Acute-on-chronic liver failure (ACLF) is one of the leading causes of mortality among patients with chronic liver disease. Potentially reversible, ACLF requires precise clinical classification to facilitate accurate diagnosis, targeted treatment, and comprehensive management. Based on the latest research findings and clinical evidence, the Severe Liver Disease and Artificial Liver Group and the Nutrition and Regeneration in End-Stage Liver Disease Group, Chinese Society of Hepatology, Chinese Medical Association, together with multidisciplinary experts, have jointly compiled China's first guideline for the diagnosis and treatment of ACLF. The guideline aims to provide guidance for the diagnosis, treatment, and individualized management of patients with ACLF in clinical practice.

Objective This study aimed to assess disease burden of nonalcoholic fatty liver disease (NAFLD) in China from 1990 to 2021 and to predict its trends from 2020 to 2040. Methods This study retrieved database from the Global Burden of Disease (GBD) and Excel software was applied toillustrate the incidence, mortality, prevalence and disability-adjusted life years (DALYS) burden of NAFLD during 1990 to 2021 period. R software was used to predict burden trends of the disease, and a Bayesian age-period-cohort model (BAPC) was constructed to predict the incidence of the disease between 2020 and 2040. Results From 1990 to 2021, the overall burden of NAFLD demonstrated a rising trend, the standardized prevalence rate increased by 22.0% (AAPC = 0.6%, P< 0.01), and the standardized incidence rate increased by 18.3% (AAPC = 0.7%, P< 0.01);the BAPC model predicted that the disease burden of NAFLD would continue to rise over the next 20 years; by 2040, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) were expected to reach 780.0, 17706.9, 11306.1, and 8.2 per 100,000, respectively, representing increases of 25.6%, 13.5%, 78.9%, and 7.8%, respectivley compared to in 2021. Conclusion The disease burden of NAFLD in Chinese population increasesgreatly from 1990 to 2021, with younger men being at higher risk. Tailored prevention and treatment strategies should be developed based on the current disease burden characteristics to effectively reduce the negative impact on human health.

Objective This study aimed to investigate and summarize magnetic resonance imaging (MRI) feature in patients with primary liver cancer (PLC) and radiation-induced liver injury RILI) after three-dimensional conformal radiotherapy (3D-CRT). Methods A total of 92 patients with PLC were encountered in our hospital between January 2023 and September 2025, and all received 3D-CRT therapy and underwent gadopentetate dimeglumine (Gd-DTPA)-enhanced MRI scan. MRI signal, dynamic contrast-enhancement patterns, distribution morphology, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values were recorded. Results By end of radiotherapy, RILI occurred in 22 cases (23.9%); tumor volume, doses of radiation, target volume and mean hepatic doses of radiation in patients with RILI were all greater than in those without RILI(P<0.05); percentages of hypointensity on T1-weighted imaging, hyperintensity on T2-weighted imaging, abnormal enhancement at arterial phase, decreased enhancement at portal venous phase and persistent hypointensity at delayed phase in lesions in patients with RILI were 77.3%, 86.4%, 81.8%, 72.7% and 68.2%, all significantly greater than 27.1%, 30.0%, 20.0%, 25.7% and 17.1%(P<0.05) in those without RILI; percentages of wedge-shaped distribution, insistency of enhanced area with radiotherapy dose distribution, distributed along hepatic segments or vascular courses and hyperintensity on DWI in patients with RILI were 86.4%, 90.9%, 68.2% and 81.8%, all much greater than 15.7%, 12.9%, 14.3% and 28.6%(P<0.05) in those without RILI; ADC value in patients with RILI was (1.5±0.2)×10^-3mm²/s, much greater than [(1.2±0.2)×10^-3mm²/s, P<0.05] in those without RILI. Conclusion Patients with PLC and RILI could have special MRI features, which might help clinicians make diagnosis and managements.

Objective The aim of this study was to investigate clinical efficacy of tenofovir amibufenamide (TMF) and tenofovir alafenamide fumarate (TAF) in rescue treatment of entecavir (ETV)-treated patients with chronic hepatitis B(CHB) and low-level viremia (LLV). Methods 68 patients with CHB were enrolled in our hospital between January 2022 and January 2024, the enrolled patients were all ETV-treated for at least 12 months, showing poor virological response with LLV and were randomly assigned to receive TMF or TAF for 48 weeks. Liver stiffness measurement (LSM) was evaluated by ultrasonic liver transient elastography, serum HBV markers, biochemical parameters and HBV DNA loads were routinely detected. Serum laminin(LN),collagen type Ⅳ(Ⅳ-C), precollagen-Ⅲ (PC-Ⅲ)and hyaluronic acid(HA)levels were assayed by ELISA. Results By end of 48 week treatment, LSM as well as serum HA, LN, Ⅳ-C and PCⅢ levels in TMF-treated patients were (6.8±1.2)KPa, (171.2±25.9)ng/mL, (147.5±42.3)ng/mL, (174.3±46.3)ng/mL and (56.8±12.4)ng/mL, all not significantly different as compared to [(6.9±1.2)KPa, (175.2±34.6)ng/mL, (148.2±46.3)ng/mL, (175.4±42.1)ng/mL and (55.5±19.5)ng/mL, respectively] in TAF-treated patients (P>0.05); serum bilirubin, ALT and AST levels in TMF-treated patients were (16.4±1.4)μmol/L, (40.3±4.8)U/L and (32.4±5.1)U/L, all not significantly different as compared to [(17.3±1.2)μmol/L, (41.8±4.5)U/L and (36.9±4.9)U/L, respectively] in TAF-treated patients (P>0.05); virological and biochemical response rates in the two groups were not significantly different as serum HBV DNA transferred to negative and serum ALT level returned to normal(P>0.05) in all patients. Conclusion As for patients with CHB and poor response to ETV treatment, rescue antiviral therapy with TMF or TAF is both satisfactory, with complete virological response, and the long-term efficacy should be followed-up in the future.

Objective The aim of this study was to investigate combination of Xuezhikang, a herbal medicine compound, and atorvastatin in treatment of patients with non-alcoholic fatty liver disease (NAFLD) and hyperlipidemia. Methods 124 patients with NAFLD and hyperlipidemia were enrolled in our hospital between January 2022 and July 2024, and were randomly assigned to receive atorvastatin in 63 cases in control, or receive Xuezhikang at base of atorvastatin in another 61 cases in observation for 24 weeks. Fasting insulin was assayed by immunoassay, and HOMA-IR and HOMA-β were calculated. Serum tumor necrosis factor(TNF-α), interleukin -6(IL-6) and IL-8 levels were detected by ELISA. Results By end of 24-week treatment, serum ALT, AST and GGT levels in the observation group were (36.5±3.3)U/L, (32.7±2.8)U/L and (46.4±4.7)U/L, all significantly lower than [(62.8±3.6)U/L, (58.9±3.2)U/L and (64.1±5.3)U/L, respectively, P<0.05] in the control; there were no significant differences as respect to serum TC, TG, LDL-C and HDL-C levels in the two groups (P>0.05); serum FINS and HOMA-IR were (5.3±1.5)μU/ml and (2.7±0.8), both much lower than [(6.4±1.2)μU/ml and (4.1±1.3), respectively, P<0.05], while HOMA-β was (92.3±15.4), much greater than [(77.2±13.7), P<0.05] in the control; serum TNF-α, IL-6 and IL-8 levels were (15.5±6.3)pg/ml, (16.2±5.1)ng/L and (5.5±1.1)μg/L, all significantly lower than [(27.6±6.8)pg/ml, (26.6±5.8)ng/L and (7.2±1.4)μg/L, respectively, P<0.05] in the control group. Conclusion Application of Xuezhikang with combination of atorvastatin in treatment of patients with NAFLD and hyperlipidemia could improve liver function test normal, which might be related to modulation of glycolipid metabolism and inhibition of cytokine reactions.

Objective The aim of this study was to investigate clinical efficacy of semaglutide and metformin combination in treatment of patients with type 2 diabetes mellitus (T2DM) and concomitant nonalcoholic steatohepatitis (NASH). Methods Eighty patients with T2DM and NASH were encountered in our hospital between October 2022 and October 2023, and were randomly assigned to receive metformin in control or to receive metformin with combination of semaglutide subcutaneously in observation group for 24 weeks. Liver biopsies at presentation and at end of 24 week treatment were performed, and liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were detected by Fibroscan 502. Results By end of 24-week treatment, body mass index (BMI), fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), hemoglobin A1c (HbAlc) and insulin resistance index (HOMA-IR)) in observation group were (23.9±0.7)kg/m², (5.5±0.5)mmol/L, (6.5±1.2)mmol/ L, (6.3±0.7)% and (3.6±0.5), all significantly lower than [(25.6±0.8)kg/m², (6.0±0.7)mmol/L, (7.9±1.0)mmol/L, (7.5±0.8)% and (4.7±0.7), respectively P<0.05] in the control; serum triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels were(2.7±0.7)mmol/L,(5.1±1.0)mmol/L and (3.3±0.5)mmol/L, all much lower than [(3.4±0.8)mmol/L, (5.8±1.1)mmol/L and (3.7±0.6)mmol/L, respectively, P<0.05], while serum high-density lipoprotein cholesterol (HDL-C)) level was (1.3±0.2)mmol/L, much higher than [(1.1±0.2)mmol/L, P<0.05] in the control; serum liver function tests in the observation group improved greatly (P<0.05); LSM and CAP were (8.6±1.0)kPa and (251.0±18.5)db/m, both much lower than [(10.1±0.9)kPa and (273.0±19.1)db/m, respectively, P<0.05] in the control; liver histo-pathological examination showed that NASH activity score (NAS) improved in 72.5%, much higher than 25.0% in the control group. Conclusion The combination of semaglutide and metformin in treatment of patients with T2DM and NASH is efficacious short-termly, which might modulate blood sugar and lipid metabolism, and improve liver function tests.

Objective The aim of this study was to investigate differential diagnosis of dysplastic nodule (DN) and small hepatocellular carcinoma (sHCC) under background of liver cirrhosis (LC) by enhanced magnetic resonance imaging (MRI). Methods A total of 104 patients with LC and intrahepatic nodular lesions were encountered in our hospital between July 2022 and July 2025, and all underwent Gd-EOB-DTPA enhancement of 3.0 T MR. The diagnosis was proven by histo-pathological examination. Results The histo-pathological examination diagnosed DN with dimeter of (0.9±0.2)cm in 46 cases and sHCC with diameter of (1.1±0.2)cm in 58 cases in our series; DN lesions presented with high or equal signals on T1WI mostly, and with low signals on T2WI and DWI mostly, while sHCC lesions showed with low or equal signals on T1WI mostly, and with high signals on T2WI and DWI mostly; sHCC lesions demonstrated with enhancement at arterial phase, clearance at portal vein phase, low signals at hepatobiliary phase and "fast-in and fast-out" mode, and their relative apparent diffusion coefficient (ADC)was much lower than ADC lesions; the differential diagnosis by MRI was excellent with sensitivity of 89.7%, the specificity of 91.3% and the accuracy of 90.4%, and the Kappa was 0.81 as compared to histo-pathological diagnosis. Conclusion MRI by Gd-EOB-DTPA enhancement could provide differential diagnosis of DN and sHCC, and the signal intensity and enhancement mode between the two lesions were mostly different.

Objective The aim of this study was to investigate efficacy of local transhepatic arterial chemoembolization (TACE) with combination of immune and targeted therapy in the treatment of patients with advanced primary liver cancer(aPLC). Methods 86 patients with aPLC were encountered in Department of Hepatobiliary Surgery, Xiangxi Autonomous Prefecture People's Hospital affiliated to Jishou University between January 2021 and January 2025, and assigned to undergo TACE in 42 cases in the control, or to receive TACE with combination of lenvatinib and tislelizumab treatment in another 44 cases in the observation for three months. Serum alpha-fetoprotein (AFP) and abnormal prothrombin-II (PIVKA-II) levels were detected routinely, and peripheral blood lymphocyte subsets were determined by FCM. Results By end of three-month treatment, the disease control rate was 70.5% and the objective remission rate was 36.4% in the observation group, both much higher than 47.6% and 16.7% (P＜0.05) in the control group; serum AFP and PIVKA-Ⅱ levels were (653.5±131.5)ng/mL and (864.5±89.6)ng/mL, both much lower than [(965.5±152.2)ng/mL and (1038.4±91.3)ng/mL, respectively, P＜0.05] in the control; percentage of peripheral blood CD⁺₄ cells and CD⁺₄/CD⁺₈ cell ratio were (33.6±3.1) % and (1.2±0.3), both significantly higher than [(29.5±2.7 %) and (0.9±0.2), respectively, P＜0.05] in the control; after treatment, the successful conversion surgery rate in the observation group was 22.7%, not significantly different as compared to 7.1% (P>0.05) in the control group. Conclusion Local TACE in combination with immune and targeted therapy in dealing with patients with aPLC is short-termly efficacious, which might alleviate immune suppression with control of tumor progression.

Objective The aim of this study was to investigate the clinical efficacy of Wuling capsule, a herbal compound, in the treatment of patients with metabolic associated steatohepatitis (MASH). Methods 117 patients with MASH were enrolled in our hospital between January 2018 and December 2023, and were randomly assigned to receive oral polyene phosphatidylcholine capsule in 58 cases in control or receive Wuling capsule and polyene phosphatidylcholine capsule combination in another 59 cases in observation for six months. All patients were carefully supervised with food intake and exercise, and hypolipidemic therapy when necessary. Serum hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen N-terminal peptide (PCⅢ) and type Ⅳ collage (IV-C), and serum interleukin-1β(IL-1β), IL-6, IL-18, IL-37 and tumor necrosis factor-α(TNF-α) levels were detected by ELISA. Results By the end of 6 month treatment, serum alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase levels in the observation group were(39.7±7.2)U/L, (36.3±8.6)U/L and (63.6±5.8)U/L, all significantly lower than [(60.5±8.9)U/L, (56.7±9.2)U/L and (72.5±9.2)U/L, respectively, P<0.05] in the control; serum HA, PCⅢ and Ⅳ-C levels were (166.3±30.8)μg/L, (106.1±34.2)μg/L and (108.2±18.4)μg/L, all much lower than [(189.6±36.3)μg/L, (147.4±36.4)μg/L and (126.5±20.7)μg/L, respectively, P<0.05] in the control; serum IL-1β, IL-6, IL-18 and TNF-α levels were (11.8±2.4)pg/ml, (18.2±3.1)mg/L, (139.2±34.7)pg/ml and (3.6±1.1)ng/L, all much lower than [(16.4±2.7)pg/ml, (27.4±3.3)mg/L, (206.5±52.3)pg/ml and (6.3±1.2)ng/L, respectively, P<0.05] in the control group. Conclusion Wuling capsule has exact efficacy in the treatment of patients with MASH, which effectively improve liver function tests, and relieve liver fibrosis and cytokine reactions.

Objective The aim of this study was to investigate global disease burden and epidemic trends and non-alcoholic fatty liver disease (NAFLD) over the past three decades in the world. Methods Based on the global burden of disease (GBD) data in 2021,this study retrieve relevant data of NAFLD all over the world. The analysis was conducted by using annual percentage change (APC), estimated annual percentage change (EAPC) and percentage change to assess epidemic trends of NAFLD burden and employed a Joinpoint regression analysis model to quantitatively describe its significant points of change. Pearson correlation coefficient was applied to evaluate geographical disparities in the NAFLD disease burden. Results From 1990 to 2021, the prevalence of NAFLD worldwide increased significantly; the crude number of cases rose from 564.43 million to 1267.87 million, with an increase rate as high as 125%, and the EAPC was 1.4 (95% confidence interval: -1.33-4.2); the Joinpoint regression analysis showed that the NAFLD prevalence particularly significantly increased during the period from 2008 to 2015; the prevalence and incidence of NAFLD had an inverted U-shaped changes as the sociodemographic index (SDI) varied, e.g., with the increase of SDI, the prevalence and incidence of NAFLD showed a trend of rising first and falling thereafter; in terms of risk factors, the research indicated that metabolic factors, such as high fasting blood glucose was the main drivers of NAFLD, and in the past 30 years, the proportion of metabolic factors in the pathogenesis of NAFLD had significantly increased; furthermore, the incidences of liver cirrhosis, non-alcoholic steatohepatitis (NASH), and even primary liver cancer derived from NAFLD increased in most regions around the world. Conclusion Overall, over the past 30 years, the disease burden of NAFLD has significantly increased globally, and its epidemic characteristics show significant heterogeneity at different regions, countries, ages and genders, indicating the necessity of constructing a multi-dimensional and hierarchical precise prevention and control system. This study might provide a key epidemiological evidence for the precise management and intervention strategies of the entity.

Objective The aim of this study was to observe clinical feature, pathogen distribution and prognosis in patients with pyogenic liver abscess (PLA). Methods A total of 122 patients with PLA were admitted to our hospital between April 2022 and April 2025, and all were treated by percutaneous catheter drainage (PCD) and intravenous antibiotics. The pathogens identification was performed by full-automatic microbial identification instrument. Results The diameter of abscess was(4.8±0.9)cm, WBC count was (13.6±2.5)×10⁹/L, serum CRP level was (124.2±26.8)mg/L and serum procalcitonin level was (4.8±1.2)ng/mL; underlying diseases, such as diabetes accounted for 42.6% and biliary tract diseases for 45.9%; abscess located at right lobe accounted for 62.3% and single abscess for 74.6%; main pathogens were Kleebsiella pneumoniae (45.1%), Escherichia coli (17.6%) and Staphylococcus aureus (11.8%); after 2 to 6, with average of (3.5±0.8)week treatment, two patients with PLA died of septic shock or multiple organ failure, and other 120 patients with PLA recovered. Conclusion In patients with PLA, the main underlying diseases are diabetes mellitus and biliary tract diseases, common pathogens are Klebsiella pneumoniae, and the prognosis of patients with PLA are satisfactory.

Objective The purpose of this study was to compare laparoscopic cholecystectomy (LC) by through posterior Calot’ s triangle approach (PCTA) or through anterior Calot’ s triangle approach (ACTA) in dealing with patients with cholecystolithiasis and chronic cholecystitis. Methods 197 patients with cholecystolithiasis and chronic cholecystitis were encountered in our hospital between June 2021 and June 2024, and all underwent LC surgery. For the operation, by through PCTA in 96 cases, and by through ACTA in 101 cases. Visual analogue scale (VAS) was evaluated for postoperative pain. Serum C-reactive protein level was detected by immunoturbidimetry, serum interleukin (IL)-6 and tumor necrosis factor (TNF)-α were detected by ELISA, plasma superoxide dismutase (SOD) level was detected by ammonium phosphate method, plasma glutathione peroxidase (GSH-Px) level was detected by DTNB direct color development, and plasma malondialdehyde (MDA) level was assayed by thiobarbituric acid. Results Surgical time and postoperative exhaust time in PCTA group were(33.6±7.3)min and (22.3±5.6)h, both much shorter than [(39.1±7.1) minand (28.8±6.1)h, respectively, P<0.05], and operational bleeding was (36.9±11.4)mL, much less than [(49.5±12.9)mL, P<0.05] in ACTA group; by end of three days, VAS score in PCTA group was (2.5±0.4)points, much lower than [(3.1±0.5)points, P<0.05] in ACTA group; by 24 h, serum IL-6, IL-8, TNF-α and CRP levels in PCTA group were (12.1±2.0)ng/L, (17.3±2.7)ng/L, (19.5±2.7)ng/L and (18.3±1.6)mg/L, all significantly lower than [(15.2±1.4)ng/L, (22.7±3.1)ng/L, (23.6±3.5)ng/L and (29.1±1.1)mg/L, respectively, P<0.05] in ACTA group; serum SOD level was (121.0±18.4)U/ml, much higher than [(105.3±19.2)U/ml, P<0.05]in ACTA group. Conclusion For LC operation, by through PCTA could be relatively easy, which might cost less operational time and induce less body inflammatory and oxidative stress.

Objective This study aimed to compare prevention of mother-to-child hepatitis B virus (HBV) transmission by tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) in pregnant HBV carriers. Methods 62 pregnant chronic HBV carriers were encountered in our hospital between May 2022 and May 2024, and were randomly assigned to receive TDF in 31 cases or TAF anti-viral therapy in another 31 cases since gestation 26 to 28 weeks until childbirth. All newborns were inoculated with hepatitis B immune globulin and hepatitis B vaccine. Serum creatinine (sCr) level and 24-hour urinary protein quantification were measured by using a fully automated biochemical analyzer, and the estimated glomerular filtration rate (eGFR) was calculated by using the CKD-EPI formula. Serum HBeAg levels were detected by chemiluminescence, and serum HBV DNA loads were measured by fluorescent quantitative PCR system. Results By end of one year follow-up, the successful blocking of mother-to-child HBV transmission in TAT-treated women was 100.0%, not significantly different as compared to 96.8%(P>0.05) in TDF-treated women; at laboring, serum HBV DNA turned to negative in the two groups, and serum HBeAg levels dint changed greatly (P>0.05); sCr, eGFR and urine protein level in TAF-treated women were (86.1±5.9)μmol/L, (96.6±8.2)mL/(min.1.73m² and (97.5±22.1)mg/24 h, all not significantly different compared to [(88.1±5.7)μmol/L, (94.4±7.9)mL/(min.1.73m² and (99.7±28.2)mg/24 h, P>0.05) in TDF-treated women; incidences of adverse events, such as premature birth, premature rupture of membranes and gestational hypertension in the two groups were not significantly different(P>0.05). Conclusion At present, we recommend both TDF or TAF for prevention of mother-to-child HBV transmission, which warrants further clinical observation.

Objective Acute-on-chronic liver failure (ACLF) is a clinical syndrome that occurs after severe impairment of hepatic synthesis, detoxification, metabolism, and transformation functions, and can be complicated by multiple organ failure with a high morbidity and mortality rate. Hepatorenal syndrome (HRS) is one of the serious complications of ACLF, which is a special form of acute kidney injury (AKI) and an independent risk factor affecting the prognosis of patients with ACLF, and early diagnosis and treatment of AKI might effectively improve the prognosis of patients with ACLF.

Objective The aim of this study was to investigate therapeutic efficacy of exenatideplus oralpolyenephosphatidylcholine in the treatment of patients with alcoholic hepatitis (AH). Method A total of 102 patients with AH were recruited in our hospital between January 2022 and January 2024,and were randomly assigned to receive oral polyene phosphatidylcholine in 50 patients in control, or receive subcutaneous exenatide injection plus oral polyene phosphatidylcholine in 52 patients in combination group for three months. Serum hyaluronic acid (HA), type III procollagen (PC-Ⅲ), collagen fiber Ⅳ (ⅳ-C) and laminin (LN)) levels were detected by radioimmunoassay, and serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-8 levels were assayed by ELISA. Result By end of three month treatment, serum ALT, AST,GGT and total bilirubin levels in combination groupwere(48.9±15.2)U/L, (45.6±12.5)U/L, (119.5±30.6)U/L and (23.1±5.6)μmol/L, all significantly lower than [(69.3±20.1)U/L,(79.6±18.1)U/L, (168.8±50.7)U/Land (33.5±6.9)μmol/L,respectively, P<0.05] in the control; serum HA, PC-Ⅲ,Ⅳ-C and LN levels in the combination group were (128.5±20.3)μg/L, (132.3±29.1)μg/L, (41.2±9.1)mg/mL and (105.4±20.6)mg/mL, all significantly lower than [(152.2±22.1)μg/L, (186.5±30.4)μg/L, (57.3±10.2)mg/mL and (134.5±20.1)mg/mL, respectively, P<0.05] in the control group; serum TNF-α,IL-6 and IL-8 levels in the combination group were (236.1±100.8)pg/L, (35.1±10.8)pg/L and (10.5±3.8)ng/L, all much lower than [(286.7±105.6)pg/L, (50.1±11.4)pg/L and (17.1±4.5)ng/L, respectively, P<0.05] in the control group; there was no significant difference in the incidence of adverse reactions between the two groups (13.5% vs. 10.0%, P>0.05). Conclusion Additional injection of exenatideat basis of oral polyenephosphatidylcholine therapy could improve liver function normal in patients with alcoholic hepatitis, which might be related to inhibition of body inflammatory reactions.

Objective The aim of this study was to observe clinical efficacy of human serum albumin in combination with lactulose and ornithine aspartate in treatment of patients with liver cirrhosis (LC) and hepatic encephalopathy (HE). Methods 58 cirrhotics with complicated HE were enrolled in our hospital between January 2022 and April 2025, and were randomly assigned to receive intravenous human albumin 5 g daily in 28 patients in control, or receive intravenous human albumin 10 g daily in 30 patients in observation. All patients were carefully managed by internal treatment for two weeks. Serum interleukin(IL)-6, IL-8 and C-reactive protein (CRP) levels were detected by ELISA, and HE was evaluated by West Haven scoring system. Results By end of two week observation, three patients (10.7%)died in the control, and one died (3.3%, P>0.05)in the observation groups; total serum bilirubin level in 29 survivals in the observation was (38.2±10.6)μmol/L, much lower than [(50.1±12.7)μmol/L, P>0.05],while serum albumin level was (35.1±2.5)g/L, much higher than [(33.5±2.1)g/L, P＜0.05)] in 25 survivals in the control; serumIL-6, IL-8 and CRP levels were (21.2±5.9)pg/mL, (31.4±8.7)pg/mL and(11.5±3.2)mg/L, all significantly lower than [(29.4±6.2)pg/mL, (40.5±10.9)pg/mL and (46.2±4.5)mg/L, respectively, P＜0.05] in the control; proportion of West Haven grade 0 in the observation group was 51.7%, much higher than 28.0%(P＜0.05) in the control group. Conclusion Human serum albumin infusion in dealing with LC patients with HE could improve regaining consciousness, which might be related to increased plasma colloid osmotic pressure and relatively quick liver functioning.

Objective The aim of this study was to investigate prediction of liver cirrhosis (LC) by shear wave elastography (SWE) and liver fibrosis index in patients with hepatolenticular degeneration (HLD). Methods 52 patients with HLD were encountered in our hospital between December 2022 and December 2024, and all underwent liver biopsies and SWE for Young’s modulus. Aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (Fib-4) were calculated. Serum hyaluronic acid (HA), laminin (LN), type III procollagen amino-terminal peptide (PIIINP) and type IV collagen (IV-C) levels were analyzed. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive efficacy. Results APRI and FIB-4 scores in 9 patients with LC were (1.1±0.4) and (2.1±0.3), both significantly greater than [(0.5±0.2) and (1.2±0.2), respectively, P<0.05] in 43 patients with HLD; serum HA level was (313.4±54.7)ng/mL, and Young’s modulus was (14.2±2.1)kPa, both much higher or greater than [(142.2±25.4)ng/mL and (7.9±0.9)kPa, respectively, P<0.05] in those with HLD; ROC analysis showed that the AUC was 0.983(95%CI:0.955-1.000), with sensitivity of 97.4% and specificity of 98.1%, when combination of Young’s modulus with APRI or FIB-4 score and serum HA level in predicting LC in patients with HLD. Conclusion Shear wave elastography with combination of serum fibrosis markers or fibrosis index really have an excellent predictive performance in assessing LC in patients with HLD.

Objective The aim of this study was to summarize clinical feature and prognosis of patients primary biliary cirrhosis (PBC) complicated with esophagogastric variceal bleeding (EVB). Methods A retrospective analysis was conducted on 106 patients with PBC and EVB, including first EVB in 33 cases and re-bleeding in 73 cases, who were admitted to our hospital between April, 2021, and December, 2023. The clinical features, laboratory indicators, complications and prognosis were analyzed. Results The ICU admission rate in the first bleeding group was significantly higher than that in re-bleeding group (12.1% vs. 0.0%, P=0.002), and the incidence of portal vein thrombosis was significantly lower than in re-bleeding group (12.1% vs. 32.9%, P=0.025); no significant differences were observed between the two groups as respect to 6-week mortality (9.1% vs. 8.2%, P =0.881), 6-week re-bleeding rate (12.1% vs. 17.8%, P=0.460), and 1-year mortality (16.2% vs. 17.2%, P=0.897). Conclusion PBC patients with decompensated liver functions might complicate EVB, and re-bleeding is very common, which should be carefully intervened with hemostasis, and even endoscopic therapy.

Objective The aim of this study was to investigate ¹²⁵I radioactive seed implantation in combination with transcatheter arterial chemoembolization (TACE) in the treatment of patients with primary liver cancer (PLC). Methods 78 patients with PLC were enrolled in our hospital between January 2021 and December 2023, and were divided into two groups, receiving TACE in 39 cases or receiving TACE and ¹²⁵I radioactive seed implantation in another 39 cases. All patients were followed-up until December 2024, and the objective remission rate (ORR) , disease control rate (DCR), overall survival (OS) and progression-free survival (PFS). Results By end of 3 months after operation, the ORR in the combination group was 87.2%, much higher than 66.7%(P<0.05) in the TACE group, while there was no significant difference as respect to DCR (97.4% vs. 89.7) between the groups (P>0.05); after operation, serum AFP level in the combination group was (349.7±111.9)ng/mL, much lower than [(452.0±147.6)ng/mL, P<0.05] in the TACE group; survival rates in the two groups were 53.8% vs. 71.8%, without significant difference (x²=2.690, P>0.05), while the OS in TACE group was 24.0(16.0, 35.0)m and in combination group was 31.0(22.0, 41.0)m, and the PFS was 22.0(12.0, 33.0)m and 28.0(19.0, 39.0)m, both much longer in the combination group than in the TACE group(Log Rank=5.380, and Log Rank=4.963, P<0.05). Conclusion ¹²⁵I radioactive seed implantation in combination with TACE in the treatment of patients with PLC is efficacious, which might improve short-term tumor control and prolong survival.

Objective This study aimed to investigate diagnostic performance of serum alpha-fetoprotein (AFP) levels and multilayer spiral CT-detected parameters in evaluating qualities of liver nodules. Methods Clinical data of 124 patients with liver nodules were collected in our hospital between October 2021 and October 2023, and all underwent CT scan for determination of mean transit time (MTT),permeability surface area product (PS), blood volume (BV) and blood flow (BF) of regions of interest. Serum AFP, carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA-199) and tumor specific growth factor (TSGF) levels were assayed by ELISA. Multivariate Logistic regression analysis and area under receiver operating characteristic curve (AUC) were applied to assess diagnostic efficacy. Results Of 124 patients with intrahepatic nodules, histo-pathological examination found benign lesions in 83 cases (66.9%) and malignant lesions in 41 cases (33.1%);PS, BV and BF in malignant lesions were (10.4±3.2)mL/(min·100 g), (4.0±1.6)mL/100 g and (26.5±5.6)mL/(min·100 g), all much higher than [(6.2±1.5)mL/(min·100 g), (1.9±0.5)mL/100 g and (17.9±3.5)mL/(min·100 g), respectively, P＜0.05] in benign ones; serum AFP, CA-199 and TSGF levels were (416.4±150.1)μg/L,(44.6±5.9)U/L and (78.3±8.3)U/mL, all much higher than [(11.8±2.3)μg/L,(36.2±4.5) U/L and (59.7±6.2)U/mL, respectively, P＜0.05] in benign lesions; multivariate Logistic regression analysis showed that PS, BV and BF as well as serum AFP levels were independent risk factors for HCC existence (P＜0.05);ROC analysis demonstrated that the AUC was 0.967(95%CI:0.927-1.000), with sensitivity of 985.1% and specificity of 95.1%, when CT parameters and serum AFP level combination in judging the quality of intrahepatic nodules. Conclusion CT parameters in combination with serum AFP levels could help in the differential diagnosis of benign and malignant intrahepatic nodules,which could guide clinical management.

Objective The aim of this study was to summarize clinical feature and antibiotic application in a series of patients with bacterial liver abscess (BLA). Methods A total of consecutive 90 patients with BLA were encountered in our hospital between May 2020 and May 2025, and all underwent puncture drainage and intravenous antibiotic administration. Bacteria separation, characterization and drug sensitivity tests were routinely performed. Results Male to female ratio in our series was 2.1:1, with mean age range of 60.5±7.4 yr; underlying diabetes accounted for 45.5%, cholelithiasis for 35.6%, hypertension for 32.2%, malignant tumors for 5.6%; white blood cell count was (12.0±1.3)×10⁹/L, serum C-reactive protein level was (69.4±5.1)mg/L, serum procalcitonin level was (2.4±0.2)ng/mL, and serum albumin level was(31.5±9.6)g/L; single abscess accounted for 74.4% and multiple for 25.6%; abscess at right lobe accounted for 77.8%, at left for 11.1% and both for 11.1%; diameter of abscess was (6.8±1.1)cm; prevalence of positive bacteria was 80.0%, with 78 strains of pathogens characterized, of which, Klebsiella pneumoniae positive in 74 cases; 100.0% sensitivity to 9 antibiotics, including cefoperazone/sulbactam; initial empirical treatment with β-lactam/enzyme inhibitor accounted for 32.2% and antimicrobial therapy switched to sensitive medicines based on drug sensitivity tests; after 13 to 25 (17.8±2.5)d treatment, the recovery rate was 94.4%, effective rate was 4.4% and one patient (1.1%)died of multiple organ failure. Conclusion The incidence of BLA is higher in middle-aged and elderly males, and most of them have underlying chronic disease. The common pathogen is Klebsiella pneumoniae, and the outcomes is satisfactory in most cases with appropriate management.

Objective The aim of this study was to summarize clinical feature and prognosis of patients with acute hepatitis E(AHE). Methods Fifty-two patients with AHE were encountered in our hospital between January 2022 and December 2023, and were dealt with conventional liver-protecting measures. Patients with liver failure(LF) were carefully treated by artificial liver supporting system (ALSS) and human blood products. Results Of the 52 patients with AHE, typical AHE was found in 30 cases, and those with hyperbilirubinemia in 17 cases and LF in 5 cases; male percentage, concomitant fatty liver, alcoholic liver disease (ALD) and hospital stay in patients with hyperbilirubinemia were 82.3%, 47.1%, 58.8% and (27.0±6.5)d, all much higher or longer than [63.3%, 10.0%, 13.3% and (15.4±3.0)d, respectively, P<0.05] in those withs AHE; peak total serum bilirubin level (TSB) in patients with hyperbilirubinemia was (195.8±45.6)μmol/L, much higher than [(84.7±23.8)μmol/L, P<0.05] in those with AHE; TSB, albumin and prothrombin time international ratio in patients with LF were(345.2±66.8)μmol/L, (28.9±8.6)g/L and (2.6±0.9); all patients, but two (60.0%)with LF died, got a good prognosis in our series. Conclusion Patients with AHE tends to have hyperbilirubinemia, especially in those with fatty liver or ALD, which might lead to death and needs carefully managed clinically.

Objective The aim of this study was to investigate the diagnostic efficacy of contrast-enhanced ultrasound (CEUS) time-intensity curve (TIC) parameters and liver imaging reporting and data system (LI-RADS) classification in differentiating diagnosis of liver space-occupying lesions (SOL). Methods 82 patients with liver SOL were encountered in our hospital between January 2020 and December 2024, and the diagnosis was proven by liver histo-pathological examination. All patients underwent CEUS to record TIC parameters, including peak intensity, time to peak, rise time, mean transit time and blood flow perfusion index. Intrahepatic lesions were classified according to LI-RADS criteria, with LR-4a as the cut-off value, e.g., LR-1 to LR-4a were classified as benign, and LR-4b to LR-5 were defined as malignant lesions. Results Of the 82 patients with liver SOL, liver histo-pathological examination found malignant lesions in 43 cases (52.4%), and benign ones in 39 cases (47.6%); peak intensity and mean transit time in malignant lesions were(126.2±15.7)% and (126.8±26.0)s, both significantly lower or faster than [(140.5±18.4)% and (246.6±42.6)s, respectively, P<0.05], while time to peak, rise time and blood flow perfusion index were (21.4±3.9)s, (34.4±6.3)s and (85.2±14.6), all much slower or greater than [(17.3±3.2)s, (30.3±5.6)s and (50.4±7.8), respectively, P<0.05] in benign lesions; false negative false positive rates by LI-RADS diagnosis was 13.9% and 10.2%; the sensitivity and specificity by CEUS quantitative parameters were 95.3%(41/43) and 84.6%(33/39), and they were 86.0%(37/43)and 89.7%(35/39) by LI-RADS. Conclusion Both the quantitative parameters of CEUS TIC and the LI-RADS classification demonstrate satisfactory diagnostic performance in distinguishing benign from malignant liver SOL, which warrants further clinical investigation.

Objective The aim of this study was to investigate the efficacy of intravenous administration of ganciclovir and glutathione in the treatment of children with cytomegalovirus (CMV)-infected hepatitis. Methods A consecutive 112 children with CMV hepatitis were encountered in our hospital between January 2021 and June 2024, and all children received intravenous administration of ganciclovir and glutathione for 2 to 3 weeks. Serum interleukin-18 (IL-18), interferon-γ(IFN-γ) and tumor necrosis factor-α(TNF-α) levels were assayed by ELISA, and serum CMV DNA loads were determined by PCR. Results Of our series, the children with CMV hepatitis were found mild hepatitis (MH) in 74 cases and severe hepatitis (SH) in 38 cases; after treatment, serum ALT and total serum bilirubin levels in children with SH decreased from (244.7±25.9)U/L and (167.5±22.3)μmol/L to (45.5±11.0)U/L and (31.2±5.8)μmol/L, respectively, and serum biochemical parameters returned to normal in children with MH; serum IL-18 and TNF-α levels in children with SH decreased from (74.8±27.9)pg/L and (41.0±10.2)pg/ml to (42.2±12.3)pg/L and (35.3±7.9)pg/ml(P<0.05), respectively, and they reduced from (56.4±17.4)pg/L and (39.4±6.9)pg/ml to (35.1±10.7)pg/L and (28.7±5.8)pg/ml(P<0.05) in those with MH; serum CMV DNA load returned to negative in (7.5±2.2)d in children with MH, much shorter than [(13.0±5.5)d, P<0.05] in those with SH; all patients but one (2.6%)who died of liver failure with complicated pneumonia with CMV-infected hepatitis recovered in our series. Conclusion Intravenous administration of ganciclovir and glutathione in the treatment of children with CMV-infected hepatitis is efficacious, and the pediatrics should take care of those with SH and deal with any complications in time.

Objective The aim of this study was to set up and validate a precise yet low-cost early prediction model for fatty liver disease based on routine indicators available in health-checkup centers. Methods A retrospective cohort of 1212 individuals for physical examination was analyzed, and the fatty liver was diagnosed based on ultrasonography. Various indexes were calculated based on clinical materials. Nested cross-validation (10-fold outer loop for validation and 5-fold inner loop for tuning) was combined random-forest and XGBoost with LASSO Logistic regression was conducted for feature selection. Variable importance was interpreted with SHAP values. Internal validation was used 1000-bootstrap optimism-corrected AUC and external validation was employed by a 30 % random split. Results Of the 1212 individuals, fatty liver was found in 542 cases(44.7%);the final model retained four variables, e.g.,triglyceride-glucose-body mass index (TyG-BMI), body-fat percentage, diastolic blood pressure and monocyte to high-density lipoprotein cholesterol (MHR); AUC of nested-cross-validation was 0.874 (95 % CI: 0.855-0.893), AUC of final-model was 0.880 (95 % CI: 0.861-0.898), AUC of optimism-corrected was 0.878 (95 % CI: 0.860-0.897) and AUC of external was 0.866 (95 % CI: 0.830-0.902); calibration was excellent (slope ≈ 1; Hosmer-Lemeshow P=0.433) and robust under 30 % Gaussian noise (AUC=0.878); SHAP analysis identified TyG-BMI as the dominant contributor. Conclusion The four-variable model demonstrates high discrimination, excellent calibration, easy acquisition and strong generalizability, which might offer health-checkup centers a“precise, efficient and low-cost” screening tool for fatty liver disease.

Objective The purpose of this study was to summarize the clinical feature of patients with acute portal vein thrombosis (PVT). Methods 15 patients with acute PVT were admitted to The First Affiliated Hospital, Soochow University between January 2020 and April 2022, the etiology, clinical feature, treatments strategy and outcomes were summarized. Results Of the 15 patients with acute PVT, there were 13 males and 2 females, with an average age of (52.5±15.6) years; the etiology included hepatitis B-induced liver cirrhosis (LC) in 5 cases, alcoholic LC in 1 case, primary biliary cholangitis in 1 case, schistosomiasis-induced cirrhosis in 1 case and cryptogenic Cirrhosis in 2 cases, and non-cirrhotics, including non-cirrhotic portal hypertension in 1 case, hereditary protein C deficiency in 1 case and cryptogenic diseases in 3 cases; anticoagulation treatment was initiated in 14 cases, of which 2 patients received interventional thrombolysis and 1 patient received anticoagulation medicine treatment; 2 patients died of septic shock derived from intestinal ischemic necrosis, 1 patient died of hemorrhagic shock derived from esophageal variceal bleeding, PVT didn’t change in 1 case, thrombolysis and vascular recanalization occurred in 2 cases, and thrombosis shrunk in the remaining patients. Conclusion The etiology vary in patients with acute PVT, without specific clinical manifestations, and early diagnosis and intervention might improve the outcomes.

Objective The aim of this study was to observe analgesic efficacy of ultrasound (US)-guided costotransverse block in patients with cholelithiasis undergoing laparoscopic cholecystectomy (LC). Methods A total of 126 patients with gallbladder stones were encountered in our hospital between January 2024 and June 2025, and all underwent LC with general anesthesia. For post-operational analgesia, the patients were randomly assigned to receive paravertebral block (n=62) in control, or receive US-guided costotransverse block (n=62) in observation. Visual analogue scale (VAS) scores in resting and motion states were recorded. Results The extubation time, PACU stay, and recovery time after anesthesia in the observation group were(12.4±1.6)min, (35.7±4.2)min and (10.1±1.9)min, all much shorter than [(15.3±1.7)min, (41.8±6.4)min and (13.6±2.1)min, respectively, P<0.05], and total dosage of intraoperative sufentanil administration and 24-hour total dosage of postoperative opioids were(18.7±2.4)μg and (24.7±3.6)mg, both significantly less than [(25.7±3.5)μg and (38.3±4.2)mg, respectively, P<0.05] in the control group; by 8 hour and 24 hour after operation, resting VAS scores in the observation group were (2.2±0.3) and (2.8±0.2), both much lower than [(2.9±0.3) and (4.1±0.5), P<0.05], and motion VAS scores were (3.8±0.5) and (4.5±0.6), both much lower than [(4.8±0.5) and (5.4±0.6), P<0.05] in the control group; by T1 and T4, heart beats and average blood pressure were much slower or lower than in the control group (P＜0.05). Conclusion US-guided costotransverse block in patients after LC exhibits a satisfactory analgesic efficacy, with minimal impact on cardiovascular hemodynamics.

Objective This study aimed to explore qualitative judgement of focal liver lesions (FLL) by quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods 107 patients with FLL were encountered in our hospital between January 2022 and January 2025, and all patients underwent DCE-MRI examination to record initial area under enhancement curve (IAUC), maximum slope of increase (MSI), maximum slope of decrease (MSD), mean enhancement time (MET) and positive enhancement integral (PEI). Golden diagnosis was proven by histo-pathological examination. Receiver operating characteristic (ROC) curves was applied to validate the diagnostic efficacy. Results Of the 107 patients with FLL in our series, pathological exam found benign lesions in 37 cases, hepatocellular carcinoma (HCC) in 56 cases and intrahepatic cholangiocarcinoma (ICC) in 9 cases; IAUC and MSD in benign lesions were (21.5±3.5) and (83.2±9.5), both much smaller than(P＜0.05), while MSI, MET and PEI were (283.2±26.6), (552.4±68.6) and (249.9±24.5), all much greater than in malignant lesions (P＜0.05); MSI, MET and PEI in HCC foci were (93.3±11.3), (486.5±61.4) and (32.5±6.6), all significantly smaller than [(103.3±10.3), (515.4±51.3) and (41.5±7.8), respectively, P＜0.05] in ICC foci; the AUC was 0.906, when IAUC, MSI, MSD, MET and PEI were combined to predict malignant lesions, and the AUC was 0.856, when MSI, MET and PEI were combined to differentiate HCC from ICC, both had to some extent implications of clinical practice. Conclusion DCE-MRI quantitative parameters could help clinicians differentiate base on imaging benign from malignant intrahepatic lesions, which warrants further clinical investigation.

Objective The aim of this study was to compare diagnostic efficacy of transient elastography (TE) to two-dimensional shear wave elastography (2D-SWE) in assessing significant liver fibrosis (SLF) in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods A total of 110 patients with MAFLD were encountered in our hospital between March 2022 and October 2024, and all underwent liver biopsies. TE was performed to obtain liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), and Young's modulus was obtained by 2D-SWE. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance. Results Of the 110 patients with MAFLD, liver histo-pathological examination proven metabolic related simple fatty liver (MRSFL) in 62 cases and metabolic dysfunction-associated steatohepatitis(MASH) in 48 cases, including F2 stage of liver fibrosis in 30 cases, F3 in 15 cases and F4 in 3 cases; serum total cholesterol, triglyceride, low-density lipoprotein and alanine aminotransferase levels in patients with MASH were significantly higher, while serum high-density lipoprotein level was significantly lower than in patients with MRSFL(P<0.05); CAP, LSM and Young's modulus in patients with MASH were (315.2±20.6)dB/m, (12.0±2.3)kPa and (10.1±2.1)kPa, all much higher than [(267.8±8.4)dB/m,(5.9±1.4)kPa and (4.9±1.4)kPa, respectively, P<0.05] in those with MRSFL; ROC analysis showed that the AUC was 0.899(95%CI: 0.831-0.987), with sensitivity (Se) of 0.888 and specificity (Sp) of 0.826, when LSM was applied to predict SLF, and the AUC was 0.885 (95%CI:0.822-0.949), with Se of 0.796 and Sp of 0.806, when Young's modulus was applied. Conclusion Both LSM and 2D-SWE could help predict SLF non-invasively in patients with MAFLD, which should be a widespread tool for clinical application.

Objective The aim of this study was to investigate diagnostic performance of sonazoid contrast-enhanced ultrasound (CEUS) and serum alpha fetoprotein(AFP) and prothrombin induced by the absence of vitamin K or antagonist-II (PIVKA II) levels in determining quality of focal liver lesions (FLL). Methods 80 patients with FLL were admitted to our hospital between May 2019 andJuly 2024, and all of them underwent liver biopsies and sonazoid CEUS examination.Serum AFP and PIVKA-II levels were measured by chemiluminescence immunoassay. Receiver operating characteristic (ROC) curves wereplotted to explore the diagnostic efficacy of sonazoid CEUS and serum AFP and PIVKA-II level combination in judging the quality of FLL. Results Of the 80 patients with FLL, liver pathological examination proved hepatocellular carcinoma(HCC)in 43 cases, focal nodular hyperplasia (FNH) in 13 cases, cirrhotic nodule in 19 case and inflammtory pseudotumor in 5 cases; serum AFP and PIVKA-Ⅱ levels in malignant group were (710.1±213.0)ng/ml and (56.0±18.0) mAU/ml, both significantly higher than [(8.4±1.5)ng/ml and (28.3±6.3)mAU/ml, respectively,P＜0.05] in benign group; CEUS diagnosed benign lesions in 29 cases and malignant ones in 51 cases; of51 patients with malignant lesions diagnosed by CEUS, the percentages of fast-in at arterial phase, fast-out at portal phase and complete clearance at delayed phase in malignant group were86.3%, 76.5% and 88.2%, all much higher than 31.0%, 0.0% and 0.0%(P＜0.05) in benign group; the AUC was 0.932(95%CI:0.853-0.976), with sensitivity of 100.0% and specificity of 86.5%, when serum AFP=400 ng/ml and PIVKA-Ⅱ=55 mAU/ml were respectively set as the cut-off-value and combined with CEUS in determining the quality of FLL, much superior to any parameter did alone(P＜0.05). Conclusion Sonazoid CEUS and serum AFP and PIVKA-II level combination isgenerally accuracy in diagnosing quality of focal liver lesions, which might help clinicians make an appropriate intervention as early as possible.

Objective The aim of this study was to investigate antiviral efficacy of entecavir (ETV) based on Beijing Standard in patients with hepatitis B-induced liver cirrhosis (LC). Method 145 patients with hepatitis B-induced LC were treated with ETV for 12 months in our hospital between July 2021 and July 2024. Serum HBV DNA loads were detected by PCR, and liver stiffness measurement (LSM) was finished by FibroScan 502 elastography. Liver biopsies was completed and evaluated by Ishak and Knodell scores, and reassessed by Beijing standard for predominantly progressive (P), indeterminate(I) and predominately regressive (R) typing. Result By end of 12 month treatment, liver histo-pathological examination showed out of the 145 patients with LC, liver injuries demonstrated in P typing, I typing and R typing were 45 cases(31.0%), 32 cases (22.1%) and 68 cases (46.9%), respectively; alcohol hobby, serum HBV DNA load and HBsAg levels at baseline in P group were 46.7%, (7.6±1.8)lg IU/mL and (8751.9±220.5)IU/mL, all significantly higher than [23.5%, (5.7±1.6)lg IU/mL and (2003.0±60.9)IU/mL, respectively, P<0.05] in R group or [34.4%, (6.5±1.7)lg IU/mL and (4312.4±111.4)IU/mL, respectively, P<0.05] in I group; by end of 12 month treatment, serum ALT, AST, LSM, Ishak score and histological activity index score in P group were (47.9±13.1)U/L, (53.1±14.2)U/L, (6.7±1.7)kPa, (3.6±0.4) points and (5.1±0.5)points, all significantly higher than [(36.2±10.9)U/L, (37.0±11.2)U/L, (5.2±1.2)kPa, (3.2±0.3) points and (4.5±0.3)points, respectively, P<0.05] in R group; serum ALT normalization rate and HBV DNA loss rate in P group were 46.7% and 71.1%, both much lower than 100.0% and 100.0%(P<0.05) in R group. Conclusion Liver histo-pathological response to ETV antiviral treatment varies, which might assessed by Beijing standard for efficacy classification.

Objective This study aimed to summarize the clinical features and clinical outcomes of patients with anti-tumor drug-induced liver injury (DILI). Methods A total of 197 patients with anti-tumor DILI were encountered in this study between January and December 2024, and the clinical types were recorded. Clinical outcomes were observed after active liver protection treatment. Results Of the 197 patients with DILI, there were 26 cases of mixed type, 54 cases of cholestasis type and 117 cases of hepatocyte injury type; proportion of anorexia in hepatocyte injury type group was 47.9%, significantly higher than 25.9% in cholestasis type group or 25.0% in mixed type group (P<0.05); serum GGT and ALP levels in hepatocyte injury group were (241.6±79.3)U/L and (99.7±22.8)U/L, both much lower than [(835.2±274.8)U/L and (269.4±78.5)U/L, respectively, P＜0.05] in cholestasis type group or [(439.7±145.1)U/L and (203.2±66.9)U/L, respectively, P＜0.05] in mixed type group, while serum AST and ALT levels were (382.4±126.7)U/L and (601.9±183.5)U/L, both much higher than [(124.9±41.3)U/L and (109.8±32.7)U/L, respectively, P＜0.05] in cholestasis type group or [(140.5±46.2)U/L and (126.4±42.8)U/L, respectively, P＜0.05] in mixed type group; percentage of severe liver injury in patients with hepatocyte injury was 29.9%, much lower than 61.1% in patients with cholestasis type or 53.9% in those with mixed injury(P＜0.05); liver function tests returned to normal in 175 cases (88.8%) and didn’t in 22 cases (11.2%), and there were no significant differences among liver function recovery rates in the three groups(P＞0.05). Conclusion Anti-tumor immune, targeting and chemotherapy might induced DILI easily, and the hepatocyte injury type is very common. The prognosis is usually good with discontinuing anti-tumor medicines in time and active liver protecting treatment.

Objective The purpose of this study was to investigate prevalence of and risk factors for overt hepatic encephalopathy (OHE) in patients with liver cirrhosis (LC) with portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS) placement. Methods A total of 118 patients with hepatitis B-induced LC and PH were encountered in our hospital between October 2023 and June 2025, and all underwent TIPS placement routinely. Multivariate Logistic regression analysis was applied to find risk factors for occurrence of OHE. Results The prevalence of OHE was 22.9% after TIPS in our series;percentages of HE history, Child-Pugh class C and sarcopenia in patients with OHE were 25.9%, 81.5% and 66.7%, all significantly higher than 8.8%, 22.0% and 16.5%, and MELD score, INR, blood ammonia and diameter of stents were 16(12,19)points, (1.3±0.2), (78.5±22.6)μmol/L and (10.4±1.2)mm,all significantly higher or greater than [12(10,15)points,(1.2±0.2), (32.9±9.4)μmol/L and (8.9±1.1)mm,P<0.05] in those without OHE, Δportal pressure gradient (ΔPPG) was(10.3±3.6)mmHg, much greater than [(7.5±3.2)mmHg, P<0.05] in those without OHE; multivariate Logistic regression analysis showed that HE history (OR=3.25,P=0.041), Child-Pugh clas C(OR=2.62,P=0.033), MELD score (OR=1.12,P=0.018), serum albumin level (OR=0.92,P=0.031), blood ammonia level (OR=1.28,P=0.004), concomitant sarcopenia (OR=2.15,P=0.048), stent diameter (OR=2.80,P=0.023) and ΔPPG(OR=3.10,P=0.009) were all the independent risk factors for OHE occurrence. Conclusion The occurrence of OHE after TIPS in patients with HBV-induced LC is very common, and appropriate prevention and management might improve patients’quality of life.

Objective The purpose of this study was to investigate risk factors impacting re-bleeding in patients with esophageal and gastric varices bleeding (EGVB) after endoscopic variceal ligation (EVL)treatment. Methods A total of 196 patients with EGVB were admitted to Changsha Central Hospital Affiliated to University of South China between January 2021 and January 2024, and 146 cases were assigned to training set and another 50 cases were assigned to validation set. All patients received EVL, some of them were treated with polidocanol injection in combination, and followed-up for 14 days. Multivariate Logistic regression analysis was applied to find risk factors, and receiver operating characteristic curve (ROC) was drawn to evaluate prediction efficacy. Results Re-bleeding was found in 55 patients (28.1%), of which, 40 cases (27.4%) in training set and 15 cases (30.0%, P>0.05) in validation set, out of our 196 patients with EGVB after treatment; in re-bleeding group, the diameter of esophageal varices (EV) was(1.0±0.2)cm, the number of ligation rings was (12.2±3.8) and the number of ligation times was (2.4±1.2), all significantly greater than [(0.7±0.1)cm, (10.4±3.1) and (2.4±1.2), respectively, P＜0.05] in non-re-bleeding group; multivariate Logistic regression analysis showed that diameter of EV, ligation rings and ligation times were all the independent risk factors for re-bleeding(P＜0.05); the ROC analysis demonstrated that the area under the curve (AUC) was 0.830(95%CI:0.767-0.881), with sensitivity (Se) of 84.2% and specificity (Sp) of 71.3% when the model we established was used to predict in the training set, and the AUC was 0.823(95%CI:0.761-0.875), with Se of 87.8% and Sp of 74.5% in validation set. Conclusion Clinicians should take risk factors for re-bleeding into consideration in clinical practice, and take an appropriate measures to deal with it for improving efficacy of hemostasis.