Objective The aim of this experiment was to investigate the effect of cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)/stimulator of interferon gene (STING) pathway on ALF in vivo. Methods Thirty C57BL/6J mice were randomly assigned into control, model and intervention group, with 10 mice in each. Model was established by intraperitoneal injection of D-GalN/LPS, intervened by specific inhibitor C-176 and gene RNA was detected by qRT-PCR. Results Compared to in the model group, the C-176 intervention group exhibited a significant prolonged survival time (P<0.05); extensive hepatocellular necrosis and disordered architecture was found in the model group, whereas the liver tissue structure in the C-176 intervention group appeared more organized with reduced necrotic areas; immunohistochemistry and gene analysis demonstrated that the protein expression and mRNA levels of key components in the STING signaling pathway were significantly upregulated in the model group, but were notably downregulated in the C-176 intervention group; furthermore, IFN-Ⅰ, IL-1β, IL-6, TNF-α and F4/80, CD4, CD8, Gr1, NK1.1 and CD11c significantly decreased in the STING intervention group compared to the those in model group (P<0.05). Conclusion The STING pathway is involved in the inflammatory storm associated with ALF occurrence, and inhibition of this signaling pathway might alleviate immune-mediated liver injury in ALF.

Objective This experiment aimed to explore the potential mechanism by which Janagliflozin (JAGN) ameliorates liver steatosis in mice with high-fat diet-induced metabolic dysfunction-associated fatty liver disease (MAFLD) by inhibiting dipeptidyl peptidase-4(DPP4)/NOX1 mediated oxidative stress. Method 30 C57BL/6 mice were randomly divided into control, model and intervention group, with 10 mice in each. The model was established by high fat diet feeding, and intervention was completed by JAGN gavage. Hepatic homogenate malondialdehyde (MDA), glutathione (GSH) and superoxide dismutase (SOD) level was routinely detected. ROS level was determined by immunofluorescence, cell apoptosis was finished by TUNEL staining, DPP4 and nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1) mRNA an their protein expression were assayed by real time fluorescence quantitative PCR and Western blot. Results Liver steatosis was found in model mice, suggesting the model was successfully established, and in JAGN-intervened group, liver steatosis was obviously ameliorated; hepatic homogenate MDA level was (4.5±0.6)μmol/L, much higher than [(2.7±0.4)μmol/L, P<0.05] in the control, while it turned to (3.1±0.9)μmol/L in the intervention group, much lower than in the model (P<0.05), GSH and SOD levels in the model were (6.5±1.1)mg/g and (0.1±0.1)U/mg, both much lower than [(8.5±1.4)mg/g and (0.5±0.1)U/mg, respectively, P<0.05] in the control, while they turned to (9.7±2.1)mg/g and (0.3±0.1)U/mg in the JAGN-intervened group, much higher than in the model (P<0.05); hepatic ROS level in the model was much higher than in the control (P<0.05), while it decreased greatly in the intervention group (P<0.05); apoptosis was obvious in the model, and it alleviated in the intervention group; hepatic DPP4 activity in the model was higher than in the control (P<0.05), while it decreased greatly in the intervention group(P<0.05); hepatic DPP4 and NOX1 mRNA level and protein expression in the model were higher or stronger than in the control(P<0.05), while they became lower or weaker in the JAGN-intervened group (P<0.05). Conclusion Janagliflozin could alleviate liver steatosis in mice with MAFLD, which might be related to the inhibition of DPP4/NOX1 mediated oxidative stress.

Objective The aim of this experiment was to investigate effects of schizocapsa plantaginea hance (SSPH), a new anti-cancer natural product, on expressions of ferroptosis-related genes, e.g., glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11) and acyl-CoA synthase long-chain family member 4 (ACSL4) in HepG2 and Huh7 cells in vitro. Methods HepG2 and Huh7 cells were respectively divided into control (DMEM), low-dose (0.73 μM), medium-dose (1.46 μM) and high-dose (2.91 μM) SSPH-intervened groups. Cell proliferations were detected by MTT, supernatant Fe²⁺ concentration was determined by o-phenanthroline colorimetry, and reactive oxygen species (ROS) was assayed by fluorescence probe. GPX4, SLC7A11 and ACSL4 mRNA were detected by qRT-PCR and the corresponding protein expressions were detected by Western blot. Results HepG2 and Huh7 cell proliferation greatly in a dose-dependent manner inhibited in low-, medium- and high-dose SSPH-intervened groups as compared to in the control(P<0.05); supernatant ROS and Fe²⁺contents in SSPH-intervened HepG2 and Huh7 cells were significantly increased compared to in the control group (P<0.05);cell GPX4 and SLC7A11 mRNA relative levels in SSPH-intervened HepG2 and Huh7 cells decreased (P<0.05), while ACSL4 mRNA relative level increased greatly compared to in the control (P<0.05); cell GPX4 and SLC7A11 protein expression SSPH-intervened HepG2 and Huh7 cells weaken significantly(P<0.05), while ACSL4 protein expression intensified significantly compared to in the control group (P<0.05). Conclusion SSPH could exert anti-liver cancer effect by inducing ferroptosis in hepatoma cells, and the mechanism by which the intracellular ROS and Fe²⁺ were overloaded, might be related to regulation of ferroptosis-related genes, e.g., ACSL4, GPX4 and SLC7A11 expressions.

Objective The aim of this study was to investigate blocking hepatitis B virus (HBV) maternal-infant transmission by tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide fumarate (TAF) in hepatitis B viral carriers. Methods 99 pregnant women carrying HBV were enrolled in our hospital between January 2022 and January 2025, and were assigned to receive TAF (n=45) or receive TDF (n=44) at 28 weeks of gestation until delivery completed. 99 neonates were vaccinated with hepatitis B vaccine and hepatitis B immunoglobulin immediately after birth, and were followed-up for 12 months after delivery. Serum biochemical parameters and urinary β2-microglobulin (β2-MG) levels were detected routinely, and estimated glomerular filtration rate (eGFR) was calculated. Serum HBsAg level was detected by ELISA, and serum HBV DNA loads were detected by real-time fluorescence quantitative PCR. Multivariate binary Logistic regression analysis was applied to analyze the factors affecting blocking efficacy. Results By delivery, there were no significant differences as respect to serum ALT levels, HBV DNA loads and eGFR between the two groups (P>0.05), while urine β2-MG level in TDF group was (2.0±0.4)mg/L, much higher than [(0.4±0.1)mg/L, P<0.05] in TAF group; incidences of adverse outcomes related to pregnancy both in women or infants (13.3% vs. 15.9%) in the two groups were not significantly different (P>0.05); successful blocking in the two groups (95.6% vs. 93.2%) was also not significantly different (P>0.05); ages of pregnant women, baseline serum HBV DNA loads and percentage of formula feeding in 5 children with failed blocking were much older, greater or higher (P<0.05), while body mass of newborns at delivery was much lower than in 94 children with successful blocking(P<0.05); multivariate Logistic regression analysis showed that older pregnant women, higher baseline serum HBV DNA loads and lower body mass at birth were all the impacting factors for failed blocking(P<0.05). Conclusion Both TDF and TAF have a similar antiviral efficacy for blocking mother-to-child HBV transmission in pregnant women carrying HBV, and whether antiviral intervention should be started in advance needs clinical investigation.

Objective The aim of this study was to investigate wound healing efficacy of cross-linked hyaluronan gel in patients with chronic hepatitis B (CHB) and chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery. Methods A prospective,randomized controlled trial was conducted on 33 patients with CHB and bilateral CRS, with or without nasal polyps in Beijing You'an Hospital between January 2022 and October 2024, and all patients underwent bilateral endoscopic sinus surgery. For nasal packing after operation, patients were randomized to receive cross-linked hyaluronan gel along with degradable hemostatic sponge in one nasal cavity in observation group or to receivedegradable hemostatic sponge alone contralaterally in control. All patients were followed-up for 12 weeks postoperatively. Visual analogue scale (VAS) scores for symptoms, endoscopic sinus Lund-Kennedy scores and bleeding scores based on Boezaart criteria were recorded. Results Two patients were lost to follow-up in our series, left 31 patients ultimately completing routine follow-up; by week 1, 2, 4, 8 and 12, LKES scores in the observation group were (3.1±0.9), (2.5±1.0), ( 2.0±1.0), (1.6±1.0) and (0.9±0.8), all significantly lower than [(4.2±1.3), (3.7±1.2), (3.2±1.2), (2.5±0.9) and (1.5±0.9), respectively, P<0.05]in the control; by end of week 4, 8 and 12, incidences of local adhesion in the observation were 25.8%, 32.2% and 12.9%, all much lower than 48.4%, 58.1% and 29.0%(P<0.05) in the control group; by day 3, week 1, 2, 4 and 8 after operation, no statistically significant differences were found as respect to nasal bleeding scores(P>0.05)between the two groups. Conclusion We recommend the cross-linked hyaluronan gel for nasal packing in patients with CHB and CRS, which could promote rapid wound healing and reduce synechia after endoscopic sinus surgery.

Objective The purpose of this study was to evaluate the efficacy and safety of sofosbuvir-velpatasvir regimen in the treatment of patients with chronic hepatitis C (CHC). Methods 108 patients with CHC were encountered in our hospital between January 2019 and December 2024, and were randomly assigned to receive coblopasvir in 54 cases in control, or sofosbuvir-velpatasvir in another 54 cases in observation for three months. Serum PC-III, LN, Col-IV and HA levels were measured by radioimmunoassay, and serum monocyte chemoattractant protein-4 (MCP-4), cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), macrophage inflammatory protein-3α (MIP-3α) and tumor necrosis factor alpha-induced protein 8-like 2 (TIPE2) levels were assayed by commercially available kits. Results Rapid virological response, end-treatment virological response and sustained virological response rates in the observation were 72.2%, 100.0% and 98.2%, all much higher than 44.4%, 64.8% and 64.8%(P＜0.05) in the control; after treatment, serum PC-Ⅲ, Col-Ⅳ and HA levels were (80.7±14.2)μg/L, (64.5±26.5)μg/L and (56.1±22.9)mg/L, all much lower than [(107.4±11.8)μg/L, (87.5±16.3)μg/L and (89.7±14.7)mg/L, respectively, P<0.05]in the control; serum MCP-4, MIP-3α, CTLA-4 and IL-12 levels were (93.1±20.3)pg/mL, (3113.2±83.4)pg/mL, (1.0±0.4)ng/mL and (24.6±7.3)pg/mL, all significantly lower than [(125.9±23.4)pg/mL, (3945.8±96.6)pg/mL, (1.6±0.6)ng/mL and (41.4±11.6)pg/mL, respectively, P<0.05], while serum TIPE2 level was (0.9±0.2)μg/L, significantly higher than [(0.6±0.2)μg/L, P＜0.05]in the control group. Conclusion Sofosbuvir/velpatasvir regimen demonstrates a definite clinical efficacy in the treatment of patients with CHC, which might improve immune-inflammatory status.

Objective The aim of study was to investigate gender differences in the burden of non-alcoholic fatty liver disease (NAFLD among the BRICS countries, e.g., Brazil, Russia, India, China and South Africa, and to analyze the epidemiologic trends in disease burden from 1990 to 2023. Methods Data on the incidence and disability adjusted life years (DALYs) of NAFLD in the BRICS countries were extracted from the Global Burden of Disease Study 2023 (GBD 2023). Age-standardized rates were applied for cross-country comparisons, and long-term trends were analyzed by using linear mixed-effects models. Factors influencing gender differences were assessed with generalized linear models. Future burden was predicted by using Bayesian age-period-cohort model (BAPC). Results In 2023, the incidence of NAFLD in BRICS countries exhibited a progressive decline in the male-to-female ratio with elderly age, culminated in a gender reversal within specific age groups, notably, earliest onset of this reversal (30 to 34 year-old) in China, whereas in India demonstrated the most delayed occurrence (60 to 64 year-old); from 1990 to 2023, both the incidence and mortality rates associated with NAFLD across BRICS nations demonstrated a sustained upward trends, and the highest increase in NAFLD incidence [42.4% (95% CI: 42.1-43.3) and average annual percent change (AAPC)=1.16 in India, while the most obvious rise in mortality [431.5% (95% CI: 409.6-456.2) and AAPC=6.18] in Russia; disability-adjusted life year trends analysis and prediction based on the Bayesian age-period-cohort model from 1990 to 2023 revealed different trends among BRICS countries, e.g., a progressive decline in disease burdens in China and India, a continuous increase in Russia and South Africa, and a relatively stable disease burden in Brazil throughout the study period. Conclusion Prevalence of NAFLD in BRICS countries is common in middle-aged and young male adults and elderly female, with a significant differencewith countries, ages and gender.

Objective The aim of this study was to investigate evaluation of hepatic steatosis by ultrasound-derived fat fraction (UFF) in combination with remnant cholesterol/high-density lipoprotein cholesterol (RC/HDL-C) ratio in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods A total of 103 patients with MAFLD were admitted to our hospital between January 2022 and March 2025, and all underwent liver biopsy. UFF was detected by color Doppler ultrasound, and blood biochemical parameter were detected and RC/HDL-C ratio was calculated. Factors impacting severity of hepatic steatosis in MAFLD patients was analyzed by multivariate Logistic regression analysis, and diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curves. Results Of the 103 patients with MAFLD, liver histopathological examination found liver steatosis S1 in 41 cases, S2 in 38 cases and S3 in 24 cases; there was a significant difference as respect to body mass index among the three groups (P<0.05); UFF and RC/HDL-C ratio in patients with S3 liver steatosis were (36.6±5.7)% and (1.0±0.3), both significantly higher than [(24.8±4.1)% and (0.7±0.2), respectively, P＜0.05] in those with S2 or [(15.7±3.3)% and (0.5±0.1), respectively, P＜0.05] in those with S1; multivariate Logistic regression analysis showed that UFF(OR=2.694,95%CI:1.473-4.927) and RC/HDL-C ratio (OR=2.115,95%CI:1.415-3.161) were both independent impacting factors for ≥S2 liver steatosis; the AUC was 0.863, with sensitivity of 87.1% and specificity of 70.7%, when UFF in combination with RC/HDL-C ratio was set in predicting S2/S3 liver steatosis. Conclusion Diagnostic performance of combination of UFF and RC/HDL-C ratio is satisfactory in predicting severe liver steatosis in patients with MAFLD, which might help clinicians make further intervention steps.

Objective This study aimed to identify key genes associated with metabolic-associated steatohepatitis (MASH) and to investigate their functional pathways. Methods Liver tissues transcriptomic data and single-cell RNA sequencing (scRNA-seq) data from MASH and normal individuals were downloaded from the Gene Expression Omnibus (GEO) database. The Scissor algorithm was employed to identify cell subpopulations and genes most strongly correlated with the MASH phenotype. Functional enrichment analysis was performed on the associated genes, and key gene levels were further validated by using independent GEO datasets. Silicovirtual knockout experiments were conducted on pivotal genes to assess their potential downstream biological functional impacts. Results A strong correlation was demonstrated in macrophages and lymphocytes frum those with MASH, while certain hepatocytes and stellate cells also showed a positive associations; enrichment analysis of the differentially expressed genes revealed a characteristic cascade in MASH, e.g., the sustained activation of inflammation and stress-response pathways was accompanied by cellular metabolic reprogramming, evidenced by the activation of amino acid catabolism and organic acid synthesis pathways; this process subsequently led to abnormalities in lipid metabolism and transport pathways, collectively exacerbating hepatocellular dysfunction and abnormal lipid accumulation; validation analysis of significantly differentially expressed genes in external datasets identified HMGCS1 as a key gene involved in pathogenesis of MASH; virtual knockout of HMGCS1 demonstrated that the perturbed genes were significantly enriched in pathways related to lipid and cholesterol transport. Conclusion By integrating single-cell and bulk transcriptomic data, this study delineates key cellular subpopulations, pathogenic molecular mechanisms and critical genes associated with MASH occurrence, which might provide a potential targets for therapeutic intervention.

Objective The purpose of this study was to investigate impact of poorly-controlled blood glucose on oxidative stress and liver fibrosis in patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver diseases (NAFLD). Methods A total of 180 patients with T2DM and concomitant NAFLD were encountered in our hospital between January 2022 and December 2024, serum malondialdehyde (MDA), glutathione peroxidase (GSH-PX) were detected by ELISA, suproxide dismulate (SOD) levels was detected by automatic biochemical analyzer. serum glycated hemoglobin (HbA1c) level was routinely obtained and fibrosis index based on the 4 factors (FIB-4) was calculated. Patients were grouped as poorly (n=96)- and well (n=84)-controlled individuals based on HbA1c level, and as low-risk (n=64), medium-risk (n=80) and high-risk subgroup of liver fibrosis (n=36) based on FIB-4 levels. Multivariate linear regression was applied to reveal influencing factors for oxidative stress and liver fibrosis. Results Serum TC level in poorly-controlled blood glucose group was (2.5±0.3) mmol/L, much higher than [(2.1±0.3) mmol/L,P＜0.001], and serum TG level was (4.4±0.5) mmol/L, much higher than [(4.1±0.5) mmol/L,P＜0.001] in well-controlled blood glucose group; serum ALT level was (40.5±6.5) U/L, much higher than [(36.8±6.2) U/L,P＜0.001],and serum AST level was (46.4±7.5) U/L,much higher than [(42.2±6.8) U/L,P＜0.001] in well-controlled blood glucose group; serum MDA level was (25.1±5.1) μmol/L,much higher than [(20.6±4.6) μmol/L,P＜0.001],while serum GSH-PX and SOD levels were (54.4±6.0) ng/L and (53.2±7.6) U/mL,both significantly lower than [(60.9±8.3) ng/L and (69.5±10.2) U/mL,respectivley, P＜0.001] in well-controlled blood glucose group; multivariate linear regression analysis showed that serum AST, HbA1c, MDA, GSH-PX and SOD levels were all the independent impacting factors for liver fibrosis in patients with T2DM and NAFLD (P<0.05). Conclusion Poorly-controlled blood glucose in patients with T2DM and NAFLD might trigger body oxidative stress and lead to liver fibrosis progress.

Objective The purpose of this study was to investigate liver ultrasound attenuation coefficient (AC) and body mass index (BMI) in predicting metabolic dysfunction-associated steatohepatitis (MASH)in obese children. Methods 129 obese children and 67 healthy children were recruited in our hospital between January 2022 and December, and all underwent ultrasonography to detect liver AC, and Fibrotouch to detect controlled attenuation parameter (CAP). MASH was diagnosed by elevation of serum ALT and/or AST levels in children with metabolic dysfunction-associated liver fatty disease (MAFLD). Receiver operating characteristic (ROC) curve was drawn to evaluate predicting efficacy. Results Of the 129 children with MAFLD, MASH was found in 58 cases (45.0%), including mild, moderate and severe liver steatosis in 26 cases, 20 cases and 12 cases, and simple fatty liver (SFL) was found in 71 cases (55.0%); BMI and AC in children with MASH were (30.1±3.4)kg/m² and (0.9±0.2)db/cm/MHz, both significantly higher than [(26.5±2.9)kg/m² and (0.6±0.1)db/cm/MHz, respectively, P<0.05]in those with SFL or [(23.7±1.7)kg/m² and (0.4±0.1)db/cm/MHz, respectively P<0.05]in healthy control; BMI and AC in MASH and severe liver steatosis were (33.9±3.6)kg/m² and (1.3±0.4)db/cm/MHz, both much higher than [(30.4±3.4)kg/m² and (1.0±0.2)db/cm/MHz, respectively, P<0.05]in those with moderate liver steatosis or [(25.1±2.0)kg/m² and (0.6±0.1)db/cm/MHz, respectively, P<0.05] in those with mild liver steatosis; ROC analysis showed that the AUC was 0.940(95% CI:0.898-0.981), with sensitivity of 79.3% and specificity of 98.6%, when AC was combined with BMI in predicting MASH in children with MAFLD. Conclusion Ultrasound-detected AC in combination with BMI could help pediatricians make judgement of MASH in obese children preliminarily, which might provide clues for further managements.

Objective The aim of this study was to investigate diagnostic efficacy of quantitative ultrasound (QUS) technology in predicting hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods 117 patients with NAFLD were enrolled in our hospital between March 2024 and August 2025, and all received liver biopsies and QUS for attenuation coefficient at tissue attenuation imaging (AC-TAI) and scatter-distribution coefficient at tissue scatter-distribution imaging (SC-TSI). Receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic performance. Results Of the 117 patients with NAFLD, liver histo-pathological examination found mild hepatic steatosis in 48 cases, moderate hepatic steatosis in 40 cases and severe hepatic steatosis in 29 cases; serum triglyceride level in patients with severe hepatic steatosis was (2.1±0.9) mmol/L, significantly higher than [(1.8±0.7) mmol/L, P<0.05] in patients with moderate hepatic steatosis or [(1.6±0.6) mmol/L, P<0.05] in patients with mild hepatic steatosis, and body mass index was (28.9±3.3) kg/m² , significantly higher than [(27.3±3.5) kg/m², P<0.05] in patients with moderate or [(26.1±2.8) kg/m², P<0.05] in patients with mild hepatic steatosis; AC-TAI and SC-TSI in patients with severe hepatic steatosis were (1.1±0.2) dB/cm/MHz and (96.9±9.4), both significantly higher than in those with moderate hepatic steatosis [(0.9±0.2) dB/cm/MHz and (90.3±4.8), respectively, P<0.05] or [(0.8±0.1) dB/cm/MHz and (81.1±6.3), respectively, P<0.05] in those with mild hepatic steatosis; ROC curve analysis showed that the AUC was 0.908 (95% CI: 0.852-0.963), when AC-TAI combined with SC-TSI in predicting severe hepatic steatosis in NAFLD patients, with sensitivity much superior to any parameter did alone. Conclusion Application of AC-TAI and SC-TSI based on QUS technology have certain diagnostic efficacy on hepatic steatosis grading in patients with NAFLD, which might provide a reference for clinical evaluation.

Objective The aim of this study was to analyze factors that impact response to ursodeoxycholic acid (UDCA) therapy in patients with primary biliary cholangitis(PBC). Methods A total of 271 patients with PBC were encountered in First Affiliated Hospital, China Medical University, between January 2019 and December 2023, all underwent liver biopsies, finding liver tissue moderate to severe interface inflammation in 37 cases. Patients received UDCA therapy. Multivariate Logistic regression analysis was applied to reveal independent impacting factors for poor response by end of 1 year of treatment. Results By end of one-year UDCA treatment, complete response (CR) was obtained in 196 cases(72.3%) in our series; percentages of male, serum anti-gp210 positive and liver tissue moderate to severe interface inflammation in patients without CR were 24.0%, 18.7% and 28.0%, all significantly higher than 6.6%, 3.1% and 8.2%(P<0.05) in those with CR; serum ALP, GGT, IgG and γ-globulin levels were (297.6±3.5)U/L, (299.0±23.9)U/L,(16.2±1.5)g/L and (16.5±1.7)%, all much higher than [(50.5±5.8)U/L, (174.9±15.1)U/L, (12.4±1.1)g/L and (8.8±2.0)%,respectively, P<0.05] in those with CR; multivariate Logistic regression analysis showed that liver tissue moderate to severe interface inflammation, high level of serum ALP and serum anti-gp210 positive were all the independent impacting factors for poor response to UDCA therapy (P<0.05). Conclusion Patients with PBC could not response to UDCA treatment completely, especially in those who didn’t meet criteria of overlapping syndrome but with liver tissue moderate to severe interface inflammation, which should be surveyed early and give them appropriate management.

Objective This study aimed to investigate combination of ursodeoxycholic acid (UDCA) and GanShuang granules, a herbal medicine compound, in the treatment of patients with primary biliary cholangitis (PBC). Methods 91 patients with PBC were encountered in our hospital between April 2022 and April 2024, and were assigned to receive UDCA (n=45 in control) or UDCA and GanShuang granules combination treatment (n=46 in observation) for six months. Serum hyaluronic acid (HA), laminin (LN), procollagen type III (PCIII) and type IV collagen (IV-C) levels were detected by using fully automated immunoassay analyzer, and serum superoxide dismutase (SOD), nuclear factor erythroid 2-related factor 2 (Nrf2) and hemeoxygenase-1 (HO-1) levels were assayed by using ELISA. Results By end of six month-treatment, serum bilirubin, gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels in observation group were 21.6±3.8μmol/L, 182.8±9.7 U/L and 269.4±27.7 U/L, all significantly lower than [26.4±4.9μmol/L, 313.5±105.7 U/L and 312.0±33.3 U/L, respectively, P<0.05] in the control; serum HA, PCⅢ and IV-C levels were 46.4±6.6μg/L, 6.4±0.8 μg/L and 51.8±6.1 ng/mL, all significantly lower than [54.4±8.6μg/L, 8.9±1.1μg/L and 67.2±7.5 ng/mL, respectively, P<0.05] in the control; serum SOD, Nrf2 and HO-1 levels were 83.5±8.3 U/L, 713.3±82.3 U/L and 27.7±3.1 U/L, all significantly higher than [72.5±7.8 U/L, 664.7±75.3 U/L and 20.7±2.5 U/L, respectively, P<0.05] in the control group. Conclusion Combination of UDCA and Chinese herbal medicine in treatment of patients with PBC is efficacious, with improved liver function tests, which might be related to inhibition of liver fibrosis and induction of antioxidation activity.

Objective The aim of this study was to investigate the clinical implication of serum microRNA (miR)-148a, and interleukin (IL)-6, IL-17 and tumor necrosis factor-α (TNF-α) levels in patients with autoimmune hepatitis (AIH). Methods 61 patients with AIH, including mild degree in 28 cases and moderate-to-severe degree in 33 cases, were enrolled in our hospital between March 2022 and February 2025, and all received immunosuppressive therapy for six months. Serum immunoglobulin G (IgG) level was measured by immunoturbidimetry, serum miR-148a load was detected by real-time fluorescence quantitative PCR, and serum IL-6, IL-17 and TNF-α levels were detected by magnetic particle luminescence method. Multivariate binary Logistic regression was applied to analyze the factors affecting poor or non-complete response (NCR) to immunosuppressive therapy in patients with AIH. Results By the end of 6 months of treatment, serum ALT, AST and IgG levels in patients with moderate-to-severe degree were all much higher than in those with mild degree (P<0.05); serum miR-148a, IL-6, IL-17 and TNF-α levels in patients with moderate-to-severe degree were (2.3±0.4), (21.2±4.3)pg/mL, (16.0±3.3)pg/mL and (19.3±4.2)pg/mL, all significantly higher than [(1.9±0.3), (15.3±3.2)pg/mL, (13.5±2.7)pg/mL and (15.2±3.7)pg/mL, respectively, P<0.05] in those with mild degree; at end of 6 month treatment, 20 patients (71.4%) in mild group and 19 patients (57.6%) in moderate-to-severe degree obtained complete response (CR); serum miR-148a, IL-6, IL-17 and TNF-α levels in NCR patients in moderate-to-severe degree group were still much higher than in NCR patients in mild group (P<0.05); multivariate Logistic regression analysis showed that serum miR-148a(OR=1.439, 95%CI:1.160-1.785), IL-6(OR=1.701,95%CI:1.323-2.186), IL-17(OR=1.516,95%CI:1.191-1.929) and TNF-α(OR=1.640,95%CI:1.330-2.023) were all the independent risk factors for NCR in patients with AIH(P<0.05). Conclusion Serum miR-148a, IL-6, IL-17 and TNF-α are closely related to the disease severity in patients with AIH, which might impact response to immunosuppressive therapy, and needs further investigation.

Objective The aim of this study was to investigate clinical features of patients with drug-induced autoimmune hepatitis (DILI-AIH), autoimmune hepatitis (AIH) and drug-induced liver injury (DILI). Methods Clinical data from 18 patients with DILI-AIH, 25 patients with AIH and 32 patients with DILI were retrospectively collected between June 2023 and June 2025, and clinical materials, immunological manifestations, histopathological study and response to treatment were reviewed. Results Percentages of female and concomitant autoimmune diseases in patients with DILI-AIH and with AIH were much higher than in those with DILI(P<0.05);serum ALP total bilirubin levels in patients with DILI were 242.1(164.5,333.2)U/L and 86.3(45.7,140.2)μmol/L,both much higher than [165.3(120.4,230.6)U/L and 56.3(32.3,98.4)μmol/L,respectively, P<0.05] in those with DILI-AIH or [130.3(105.4,193.4)U/L and 48.2(25.2,80.4)μmol/L,respectively, P<0.05] in those AIH,while serum IgG level as well as serum ANA and SMA positive rates were much lower than in those with DILI-AIH or with AIH(P<0.05);incidences of liver tissue interface hepatitis and plasma cell infiltration in patients with DILI-AIH or with AIH were significantly higher than in those with DILI(P<0.05); all patients with DILI-AIH and with AHI received steroid therapy, but only a few with DILI did(P<0.05),and serum ALT level returning to normal took longer times than in those with DILI(P<0.05), with more steroid dependence or resistant to steroid in those DILI-AIH or with AIH (P<0.05). Conclusion DILI-AIH shares clinical, immunological, and histopathological features of both DILI and AIH, much similar to clinical manifestations and prognosis in patients with AIH. These findings suggest that DILI-AIH might represent an immune-mediated liver injury triggered by medicines. In individuals with a history of drug exposure accompanied with elevated serum IgG levels and positive autoantibodies, DILI-AIH should be considered. Early recognition and appropriate immunosuppressive therapy might improve long-term outcomes.

Objective The purpose of this study was to investigate efficacy of polyene phosphatidylcholine (PPC) and compound glycyrrhizin combination in the treatment of patients with anti-tuberculosis drug-induced liver injury (DILI). Methods 65 patients with anti-tuberculosis DILI were encountered in our hospital between January 2022 and June 2024, and were assigned to receive compound glycyrrhizin in 35 cases or receive PPC and compound glycyrrhizin simultaneously therapy. Serum malonaldehyde (MDA), superoxide dismutase (SOD) and reduced glutathione (GSH) levels were detected by RIA. Results By end of four to eight week treatment, serum bilirubin, ALT, AST and GGT levels in combination group were (16.8±4.4)μmol/L, 38.1(30.5,46.7)U/L, 36.6(28.1,44.2)U/L and 68.2(56.5,81.1)U/L, all much lower than [(19.6±5.0)μmol/L, 55.5(44.3,70.1)U/L, 50.2(40.4,63.3)U/L and 82.2(75.1,104.4)U/L, respectively, P<0.05] in the control; by end of eight week treatment, serum MDA level was (4.1±1.0)nmol/ml, significantly lower than [(5.6±1.2)nmol/ml,P<0.05], while serum SOD and GSH levels were (132.5±13.9)U/ml and (8.2±1.1)μmol/L, both significantly higher than [(115.8±12.7)U/ml and (6.7±1.1)μmol/L, respectively, P<0.05] in the control; serum ALT and AST level back to normal times were 3.2(2.4,4.0)w and 3.0(2.2,4.0)w,both much shorter than [4.8(3.5,6.2)w and 4.5(3.2,6.0)w,respectively, P<0.05] in the control group. Conclusion In the process of anti-tuberculosis treatment, early combined administration of polyene phosphatidylcholine and compound glycyrrhizin could improve liver function test normal and maintenance of anti-tuberculosis treatment, once DILI occurs.

Objective The aim of this study was to investigate the clinical efficacy of polyene phosphatidylcholine in combination with compound glycyrrhizin in the treatment of patients with drug-induced liver injury (DILI). Methods 122 patients with DILI were encountered in our hospital between January 2023 and December 2024, and were randomly assigned to receive intravenous polyene phosphatidylcholine in control (n=61), or receive intravenous polyene phosphatidylcholine and compound glycyrrhizin combination in observation (n=61) for two to six weeks. Serum superoxide dismutase (SOD) level was measured by radioimmunoassay, serum malondialdehyde (MDA) level was determined by biochemical colorimetry and serum glutathione peroxidase (GSH-Px) level was detected by velocity method. Serum interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) levels were measured by ELISA. Cost/efficacy was calculated by medicine cost/effectiveness. Results By end of average four-week treatment, serum ALT, AST and ALP levels in the observation group were (56.2±9.3)U/L, (46.3±9.8)U/L and (90.6±10.2)U/L, all much lower than [(69.1±10.7)U/L, (59.5±10.2)U/L and (109.3±11.3)U/L, respectively, P<0.05] in the control; serum SOD and GSH-Px levels were (95.1±10.4)U/mL and (119.7±13.1)μmol/L, both significantly higher than [(73.4±9.2)U/mL and (95.3±11.9)μmol/L, respectively, P<0.05], while serum MDA level was (2.7±0.6)μmol/L, significantly lower than [(3.8±0.7)μmol/L, P<0.05] in the control; serum IL-6, IL-1β and TNF-α levels were (7.2±1.6)pg/mL, (16.5±3.1)ng/mL and (7.5±1.8)pg/mL, all significantly lower than [(9.8±1.9)pg/mL, (22.4±4.0)ng/mL and (11.3±2.1)pg/mL, respectively, P<0.05] in the control group; medical cost in the observation group was higher than in the control, but the treatment effectiveness rate was 98.4%, much higher than 59.0%(P<0.05) in the control group. Conclusion Combination of polyene phosphatidylcholine and compound glycyrrhizin in dealing with patients with DILI could get a satisfactory effectiveness, which might be related to inhibition of oxidative stress and cytokine reactions.

Objective The aim of this study was to investigate evaluate the efficacy ofpolyene phosphatidylcholine and glycyrrhizin combination in the treatment of patients with chemotherapy-induced liver injury. Methods A total of 98 patients with naïve diagnosed breast cancer were encountered in our hospital between January 2022 and December 2024, all received surgical resection of tumors, and standardized anthracycline-based combination chemotherapy post-operationally for four circles. The patients with drug-induced liver injures (DILI) were managed with oral polyene phosphatidylcholine and glycyrrhizin combination for four to eight weeks. Results Of the 98 patients with breast cancer, DILI occurred in 57 cases (58.2%) during antitumor chemotherapy; baseline body mass index, percentages of concomitant hypertension, diabetes, and stage III/IV tumors in patients with DILI were (25.4±2.7)kg/m², 24.6%, 19.3% and 56.1%, all significantly greater or higher than [(23.5±2.3)kg/m², 7.3%, 4.9% and 29.3%, respectively, P<0.05] in those without DILI; of the 57 patients with DILI, we found hepatocellular type in 24 cases, cholestatic type in 22 cases and mixed type in 11 cases, with<grade 3 in 45 cases and ≥grade 3 in 12 cases; the recovery time in patients with ≥grade 3 liver injury was (47.5±8.0)d, much longer than [(22.6±4.5)d, P<0.05] in those with <grade 3; all but one, who died of liver failure, got their liver function tests back to normal. Conclusion Oral polyene phosphatidylcholine and glycyrrhizin combination in dealing with DILI in patients with breast cancer during chemotherapy has a satisfactory efficacy, which merits broaden clinical investigation.

Objective The aim of this study was to explore the evaluation of liver fibrosis by ultrasound elastography(UE) and serum liver fibrosis indexes in patients with schistosomiasis liver disease (SILD). Methods A total of 98 patients with SILD were admitted to our hospital between October 2022 and September 2025, and all underwent liver biopsies. Liver stiffness measurement (LSM) was detected by UE, and shear wave velocity (SWV) was obtained. Serum hyaluronic acid (HA), laminin (LN), IV collagen (IV-C) and III procollagen (PCIII) levels were assayed by ELISA. Diagnostic efficacy for severity of liver fibrosis was evaluated by receiver operating characteristic (ROC) curves. Results Of 98 patients with SILD, liver histopathological examination found significant liver fibrosis (SLF) in 62 cases (63.3%)and non-SLF (NSLF) in 36 cases (36.7%); LSM and SWV in SLF group were (12.2±3.7)kPa and (1.7±0.4)m/s, both much greater than [(6.9±1.1)kPa and (1.2±0.3)m/s, respectively P＜0.05] in NSLF group; serum HA and Ⅳ-C levels in SLF group were (287.3±92.8)ng/mL and (191.6±34.4)ng/mL,both much higher than [(144.7±18.4)ng/mL and (82.3±15.2)ng/mL,respectively, P＜0.05] in NSLF group; ROC analysis showed that AUC(0.962), sensitivity (95.2%) and specificity (86.1%) were all met request of clinical diagnosis for SLF. Conclusion The diagnostic efficacy of UE parameters in combination with serum liver fibrosis indexes is good for screening of liver fibrosis in patients with SILD, which warrants further clinical investigation.

Objective The purpose of this study was to investigate prediction of esophageal gastric varices (EV/GV) by abdominal CT scan parameters in patients with liver cirrhosis (LC) and portal hypertension. Methods 110 patients with LC and portal hypertension were encountered in our hospital between January 2021 and December 2025, and all patients underwent electronic gastroscopy. Abdominal CT scan was conducted to measure hepatic and splenic parenchyma iodine concentrations, and gastric coronary vein (GCV) diameter. Predicting efficacy was evaluated by receiver operating characteristic (ROC) curve. Results Of the 110 patients with LC, gastroscopy found mild EV in 61 cases, and moderate to severe EV/GV in 49 cases; iodine concentrations in left lobe, right lobe, caudate lobe of the liver, and splenic parenchyma as well as diameter of GCV in patients with moderate to severe EV/GV were (5.9±1.1)mg/ml, (5.6±0.7)mg/ml, (6.1±0.9)mg/ml, (20.4±1.5)mg/ml and (5.5±0.8)mm, all significantly higher or greater than [(5.1±0.7)mg/ml, (5.0±0.4)mg/ml, (5.5±0.5)mg/ml, (17.7±1.2)mg/ml and (3.6±0.5)mm, respectively, P＜0.05] in those with mild EV; the sensitivity, specificity and accuracy were 77.6%, 83.6% and 80.9%, when diameter of GCV≥4.7 mm, iodine concentrations in caudate lobe of liver≥5.8 mg/ml and splenic parenchyma≥19.2 mg/ml were set as the cut-off-value in predicting moderate to severe EV/GV. Conclusion Abdominal CT scan could help judge EV/GV existence in patients with LC.

Objective The aim of this study was to investigate efficacy of liver stiffness measurement (LSM) in combination with fibrosis-4 (FIB-4) index and serum chitinase-3-like protein 1 (CHI3L1) levels in predicting esophageal varices (EV) in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 123 patients with hepatitis B-induced liver cirrhosis were enrolled in this study between January 2023 and January 2025, and all patients underwent gastroscopy to record occurrence of EV. LSM was measured by Fibro Scan502, FIB-4 index was calculated based on clinical laboratory indexes, and serum CHI3L1 level was determined by ELISA. The receiver operating characteristic (ROC) curve was employed to evaluate the predictive efficacy. Results Gastroscopy found EV in 74 cases (60.2%), and no obvious EV in another 49 cases (39.8%) out of our 123 patients; LSM, FIB-4 index and serum CHI3L1 level in patients with EV were (16.7±3.8)kPa, (5.7±1.4) and (151.4±41.8)ng/ml, all much higher or greater than [(13.1±3.0)kPa, (4.5±1.0) and (122.5±20.2)ng/ml,respectively, P＜0.05] in those without EV; LSM, FIB-4 index and serum CHI3L1 level in 15 patients with severe EV were (19.5±3.9)kPa, (6.7±1.4) and (177.6±42.0)ng/ml,all much higher or greater than [(15.5±3.8)kPa, (5.1±1.5) and (141.4±41.7)ng/ml,respectively, P＜0.05] in 33 patients with mild EV or [(16.4±3.9)kPa, (5.7±1.3) and (148.9±42.0)ng/ml,respectively, P＜0.05] in 26 patients with moderate EV; ROC analysis showed that the AUC was 0.846(95%CI:0.770-0.905),with sensitivity and specificity of 68.9% and 83.7%, respectively, when LSM was combined with FIB-4 index and serum CHI3L1 level in predicting existence of EV in patients with LC. Conclusion The combination of LSM, FIB-4 index and serum CHI3L1 level exhibit a promising predictive efficacy for EV occurrence in patients with hepatitis B-induced LC, which warrants further clinical verification.

Objective This study aimed to investigate endoscopic varies ligation (EVL) and tissue glue plus lauromacrogol sandwich therapy in patients with hepatitis B-induced liver cirrhosis (LC) and esophagogastric variceal bleeding (EGVB). Methods 75 patients with hepatitis B-induced LC and complicated EGVB were emergently admitted to our hospital between September 2020 and September 2025, and were assigned to underwent EVL and endoscopic lauromacrogol sclerotherapy in 35 cases in control, or to underwent EVL and endoscopic tissue glue and lauromacrogol sandwich therapy in another 40 cases in observation group. Endoscopy was conducted one month later. Results Two(5.0%)in the observation and seven patients (20.0%)in the control group died, with successfulhemostasis of 95.0% in the former, much higher than 80.0%(P＜0.05) in the latter; there was no significant difference as respect to incidences of re-bleeding in the two groups (7.9% vs. 21.4%, P>0.05); after treatment, total serum bilirubin, albumin and hemoglobin levels in survivals in the observation group were(15.6±1.6)μmol/L, (33.5±2.9)g/L and (86.5±8.1)g/L,all not significantly different as compared to [(15.3±1.9)μmol/L, (33.8±3.1)g/L and (87.3±7.9)g/L, P＞0.05] in those in the control group. Conclusion EVL and tissue glue plus lauromacrogol sandwich therapy in patients with hepatitis B-induced LC and complicated EGVB is clinically efficacious, with satisfactory hemostasis and less re-bleeding.

Objective The aim of this study was to assess esophageal varices (EV) by spectral CT parameters in patients with hepatitis B-induced liver cirrhosis (LC). Methods 67 patients with hepatitis B-induced LC were encountered in our hospital between January 2024 and June 2025, and all patients underwent gastroscopy that found high risk EV in 34 cases and low-risk EV in 33 cases. Abdominal spectral CT scan was performed to record liver iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number (Zeff) and spectral curve slope (λHU), total liver volume (TLV), standardized liver volume (SLV), functional liver volume (FLV) and FLV/body surface area (BSA) (FLV/BSA) ratio was calculated. Multivariate Logistic regression analysis was applied to find impacting factors. Results Percentages of Child-Pugh class C and splenomegaly, MELD score, total serum bilirubin and INR in patients with high-risk EV were all significantly greater or higher than (P<0.05), while platelet count and serum albumin level were significantly lower than in those with low-risk EV (P<0.05); IC, NIC, Zeff and λHU were (1.4±0.3)mg/ml, (0.4±0.1), (7.3±0.2) and (1.4±0.4), all much smaller than [(1.6±0.3)mg/ml, (0.5±0.1), (7.7±0.2) and (1.6±0.4), respectively, P<0.05] in patients with low-risk EV; TLV, SLV, FLV and FLV/BSA ratio were (1086.2±205.6)ml, (664.8±103.5)ml/m², (958.3±183.4)ml and (585.3±94.1)ml/m², all much smaller than [(1243.6±221.4)ml, (731.6±110.8)ml/m², (1114.2±198.1)ml and (654.3±101.7)ml/m², respectively, P<0.05] in those with low-risk EV; multivariate Logistic regression analysis showed that Child-Pugh classification, PLT count, IC, NIC, Zeff and FLV were all the independent risk factors for high-risk EV occurrence (P<0.05); by end of one-year follow-up, EV bleeding (EVB) happened in 12 cases in our series, of which 11 patients (32.4%) in high-risk EV and 1 (3.0%, P<0.05) in those with low-risk EV. Conclusion Spectral CT quantitative parameters, including liver volume measurement, could help predict EV or even EVB risk in patients with LC, and an appropriate preventive measures should be given to improve the prognosis.

Objective This study aimed to analyze the disease burden of liver diseases in China from 1990 to 2021, with emphasis on prevalence, mortality, and disability-adjusted life years (DALYs), and to predict the disease burden for the period of 2022 to 2035 in order to provide an epidemiological basis for precise prevention and control. Methods By using search of global burden of disease study(GBD) 2021 database, the characteristics of liver diseases burden in China were analyzed, including age-standardized prevalence, mortality, and DALY rates. Furthermore, an age-period-cohort (APC) model was applied to explore the age, period, and cohort effects on liver diseases, and an Bayesian age-period-cohort (BAPC) model was employed to forecast the liver disease trends from 2022 to 2035. Results From 1990 to 2021, the age-standardized prevalence, mortality, and DALYs of acute hepatitis, including hepatitis A, B, Cand E) in China showed a downward trend; the overall prevalence, mortality, and DALYs of liver cancer series diseases slightly decreased, but liver cancer caused by hepatitis B, C, alcohol and non-alcoholic hepatitis presented a trend of decreased mortality and DALYs with increased prevalence; the mortality and DALYs of non-alcoholic hepatitis, including cirrhosis, demonstrated a downward trend, while the prevalence was in upward trend;age effect analysis indicated that the DALY rates and mortality of liver diseases decreased with age, especially significant in the elderly population, the prevalence firstly decreased, andincreased with age thereafter; period and cohort effect analysis showed that the relative risk (RR) of prevalence fluctuated and increased over time, while the RR of mortality and DALY rates decreased over time; model projections from 2022 to 2035 indicated that age-standardised prevalence of liver diseases would continue to climb to an estimated 22 725.4 per 100 000, with an increase of 3.4% compared with 2021, while age-standardised mortality and DALY rates are expected to fall further to 14.5 and 436.8 per 100 000, representing a declines of 10.6 % and 8.0 %, respectively. Conclusion The standardized prevalence of liver diseases in China generally shows an upward trend, while the standardized mortality and standardized DALY rates show an overall downward trend, influenced by a combination of age, period and cohort factors. Prevention and control strategies should enhance the coverage of vaccination and screening measures to address the challenges brought by the increasing prevalence in the future.

Objective This aimed to investigate clinical effectiveness of transhepatic arterial chemoembolization (TACE) in combination with targeted and immunotherapy plus Huai’er granule, an herbal compound, in the treatment of patients with unresectable primary liver cancer (PLC ). Methods 78 patients with unresectable PLC were admitted to our hospital between June 2022 and June 2024, and were divided into control (n=38) and observation (n=40) groups. All patients in the two groups received TACE in combination with targeted and immunotherapy, and those in the observation group received additionally Huai’er granules for six circles. All patients were followed-up until September 2025, and objective response rate (ORR) and disease control rate (DCR) were recorded. Serum des-γ-carboxy prothrombin (DCP), α-L-fucosidase (AFU) and alpha-fetoprotein (AFP) levels were routinely detected. Results ORR in the observation group was 45.0%, much higher than 21.1%(P＜0.05)in the control, while there was no significant difference as respect to DCR(80.0% vs. 60.5%) between the two groups (P>0.05); after treatment, serum DCP, AFU and AFP levels in the observation group were (95.3±23.4)mAU/mL, (67.9±20.9)U/L and (231.8±78.9)ng/mL, all much lower than [(121.5±25.7)mAU/mL, (111.5±18.2)U/L and (368.5±85.7)ng/mL, respectively, P＜0.05] in the control; β2-MG level was (0.6±0.1)mg/L, much lower than [(0.9±0.1)mg/L,P＜0.05], while eGFR was (108.8±11.9)mL/min /1.73m²,much higher than [(90.9±11.3)mL/min /1.73m²,P＜0.05] in the control; by end of follow-up, survival rate was 62.5%,much higher than 39.5%(x²=4.136,P=0.042)in the control; OS was (10.4±0.3)mon, and PFS was (9.5±0.5)mon, both much longer than [(8.3±0.5)mon and (7.6±0.6)mon, respectively, Log-Rank x²=6.970,P=0.008; x²=5.651,P=0.017] in the control. Conclusion Oral Huai’er granule at base of TACE and targeted and immunotherapy in dealing with unresectable PLC might protect hepatic and renal functions, and the clinical survival benefits needs further observation.

Objective The aim of this study was to explore clinical benefits of drug-loaded microsphere transcatheter arterial chemoembolization (D-TACE) in treatment of patients with primary liver cancer(PLC). Methods 84 patients with PLC were encountered in our hospital between January 2022 and January 2024, and were randomly assigned to underwent D-TACE in 42 cases in observation or underwent conventional TACE in another 42 cases in control. Clinical efficacy was evaluated by mRECIST criteria three months after operation, and objective remission rate (ORR) and disease control rate (DCR) were recorded. All patients were followed-up for one year, and progression-free survival (PFS) and overall survival (OS) were compared. Results There were no significant differences as respect to ORR(54.8% vs. 50.0%) or DCR (97.6% vs. 90.5) between the two groups (P>0.05); by end of one-month after treatment, serum ALT level in the observation was (46.5±8.2)U/L, much lower than [(68.9±11.4)U/L, P＜0.05] in the control, while there were no significant differences as respect to serum bilirubin and AFP levels between the two groups (P＞0.05); one-year survival rate in the observation was 69.1%, not significant different compared to 59.5% in the control (x²=0.830, P=0.362); either PFS (10.9±0.3) mon, or OS(11.1±0.3)mon, both not significant different as compared to (9.9±0.4) mon(Log-Rank x²=3.287, P=0.070) or (10.0±0.4) mon (Log-Rank x²=3.397, P=0.065) in the control group. Conclusion D-TACE could decrease liver injury in treatment of patients with PLC, and the clinical benefits needs long-term observation.

Objective The aim of this study was to investigate magnetic resonance imaging (MRI) features impacting recurrence of tumor in patients with hepatocellular carcinoma (HCC) after hepatectomy. Methods 58 patients with HCC were encountered in our hospital between June 2022 and June 2025, and all underwent hepatectomy after gadoxetic acid disodium-enhanced MRI scan. Patients were followed-up until February 2026. Relative intensity ratio (RIR) was calculate based on MRI. Cytokeratin 19 (CK19) expression was detected by immunochemical staining. Multivariate Logistic regression analysis was applied to find impacting factors for tumor recurrence. Results By end of follow-up, intrahepatic tumor recurrence was found in 23 cases (39.7%) in our series; baseline serum protein induced by vitamin K absence or antagonist-II (PIVKA-II), alpha fetoprotein levels, diameters of tumors, poor histological differentiation, CK19 positive rate and percentage of T2N0M0 in tumor recurrence group were significantly higher or greater than in non-recurrence group (P＜0.05); RIR at hepatobiliary phase was (0.5±0.2), much lower than [(0.7±0.1),P<0.05] in non-recurrence group; multivariate Logistic regression analysis showed that serum PIVKA-II, poor differentiation, TNM staging, mosaic pattern and peritumoral hypointensity at hepatobiliary phase were all the independent risk factors, while RIR at hepatobiliary phase was the independent protective factor(P＜0.05) for tumor recurrence. Conclusion Gadoxetic acid disodium-enhanced MRI features in combination with clinical materials could help predict tumor recurrence in patients with HCC after hepatectomy, which might guide individualized surveillance strategies.

Objective The aim of this study was to investigate computed tomography (CT) spectral imaging features of lymph node metastasis in patients with primary liver cancer (PLC). Methods 118 consecutive patients with PLC were encountered in our hospital between January 2023 and June 2025, and all received CT spectral imaging to record iodine concentration (IC), normalized iodine concentration (NIC) and slope of spectral curve (λHU) of interested lymph nodes. All patients underwent radical resection of intrahepatic tumors and adjacent enlarged lymph nodes. Results Of the 118 patients with PLC, histopathological examination found lymph node metastasis in 31 cases(26.3%),and without lymph node metastasis in 87 cases (73.7%); tumor diameter in lymph node metastasis group was(5.9±1.5)cm, significantly greater than [(5.1±1.2)cm, P<0.05],and percentage of tumor stage Ⅲ/Ⅳ was 61.3%,significantly higher than 36.8%(P<0.05) in those without lymph node metastasis group; IC, NIC and λHU at arterial phase in lymph node metastasis group were (12.9±3.1)×100 μg/cm³,(0.3±0.1)×100 μg/cm³ and (1.5±0.2),all significantly lower than [(19.3±3.8)×100 μg/cm³, (0.5±0.1)×100 μg/cm³ and (1.9±0.4),respectively, all P<0.05] in those without metastasis. Conclusion CT spectral imaging could effectively identify lymph node metastasis in time in patients with PLC, which might help determine clinical tumor stages and put forward management strategy.

Objective The aim of this study was to explore the application of contrast-enhanced ultrasound (CEUS) in the diagnosis and treatment of patients with early bacterial liver abscess (BLA). Methods A total of 113 patients with suspected liver abscess were admitted to our hospital between May 2022 and December 2024, and all underwent routine ultrasonography and CEUS examinations. The abscess tying was performed based on CEUS enhancement model as type I, e.g., liquefaction, and type II, e.g., consolidation. The surveillance of abscess changes by CEUS was also performed. Results Of the 113 patients with suspected intrahepatic occupying lesions, comprehensive clinical materials confirmed BLA in 98 cases (86.7%), hepatocellular carcinoma in 7 cases, liver metastases in 5 cases and hepatic hemangioma in 3 cases; of the 98 patients with early BLA, CEUS found type I in 82 cases (83.7%), and type II in 16 cases (16.3%); all patients with type I recovered (100.0% effective) after puncture drainage and intravenous antibiotics tretament, and patients with type II patients responded well in 14 cases (87.5%), and abscess liquefied 1 week after in 2 cases, switched to puncture drainage and recovered; as for surveillance of therapeutic efficacy, CEUS showed a satisfactory priority, as it found effective earlier than clinical manifestations and/OR laboratory indexes. 3 days after treatment, there were 76 cases (77.6%) with reduction of abscess, while only 42 cases (42.9%) and 38 cases (38.8%) presented with normal body temperature and white blood cell count normal, at that time. Conclusion CEUS could help diagnose BLA early, and it also could help clinicians monitor the therapeutic process, and the clinical application needs further verification.

Objective The aim of this study was to summarize multimodal ultrasound features of inflammatory pseudotumor of liver (IPT). Methods The clinical and multimodal ultrasound, e.g., two-dimensional ultrasound, color Doppler, ultrasound elastography, and contrast-enhanced ultrasound CEUS) data were collected from 40 patients with pathologically confirmed IPT in our hospital between August 2023 and August 2025. The multimodal ultrasound features were summarized. Results Two-dimensional ultrasonography showed that the maximum diameter in the 40 patients with IPT was (4.2±2.3) cm, main located in right lobe(77.5%), irregular shape (67.5%), hypoecho (80.0%), blurred boundary (62.5%) and uneven internal echo (77.5%), liquefactive necrosis in 14 cases(35.0%), color Doppler ultrasonography showed blood flow signals in 12 cases (30.0%) ; ultrasound elastography showed that average elasticity score of lesions in 40 patients with IPT was (1.95±0.85) points, with low to medium stiffness; CEUS demonstrated that enhancement initiation time, time to peak and clearance time were (15.2±1.3) s, (23.5±2.1) s and (36.6±4.3) s, respectively; percentage of even enhancement patterns at arterial phase was 27.5%, uneven was (25.0%) and ring-like enhancement was (25.0%); hyper-enhancement was 57.5%, blurred boundary after enhancement was 80.0%, hypoecho at portal/delayed phase was 70.0%, and fast in and fast out was 72.5%. Conclusion IPT has multimodal ultrasonographic features, which might help clinicians make up surgery plan preoperatively.

Objective The aim of this study was to summarize imaging features of hepatocellular adenoma (HCA). Methods The clinical materials of 39 patients with HCA encountered in our hospital between May 2020 and March 2024 were reviewed. All patients underwent CT and MR scan. Histo-pathological typing was performed by immunohistochemistry and genotype sequencing. Results Of 39 patients with HCA in our series, inflammatory HCA (I-HCA), β-catenin-activated HCA (B-HCA), hepatocyte nuclear factor 1α-inactivated HCA (H-HCA) and unclassifled HCA (U-HCA) were found in 18 cases, 10 cases, 6 cases and 5 cases, respectively; percentage of low enhancement at delayed phase in I-HCA lesions was 55.6%, much higher than 10.0%(P<0.05) in H-HCA or 0.0%(P<0.05)in H-HCA or 0.0%(P<0.05)in U-HCA lesions; percentage of subcapsular enhancement in B-HCA lesions was 100.0%(P<0.05), much higher than 38.9%(P<0.05) in I-HCA or 10.0%(P<0.05)in H-HCA or 20.0%(P<0.05)in U-HCA; percentage of high signal at MR T1WI sequence in I-HCA was 72.2%, much higher than 10.0%(P<0.05) in H-HCA or 16.7%(P<0.05) in B-HCA or 0.0%(P<0.05)in U-HCA lesions; low signal intensity at T2WI sequence in H-HCA was more common, with a slight enhancement, gradually decreased, significantly different from other HCA types(P<0.05). Conclusion I-HCA is more common clinically, with a slight different imaging feature in different HCA types, which needs further summarization.

Objective This study aimed to investigate risk factors for postoperative stone recurrence after laparoscopic gallbladder-preserving cholecystolithotomy in patients with gallstones. Methods A total of 244 consecutive patients with gallstones were encountered in our hospital between January 2022 and December 2024, and all patients underwent before operation color Doppler ultrasonography to record peak systolic veIocity (PSV), end diastolic velocity (EDV) and mean flow velocity (Vm) of gallbladder artery. All patients underwent laparoscopic cholecystolithotomy, and were followed-up for one year. Multivariate Logistic regression analysis was applied to identify independent risk factors for postoperative stone recurrence. Results The stone recurrence rate was 11.9% (29/244) in our series by end of one-year follow-up after surgery; the gallbladder wall thickness, proportion of stone impaction and EDV level in the stone recurrence group were(2.8±0.4)mm, 13.8% and (10.9±2.2)cm/s, all significantly greater than [(2.4±0.2)mm, 3.7% and (9.2±1.4)cm/s, respectively, P＜0.05] in non-recurrence group; multivariate Logistic regression analysis showed that thicken gallbladder wall (OR=14.534,P<0.05), impacted stone (OR=4.656,P<0.05) and increased EDV level(OR=1.329,P<0.05) were all the independent risk factors for stone recurrence. Conclusion Gallstone might recur after laparoscopic cholecystolithotomy in patients with gallbladder stones, and color Doppler ultrasound could be the best postoperative follow-up strategies to find it early.

Objective The aim of this study was to investigate transumbilical single-port laparoscopic cholecystectomy (LC) in treatment of patients with gallbladder stones. Methods 94 patients with gallbladder stones were encountered in our hospital between April 2023 and September 2025, and were randomly assigned to receive conventional three-port LC in 47 cases in control, or receive transumbilical single-port LC in another 47 cases in observation group. Visual analog scale (VAS) scores and scar condition were evaluated routinely. Serum C-reactive protein (CRP) level was detected. Results Medical cost in the observation group was (8.0±1.0) thousand yuan, much lower than [(9.0±2.0) thousand yuan, P＜0.05]; by 6 h, 24 h and 72 h after operation, VAS scores in the observation were (1.7±0.5), (1.8±0.6) and (1.6±0.5), all much lower than [(2.2±0.6), (2.9±0.8) and (2.5±0.7), respectively, P＜0.05] in the control; bowel sound recovery, first flatus, eating and defecation in the observation group were(11.7±2.6)h, (13.5±3.5)h, (25.8±6.1)h and (31.1±5.3)h, all much shorter than [(15.2±3.4)h, (16.6±4.1)h, (30.1±6.5)h and (46.2±6.4)h, respectively, P＜0.05] in the control; by 72 h after operation, serum CRP level was (20.1±6.2)mg/L, significantly lower than [(26.7±5.4)mg/L, P＜0.05] in the control; by end of one month, scar color, thickness and softness scores were (0.4±0.1), (0.3±0.1) and (1.1±0.3), all much lower than [(0.8±0.2), (0.7±0.2) and (1.8±0.5), respectively, P＜0.05] in the control group. Conclusion Transumbilical single-port LC has undoubtedly its own superiority, but the surgical process might be more sophisticated.

Objective The aim of this study was to investigate diagnostic performance of endoscopic ultrasonography (EUS) in comparison with abdominal ultrasonography (US), computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) in detecting sludge-like stones in the common bile duct. Methods 67 patients with sludge-like stones and 70 patients with formed stones were encountered in our hospital between August 2022 and June 2025, and all underwent EUS, US, CT and MRCP, and endoscopic retrograde cholangiopancreatography (ERCP) or surgical removal of stones. Results Of 67 patients with sludge-like common bile duct stones proven by EUS, stones presented as diffuse punctate hyperechoic spots in 59 cases (88.1%), blurred bile duct walls or focal thickened in 52 cases (77.6%), stratified deposition in 46 cases (68.7%), faint tapering shadow in 41 cases (61.2%) and flocculent floating echoes in 38 cases (56.7%); the AUCs were 0.92, 0.95, 0.97 and 0.99 by US, CT, MRCP and EUS in detecting formed stones, while they were 0.73, 0.78, 0.83 and 0.98 in detecting sludge-like stones,suggesting EUS detection much superior to conventional imaging; of the 67 patients with sludge-like stones proven by EUS, misdiagnosis by US, CT, MRCP occurred in 49 cases (73.1%), and of which, either US, CT or MRCP didn’t find it in 5 cases (7.5%); reasons of missed diagnosis included diameter of stone less than 3 mm, scattered deposition or lack of typical echo, etc. Conclusion EUS holds significant diagnostic value for sludge-like stones in the common bile ducts, particularly when conventional imaging results are negative or atypical. Future studies should further validate the specific signs of sludge-like stones on EUS and explore its role in monitoring and treatment strategy selection, which might provide a more robust evidence for the precise diagnosis and management of biliary diseases.

Objective The aim of this study was to investigate endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) in combination with laparoscopic cholecystectomy (LC) in treatment of patients with common bile duct stones (CBDS) and acute cholangitis (AC). Methods A total of 118 patients with CBDS and AC were encountered in our hospital between January 2023 and May 2025, and of them, 67 patients in the observation group underwent ERCP/EST and LC, and another 51 patients in the control group received laparoscopic common bile duct exploration (LCBDE) and LC. All patients were followed-up for three months. Results Intraoperative blood loss and postoperative exhaust time in the observation group were (52.3±3.5)mL and (32.6±2.1)h, both significantly less or shorter than [(58.7±4.9)mL and (35.3±2.6)h, respectively, P＜0.05],while total operation time, hospital stay and medical cost were (2.9±0.6)h, (10.7±1.6)d and (22.0±4.0)thousand yuan, all significantly longer or much more than [(2.1±0.4)h, (6.6±1.2)d and (18.0±3.0)thousand yuan,respectively, P＜0.05] in the control;by day five after operation, serum ALT, AST and GGT levels in the observation group were (46.5±5.1)U/L, (41.2±5.0)U/L and (92.8±8.6)U/L, all much lower than [(58.6±6.7)U/L, (55.2±6.2)U/L and (115.4±10.5)U/L,respectively, P＜0.05] in the control;post-operationally, incidence of complications in the observation group was 10.5%, not significantly different compared to 11.8% in the control (P＞0.05);there was no significant difference as respect to stone clearance rate between the two groups (97.0% vs. 96.1%, P>0.05). Conclusion Both ERCP/EST combined with LC or LCBDE and LC could be performed in dealing with patients with CBDS and AC, and the choice might depend on surgeons skills and patients’ conditions.

Objective The aim of this study was to investigate simultaneous three endoscopic (e.g., laparoscope, choledochoscope and duodenoscope) operation in combination with balloon nasobiliary drainage in treatment of patients with gallbladder stones and common bile duct stones. Methods 92 patients with gallbladder stones and common bile duct stones were encountered in our hospital between June 2020 and December 2024, of them, 46 patients in control group received laparoscopic cholecystectomy (LC) and laparoscopic choledocholithotomy with T-tube drainage, and another 46 patients in observation group received simultaneous three endoscopic operations and balloon nasobiliary drainage treatment. Serum C-reactive protein, interleukin-6 and tumor necrosis factor-α levels were detected by ELISA. Results Operation time in the observation group was (78.5±12.3)min,much longer than [(65.2±10.1)min,P<0.05], while postoperative first exhaust time was(18.5±3.2)h,much shorter than [(24.3±4.1)h,P<0.05] in the control group,and stone clearance rates in the two groups were 97.8% vs. 95.7%,not significantly different (P>0.05);pre- or post-operationally, serum liver function tests and cytokine levels didn’t significantly be different between the two groups(P>0.05);post-operationally, incidences of adverse effects, such as bile leakage, bleeding, infection and pancreatitis were not significantly different between the two groups(6.5% vs. 6.5%, P>0.05). Conclusion Simultaneous three endoscopic operations and balloon nasobiliary drainage could optimize surgery protocol, which might improve quality of life in patients with gallbladder stones and common bile duct stones and is worthy of further clinical verification.

Objective The aim of this study was to investigate anesthetic efficacy of remimazolam and ciprofol combination in patients with intrahepatic bile duct stones (IHBDS) undergoing laparoscopic partial hepatectomy (LPH). Methods 119 patients with IHBDS were encountered in our hospital between December 2023 and June 2025, and all underwent LPH for resection of intrahepatic tumors. Patients were randomly divided into two groups, receiving ciprofol (group C, n=60) or remimazolam and ciprofol combination (group RC, n=59) intravenous anesthesia. Serum cortisol (Cor), adrenocorticotropic hormone (ACTH) and norepinephrine (NE) levels were measured by ELISA, and peripheral blood CD3⁺, CD4⁺ and CD8⁺ cell percentages were detected by flow cytometry, and CD4⁺/CD8⁺ cell ratio was calculated. The cognitive function was evaluated by mini-mental state examination (MMSE). Results By end of three days after operation, serum Cor, ACTH and NE levels in group RC were (240.9±42.6)mmol/L, (19.3±3.9)pmol/L and (2.8±0.6)pg/mL, all significantly lower than [(288.2±55.7) mmol/L, (24.4±5.3) pmol/L and (3.4±0.7)pg/mL, respectively, P<0.05] in group C; MMSE score in group RC was (28.6±1.9), not significantly different as compared to [(28.0±1.6), P>0.05] in group C; percentages of peripheral blood CD3⁺, CD4⁺ and CD8⁺ cells, and CD4⁺/CD8⁺ cell ratio in group RC were (68.2±8.7)%, (42.0±8.3)%, (23.7±5.9)%, and (1.9±0.7), all not significantly different compared to [(66.9±9.1)%,(40.4±7.8)%,(24.3±6.1)%, and (1.8±0.7), P>0.05] in group C; incidence of hypotension during operation in group RC was 8.5%,much lower than 21.7%(P<0.05) in group C,while there was no significant difference as respect to total incidence of complications (22.0% vs. 36.7%)between the two groups(P>0.05). Conclusion Application of remimazolam in combination with ciprofol anesthesia could effectively inhibit body stress reactions in patients with undergoing LPH, which don’t impact postoperative cognitive functions.

Objective This study was to investigate choledochoscope stone removal (CSR) during laparoscopic left hepatectomy (LLH) in dealing with patients with sophisticated intrahepatic bile duct stones (sIHBDS). Methods 100 patients with sIHBDS were encountered in our hospital between April 2022 and December 2023, and were randomly assigned to underwent LLH in control (n=50) or underwent CSR during LLH in observation (n=50). Serum C-reactive protein (CRP level was detected by ELISA, serum cortisol (COR) and epinephrine (EP) levels were measured by using chemiluminescence immunoassay, and peripheral blood lymphocyte subsets and natural killer cells were determined by FCA. Results Intrahepatic stone clearance rate in the observation group was 92.0%, much higher than 76.0%(P＜0.05)in the control as confirmed by US two months after surgery; by end of seven days after operation, white blood cell count, percentage of neutrophils andserum CRP level in the observation group were (6.6±1.1)×10⁹/L, (73.1±6.3)% and (13.2±2.2)mg/L, all much lower than [(7.7±1.1)×10⁹/L, (77.9±6.9)% and (18.0±2.1)mg/L, respectively, P<0.05] in the control; there were no significantly differences as respect to serum COR and EP levels between the two groups (P＞0.05); serum bilirubin, ALT and AST levels were (20.4±6.0)μmol/L, (73.9±20.2)U/L and (50.2±9.8)U/L, all much lower than [(27.0±8.1)μmol/L, (94.0±23.4)U/L and (51.3±10.9)U/L, respectively, P<0.05] in the control; percentages of peripheral blood CD3⁺, CD4⁺ and NK cells were (68.4±6.5)%, (41.1±5.0)% and (18.7±2.2)%, all significantly higher than [(62.1±6.0)%, (37.2±4.2)% and (15.5±2.1)%, P<0.05], while percentage of CD8⁺ cells was(20.3±3.2)%, significantly lower than [(24.0±3.1)%, P<0.05] in the control group. Conclusion Choledochoscopy-assisted LLH in patients with sIHBDS could improve stone removal, promote liver function test recovery and enhances immune functions, and the long-term efficacy needs further clinical observation.