early screening serum AMA-M2 antibody is helpful for early diagnosis of PBC.
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    Dynamic enhanced CT manifestation of liver metastases in patients with colorectal cancer
    Jiang Haitao, Zhang Yanmei, Fan Lu
    JOURNAL OF PRACTICAL HEPATOLOGY    2018, 21 (1): 125-126.   DOI: 10.3969/j.issn.1672-5069.2018.01.034
    Abstract502)      PDF(pc) (871KB)(765)      
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