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 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 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 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 magnetic resonance cholangiopancreatography (MRCP) and abdominal CT scan in preoperative evaluation of surgical difficulty in patients with gallstones and cholecystitis. Methods A total of consecutive 102 patients with gallstones and cholecystitis were encountered in our hospital between January 2022 and June 2024, and all underwent laparoscopic cholecystectomy (LC). Prior to operation, all patients received MRCP and abdominal CT scan. Operation difficulty was evaluated according to literature report, and readability of cystic arteries and cystic ducts were assessed based on imaging. Results Of the 102 patients with gallstones and cholecystitis, the imaging showed types of cystic arteries weretypeⅠa in 81 cases, type Ⅰb in 9 cases, type Ⅱa in 5 cases and type Ⅱb in 7 cases, with normal shape in 81 cases (79.4%), and abnormal in 21 cases (20.6%); the imaging also showed normal cystic duct shape in 85 cases (83.3%) and abnormal in 17 cases (16.7%);the scores of gallbladder artery display and gallbladder duct display in24 patients with surgical difficulty as assessed pre-operationally were (1.3±0.3) points and (1.4±0.3)points, both significantly lower than [(1.6±0.3) points and (1.7±0.3)points, respectively, P＜0.05] in 78 patients with operation easily, while the gallbladder wall thickness, gallbladder volume and stone diameter were (10.1±2.3)mm, (53.2±8.3)mm³ and (18.2±3.3)mm, all significantly greater than [(7.5±2.1)mm, (46.4±7.1)mm³ and (14.4±5.1)mm, respectively, P＜0.05] in easy operation group. Conclusion MRCP and abdominal CT scan could clearly display anatomic structure around gallbladder artery and cystic duct, which might help evaluate pre-operationally LCdifficulty in patients with gallstones and cholecystitis.

Objective The aim of this study was to investigate the clinical efficacy of silymarin and diammonium glycyrrhizinate combination in the treatment of patients with non-alcoholic steatohepatitis(NASH). Methods 97 patients with NASH were encountered in our hospital between October 2022 and June 2024, and were randomly assigned to receive oral diammonium glycyrrhizinate in control (n=48), or to receive diammonium glycyrrhizinate with combination of silymarin in observation (n=49) at base of sport exercise and food guidance for six months. Serum hyaluronic acid (HA), laminin (LN), IV collagen (Ⅳ-C) and III procollagen (PCⅢ) levels were assayed by RIA, and serum interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) and IL-6 levels were detected by ELIS. Liver stiffness measurements (LSM) and controlled attenuation parameter (CAP) were measured by Fibrotouch. Results By end of six month treatment, serum ALT, AST, GGT levels, and LSM and CAP in the observation group were (49.4±4.2)U/L, (41.1±3.9)U/L, (60.1±5.5)U/L, (7.3±1.2)kPa and (272.3±10.6)dB/m, all significantly lower than [(57.2±6.3)U/L, (49.5±5.2)U/L, (81.5±7.3)U/L, (8.8±2.5)kPa and (289.5±13.8)dB/m, respectively, P<0.05] in the control; serum HA, Ⅳ-C and PCⅢ levels were (62.1±5.7)μg/L, (60.5±6.2)μg/L and (90.3±10.4)μg/L, all much lower than [(73.2±7.4)μg/L, (68.2±8.7)μg/L and (148.5±13.7)μg/L, respectively, P<0.05] in the control; serum IL-10 level was (30.5±7.6)mg/L, much higher than [(25.2±6.3)mg/L, P<0.05], while serum TNF-α and IL-6 levels were (13.1±3.8)mg/L and (13.6±4.0)ng/L, both much lower than [(26.2±5.7)mg/L and (20.1±6.4)ng/L, respectively, P<0.05] in the control group. Conclusion Combination of oral silymarin and diammonium glycyrrhizinate at base of sport and diet guidance in patients with NASH is short-termly efficacious, which needs further clinical investigation.

Objective The aim of this study was to investigate short-term efficacy of Wuzhi capsule, a herbal medicine compound, and compound glycyrrhizin combination in the treatment of patients with non-alcoholic steatohepatitis(NASH). Methods 120 patients with NASH were encountered in our hospital between May 2021 and December 2024, and were randomly assigned to receive compound glycyrrhizin intravenously in 60 cases in the control or to receive oral herbal medicine plus compound glycyrrhizin in another 60 cases in the observation for 8 weeks. Serum procollagen-III (PC-III),laminin (LN),collage type Ⅳ(IV-C) and hyaluronidase (HA) levels were detected by RIA; serum(cortisol(COR),glutathione (GSH),superoxide dismutase(SOD) and malondialdehyde (MDA) levels were assayed by chemiluminescence; Serum interleukin-6 (IL-6),IL-1βand tumor necrosis factor-α(TNF-α) levels were determined by ELISA. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were determinedby Fibrotouch. Results By end of eight week treatment, serum alanine aminotransferase,aspartate aminotransferase and γ-glutamyl transpeptidase levels in the observation group were (38.9±2.7)U/L, (31.8±5.0)U/L and (46.7±3.8)U/L, all significantly lower than [(57.1±6.9)U/L, (43.7±6.9)U/L and (70.1±6.2)U/L, respectively, P＜0.05] in the control; serum HA, PC-III and IV-C levels were (132.3±21.8)ng/mL, (85.2±17.0)mg/L and (34.6±5.0)μg/L, all significantly lower than [(181.9±20.6)ng/mL, (122.4±15.3)mg/L and (65.8±7.2)μg/L, respectively, P＜0.05] in the control group; serum COR and MDA levels were (231.7±23.6)nmol/L and (1.9±0.7)μmol/L, both much lower than [(390.7±30.5)nmol/L and (5.0±1.2)μmol/L, respectively, P＜0.05], while serum GSH and SOD levels were (85.1±9.8)mg/L and (187.3±19.2)U/ml, both much higher than [(49.6±7.4)mg/L and (151.2±14.3)U/ml, respectively, P＜0.05] in the control; CAP was (271.9±17.6)db/m, much lower than [(287.2±25.1)db/m, P＜0.05], and serum cytokine levels were also much lower than in the control group (P＜0.05). Conclusion Combiantion ofWuzhi capsule and compound glycyrrhizin in treatment of patients with NASH is short-termly efficacious, which might relieve oxidative stress and cytokine reactions.

Objective This study was conducted to investigate targeted and immunotherapy plus transarterial chemoembolization (TACE) in the treatment of patient with primary liver cancer (PLC). Methods A total of 100 PLC patients were encountered in our hospital between May 2021 and April 2023, randomly divided into control (n=50) and observation (n=50) groups, and all patients in the two groups underwent TACE for two to five times. Patients in the observation group received target medicine, including apatinib or cangvatinib, and immunomodulators, including carilizumab or trelizumab, etc., combination therapy for three months. Peripheral blood lymphocyte subsets were detected by FCM, serum AFP level were routinely obtained, and serum macrophage metastasis inhibitor (MIF) and vascular endothelial growth factor (VEGF) levels were determined by ELISA. Results By end of three month treatment, Objective response rate (ORR) in the observation group was 62.0%, much higher than 42.0% in the control group (P<0.05); after treatment, percentage of peripheral blood CD4⁺ cells and ratio of CD4⁺/CD8⁺cells in the observation group were (46.8±4.6)% and (1.8±0.3), both much higher than [(37.3±4.2)% and (1.3±0.3), respectively, P＜0.05], while percentage of CD8⁺ cells was (25.1±2.4)%, much lower than [(28.5±2.5)%, P＜0.05] in the control; serum AFP, MIF and VEGF levels were (110.2±27.5)μg/L, (55.8±10.1)ng/mL and (180.1±48.7)pg/mL, all significantly lower than [(288.1±31.5)μg/L, (80.1±11.3)ng/mL and (261.1±54.3)pg/mL, respectively, P＜0.05] in the control; by end of one-year follow-up, survival rate in the observation group was 66.0%, not statistically significantly different as compared to 46.7% in the control group (Log-Rank=2.643, P=0.104). Conclusin Targeted and immunotherapy with combination of TACE in dealing with patients with advanced PLC could get a satisfactory short-term clinical efficacy, which might be related to improvement of body immune functions, but the long-term efficacy should be investigated further.

Objective The aim of this study was to summarize etiology and prognosis of children with non-hepatophilic viral infection with liver injury. Method 102 children with non-hepatotropic virus infection-induced liver injury were encountered in our hospital between January 2022 and December 2023, serum viral RNA loads were assayed by RT-PCR, and liver-protecting procedures were given. Result Of 102 children with non-hepatotropic virus infection-induced liver injury, the etiologies included respiratory tract infection in 43 cases (41.7%), gut infections in 32 cases (31.1%), infectious mononucleosis in 10 cases (9.7%), drug-induced liver injury (DILI) in 9 cases (8.8%)and hand-foot-mouth disease in 8 cases(7.8%); fever in 58 cases (56.9%), diarrhea in 37 cases (36.3%), cough in 33 cases (32.4%), nausea and vomiting in 27 cases (26.5%), anorexia in 17 cases (16.7%), itching in 3 cases(2.9%); hepatomegaly in 26 cases (25.2%), lymphadenopathy in 21 cases (20.6%), tonsillitis in 19 cases (18.6%), splenomegaly in 13 cases (12.8%), rash in 8 cases (7.8%) and eyelid edema in 6 cases (5.9%); liver function tests recovered at 7 to 18 days, averaged in two weeks, in 73 cases (71.6%), and other 29 children (28.4%) got their liver function tests normal after 4 to 6 (average 5) week treatment. Conclusion The common causes of liver damage in children with non-hepatotropic virus infection are mainly respiratory tract, intestinal infection, and infectious mononucleosis. The overall prognosis of children with non-hepatotropic virus infection-induced liver injury is good as protecting liver function treatment is given.

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 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 This experiment aimed to investigate the mechanism by which dual specificity protein phosphatases 10(DUSP10) mediates lenvatinib resistance by through regulating stemness characteristics in hepatocellular carcinoma (HCC) in vitro. Methods Lenvatinib-resistant cell lines, e.g., Huh7-resistant and Hep3B-resistant, were established, and stable DUSP10-overexpressing (Huh7 and PLC/PRF/5) and knockdown (Huh7-resistant, Hep3B-resistant, Hep-12) cell models were constructed. Western blot was conducted to detect stemness markers (Nanog, BMI1, ABCG2) expression, and CCK-8 assay was performed to determine IC50 values and calculate the resistance index (RI). Results DUSP10 expression in resistant cell lines was up-regulated by 2.1 to 3.8 fold compared to in wild-type cells (P<0.01); overexpression of DUSP10 increased the IC50 of lenvatinib in Huh7 cells from 1.376 μM to 28.44 μM (RI=20.67) and in PLC/PRF/5 cells from 4.118 μM to 18.01 μM (RI=4.37), accompanied by a 1.5 to 2.3 fold up-regulation of stemness genes; conversely, DUSP10 knockdown reduced the IC50 in Huh7-resistant, Hep3B-resistant, and Hep-12 cells by 6.53 fold, 12.02 fold, and 3.29 fold, respectively (all P<0.001), with a 40% to 60% down-regulation of stemness genes. Conclusion DUSP10 significantly decreases the sensitivity of HCC cells to lenvatinib by probably up-regulating stemness-related genes, such as Nanog/BMI1/ABCG2, and targeting the DUSP10-stemness pathway might reverse drug resistance.

Objective The aim of this study was to investigate immunological response of infants born to hepatitis B viral infected mothers to hepatitis B vaccination and its influencing factors. Methods 86 HBV-infected pregnant women and their 86 infants were encountered in our hospital between January 2019 and December 2020, and out of the 86 hepatitis B viral carriers, 64 women received oral tenofovir at 28 gestational week for blocking hepatitis B viral mother-to-infant transmission until delivering. All infants received hepatitis B immunoglobulin and hepatitis B vaccine routinely, and were followed-up for three years. Serum HBsAg and anti-hepatitis B surface antigen antibody (HBsAb) were detected by ELIS, and serum HBV DNA loads was assayed by PCR. Results By delivery, serum HBV DNA loads transferred to negative in tenofovir-treated women, and by end of three-year follow-up, serum HBsAb positive in 82 infants(95.3%), including weak positive in 16 cases (19.5%) and strong positive in 66 cases (80.5%), and negative in 4 infants (4.7%) in the 86 infants; concomitant diabetes percentage in mother with their infants positive response was much lower than in those with weak response (12.1% vs. 31.2%), while birth weights and gestational weeks were significantly heavier than(3442.7±333.1 g vs. 3385.4±370.6 g)or longer than(39.3±1.2 w vs. 37.4±1.2 w) in weak responders (P<0.05); multivariate Logistic regression analysis showed that concomitant diabetes, low infant birth weight and short gestational weeks at birth were all the risk factors impacting immunological response (P<0.05). Conclusion Hepatitis B vaccination might fails in infants who have a hepatitis B viral infection mothers, the surveillance is important and should re-vaccinates sometimes.

Objective This study aimed to investigate iron metabolism index changes in patients with nonalcoholic fatty liver disease (NAFLD). Methods Ninety-eight patients with NAFLD and ninety-eight healthy individuals for physical examination were encountered in Yizheng People's Hospital between January 2022 to March 2024, and all underwent abdominal CT scan and total adipose area (TAA), total skeletal muscle area (SMA), liver-to-spleen CT value ratio (CT_L/S) and visceral adipose volume/subcutaneous adipose volume (VAV/SAV)ratio were measured and calculated by Reformate software. Serum ferritin light chain (FTL)was detected by ELISA, serum iron (SI)and unsaturated iron binding capacity (UIBC) were detected by colorimetry, and transferrin receptor (TRF) were assayed by turbidimetry. Fatty liver degree was determined by ultrasonography. Result Ultrasonography found mild, moderate and severe fatty liver in 31 cases, 33 cases and 34 cases in our series; serum ALT, AST, TG and TC levels in patients with moderate fatty liver were much higher than in those with mild fatty liver or healthy persons (P<0.05), and they were much higher in patients with severe fatty liver than in those with moderate (P<0.05);serumSI, FTLand UIBC levels in patients with moderate fatty liver were (29.6±3.3)μmol/L,(439.5±15.6)μg/L and (73.1±5.7)μmol/L, all much higher than [(20.9±3.9)μmol/L, (417.5±16.6)μg/Land (62.6±6.6)μmol/L, respectively, P<0.05] in patients with mild fatty liver or [(14.3±3.0)μmol/L, (303.6±18.5)μg/L and (50.5±7.5)μmol/L, respectively, P<0.05] in healthy persons, while serum TRF level was (2.6±0.3)g/L, much lower than [(3.0±0.4)g/L, P<0.05] in patients with mild fatty liver or [(3.5±0.6)g/L, P<0.05] in healthy individuals; TAA,SMA and VAV/SAV ratio in patients with moderate fatty liver were much greater (P<0.05), while CT_L/S was much less than in patients with mild fatty liver (P<0.05);TAA, SMA and VAV/SAV ratio in patients with severe fatty liver were much greater (P<0.05), while CT_L/S was much less than in patients with moderate fatty liver(P<0.05). Conclusion Iron metabolism is unstable in patients with NAFLD, which might be related to liver steatosis and inflammation and needs further investigation.

Objective The purpose of this study was to investigate diagnostic performance of ultrasound-derived fat fraction (UDFF) in patients with metabolic associated fatty liver disease (MAFLD). Methods 54 allegedpatients with fatty liver were encountered in our hospital between October and December 2023, and all received MRI proton density fat fraction sequence (MRI-PDFF) and UDFF examination simultaneously. Intragroup correlation coefficient (ICC) was conducted to compare the consistency, and area underreceiver operating characteristic curve (AUC) was applied to assess the diagnostic efficacy. Results Based onMRI-PDFF results, non-fatty liver was found in 16 cases, mild fatty liver in 28 cases, moderate fatty liver in 3 cases and severe fatty liver in 7 cases; UDFF in 10 patients with moderate/severe fatty liver was 20.5(15.8, 28.0) %, much higher than [13.0(11.0,17.0)%, P＜0.01] in 28 patients with mild fatty liver or [5.5(4.0,7.0)%, P＜0.01] in 16 persons without fatty liver; ICC between MRI-PDFF and UDFF was 0.808,presenting as satisfactory diagnostic consistency; AUC in diagnosing MAFLD by UDFF was 0.987 (P<0.001), when the cut-off value was set as 8.0%,with the sensitivity (Se) of 97.4%, and the specificity (Sp) of 93.8%, and the AUC in diagnosing moderate/severe fatty liver was 0.908(P<0.001), when the cut-off value was set as 14.0%, with Se of 91.7% and Sp of 79.6%; our study didn't found difference of point shear wave elastography (pSWE) among individuals with or without fatty liver(P>0.05). Conclusion We recommendUDFF for diagnosis of metabolic associated fatty liver disease as its excellent efficacy, while the application of pSWE still needs multiple center validation.

Objective Theaim of this study was to compare clinical efficacy of lauromacrogol or anhydrous alcohol sclerotherapyin the treatment of patients with simple hepatic cysts(SHC) under ultrasound (US) guidance. Methods An consecutive 58 patients with SHC were encountered in the First Hospital of Yulin between June 2022 and January 2024, and were randomly divided into lauromacrogolgroup (n=28) and ethanol group (n=30). Patients received percutaneous transhepatic puncture under US guidance for cyst fluid extraction, then the sclerotherapy was carried out. Serum Golgi protein 73 (GP73), protein disulfide isomerase A3 (PDIA3) and chitosinase 3-like protein 1 (CHI3L1) levels were detected by ELISA, and post-operational pain was evaluated by visual analogue scale (VAS) score. Results At three days post-operationally, serumGP73, PDIA3 and CHI3L1 levels in patients with lauromacrogol sclerotherapy were (24.0±4.7)pg/L, (73.2±6.6)ng/ml and (41.7±4.5)ng/L, all much lower than [(36.7±6.1)pg/L, (92.8±7.9)ng/ml and (65.8±6.3)ng/L, respectively, P<0.05] in patients with ethanol sclerotherapy; at 2hour and 24hour, the resting and motion VAS scores in lauromacrogol group were all much lower than in ethanol group (P<0.05); incidence of adverse effects in lauromacrogol group was 14.3%, much lower than 36.7%(P<0.05) in ethanol group; by end of six months after treatment, disappearance rate of cysts in lauromacrogol group was 78.6%, much higher than 53.3%(P<0.05), and reduction of cyst volume was (93.7±9.7)%, much higher than [(83.0±9.2)%, P<0.05] in ethanol group. Conclusion Our results suggest that US-guided liver cyst puncture and fluid drainage with lauromacrogol sclerotherapy in dealing with patients with SHC has a satisfactory efficacy with less adverse effects.

Objective The aim of this study was to summarize magnetic resonance imaging (MRI) manifestation of atypical focal nodular hyperplasia (FNH) of the liver. Methods 116 patients with liver FNH were encountered in our hospital between January 2022 and July 2024, all underwent plain, enhanced MRIscan, including diffusion weighted imaging (DWI), and the diagnosis was confirmed by biopsies or post-operational histo-pathological examinations. Results Of the 116 patients with liver FNHA, all had solitary intrahepatic nodule, located at right and/or left lobe, with diameters of 1.0to 11.2 cm, averaged with (6.1±1.3)cm, including≤2.0 cm in 31 cases, 2.0-5.0 cm in 51 cases and ＞5.0 cm in 34 cases; equal or slightly lower signals on T1WI, equal or slightly higher signals on T2WI, slightly higher signals on DWI, high signals at arterial phase, slightly high or equal signals at portal phase, equal or low signals at delayed phase, and high or equal signals at hepatobiliary phase; without central scar in 49lesions(42.2%),with pseudocapsule in 69lesions(59.5%),with internal bleeding or necrosis in 43lesions (37.1%),with fat infiltration in 37lesions (31.9%) and without significant enhancement at arterial phase in 56lesions(48.3%); percentages of without central scar, pseudocapsule, internal bleeding or necrosis, fat infiltration and non-significant enhancement at arterial phase in lesions >5.0cm were 64.7%, 88.2%, 61.8%, 52.9%and 73.5%, all significantly higher than 41.2%, 56.9%, 35.3%,31.4% and 47.1%(P＜0.05)in lesions of 2.0 to 5.0 cm or 19.4%, 32.3%, 12.9%, 9.7%and 22.6%(P＜0.05)in ≤2.0 cm of lesions. Conclusion Liver FNH, including atypical ones could have specific MRI feature, which might help clinicians make an appropriate measures to deal with.

Objective The aim of this study was to compare conventional and contrast-enhanced ultrasonography (CEUS) features of hepatocellular carcinoma (HCC0 and intrahepatic cholangiocarcinoma(ICC) for differentiation of the two entities. Methods 86 patients with HCC and 16 patients with ICC were encountered in our hospital between March 2019 and May 2024, and all underwent conventional and contrast-enhanced ultrasonography. The imaging features were compared between the two malignant tumors. Results There were no significant differences as respect to numbers of intrahepatic space-occupying lesions, shapes, diameters, intratumor echos, echo features and portal thrombosis between the two groups (P＞0.05), while the percentage of bile duct dilatation in patients with ICC was 37.5%, much higher than 2.3%(P＜0.05)in those with HCC; CEUS demonstrated that percentages of arterial-phase ring enhancement, arterial-phase hypo-enhancement, portal-phase hypo-enhancement andclearing time at delayed phase in ICC group were 37.5%, 18.8%, 93.8% and (45.2±8.1)s, all significantly higher or shorter than 10.5%, 2.3%,59.3% and (66.7±11.8)s in HCC group (P＜0.05). Conclusion The imaging features, such as bile duct dilation, arterial phase enhancement mode, arterial phase enhancement characteristics, and significant differences in clearance time in patients with ICC and HCC are obvious different, which might help clinicians differentiate the two liver cancers.

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 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 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 aim of this experiment was to investigate molecular mechanism of diethyldithiocarbamate (DDC) in improving metabolic dysfunction associated steatohepatitis (MASH) by regulating Insr/Akt signaling pathway. Methods 18 male C57BL/6 mice were randomly divided into control, MASH and DDC-intervened group (n=6 in each) and MASH model was established by feeding a choline-deficient, L-amino acid-defined (CDAA) diet, and the intervention was carried out by DDC gavage simultaneously. The expression of insulin receptor (Insr) and pro-apoptotic molecule, e.g., Bax in mouse liver tissue were detected by real-time PCR and Western blot. Model of lipotoxicity was established by induction of palmitic acid (PA) on AML12 cells, and was treated with DDC simultaneously. The expression of Insr, Akt, pAkt, Bax and Bcl2 were detected by Western blot. Results Insr mRNA level in liver tissue in MASH group was (0.38±0.13), significantly lower than [(1.03±0.27), P<0.05] in the control; the expression of Insr protein in liver tissues in MASH group was (0.61±0.11), significantly lower than [(1.68±0.58),P<0.05] in the control, while the expression of Insr protein in liver tissues in DDC-intervened group was (1.03±0.11), significantly higher than that in MASH group (P<0.05); the expression of Bax protein in liver tissue in MASH group was (1.14±0.39), significantly higher than [(0.47±0.26), P<0.05] in the control; the expression of Bax protein in liver tissues in DDC-intervened group was (0.66±0.19), significantly lower than that in MASH group (P<0.05); the expression of Insr protein in AML12 cells in PA group was (0.38±0.13), significantly lower than [(0.74±0.21), P<0.05] in the control, while the expression of Insr protein in AML12 cells in DDC-intervened group was (0.71±0.20), significantly higher than that in PA group (P<0.05); the ratio of pAkt/Akt protein in AML12 cells in PA group was (0.28±0.07), significantly lower than [(0.69±0.06), P<0.05] in the control, while the ratio of pAkt/Akt protein in AML12 cells in 25 μM or in 50 μM DDC-intervened groups were (0.85±0.02) and (0.97±0.04), both significantly increased than in PA group (P<0.05); the ratio of Bcl2/Bax in AML12 cells in PA group was (1.28±0.29), much lower than [(1.74±0.10),P<0.05] in the control, while the ratio of Bcl2/Bax in AML12 cells in DDC-intervened group was (2.30±0.78), much higher than that in PA group (P<0.05). Conclusion The Insr/Akt pathway is inhibited and apoptosis is increased in liver tissues in mice with CDAA diet-induced MASH, and DDC might inhibit hepatocyte apoptosis by stimulating Insr/Akt signaling pathway, thereby improving MASH progression.

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 clinical efficacy of rosiglitazone and metformin combination in the treatment of patients with non-alcoholic fatty liver disease (NAFLD)and type 2 diabetes mellitus(T2DM). Methods A total of 98 patients with NAFLD and T2DMwere enrolled in our hospital between January 2023 and March 2024, and were randomly assigned to receive oral metformin (control, n=49) or combination of metformin and rosiglitazone (observation, n=49) for six months. Serum high density lipoprotein cholesterol(HDL-C), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) levels were routinely detected. Fasting insulin level was detected by radioimmunoassay. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were detected by Fibroscan. Results By end of six-month treatment, serum HDL-C level in the observation group was(1.3±0.3)mmol/L, much higher than [(1.1±0.2)mmol/L, P＜0.05], while serum TG level was(2.0±0.3)mmol/L, much lower than [(2.9±0.5)mmol/L, P＜0.05] in the control; fasting insulin level in the observation was (6.5±1.3)μU/ml, much lower than [(7.4±1.6)μU/ml, P＜0.05] in the control, while there were no significant differences as respect to HbA1c and FBG between the two groups(P>0.05); serum AST and CAP were (38.9±4.3)U/L and (266.1±10.7)dB/m, both much lower than [(45.4±4.8)U/L and (286.0±11.9)dB/m, respectively, P＜0.05]in the control group. Conclusion Rosiglitazone and metformin combination in the treatment of patients with NAFLD and T2DM could improve lipid metabolism disorder, which is worthy of further clinical study.

Objective The aim of this study was to investigate ultrasound-guided polidocanol sclerotherapy in patients with hepatic cysts (HC). Methods Ninety-one patients with HC were recruited in Henan Provincial Children's Hospital between March 2022 and March 2024, and were randomly divided into control group (n=45) and observation group (n=46), receiving ethanol sclerotherapy, or polidocanol sclerotherapy under ultrasound-guidance. Serum Golgi protein 73 (GP73), protein disulfide isomerase A3 (PDIA3) and chitinase 3-like protein 1 (CHI3L1) levels were detected by using automatic immunoassay analyzer, and serum superoxide dismutase (SOD), nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) levels were measured by ELISA. Results After treatment, serum ALT and AST levels in the observation group were 48.4±9.2U/L and 38.4±7.3U/L, both significantly lower than [59.8±11.3U/L and 62.0±14.3U/L, P<0.05] in the control; serum GP73, PDIA3 and CHI3L1 levels were 24.4±3.6pg/L, 67.7±5.2ng/mL and 46.4±5.8ng/L, all much lower than [36.4±5.1pg/L, 92.7±5.4ng/mL and 65.8±6.4ng/L, respectively, P<0.05] in the control group; serum SOD, Nrf2 and HO-1 levels were 83.5±8.3 U/L, 713.3±82.3 U/L and 27.7±3.1U/L, all much higher than [77.5±7.8U/L, 664.7±75.3U/L and 23.7±2.5U/L, respectively, P<0.05] in the control; post-operationally, incidence of adverse effects in the observation group was 6.5%, much lower than 24.4%(P<0.05)in the control; six months after sclerotherapy, disappearance rate of HC in the observation group was 87.0%, much higher than 66.7%(P<0.05)in the control group. Conclusion Our observation backs up lauromacrogol sclerotherapy under ultrasound-guidance in patients with HC, which is efficacious and safe.

Objective The purpose of this experiment was to investigate the protective effect of histone deacetylase (HDAC) inhibitor ACY1215 on acute liver failure (ALF) in mice and to explore its possible mechanism. Methods 18 mice were randomly divided into control, model and ACY1215-intervened group, with 6 in each. The ALF model was induced by intraperitoneal injection of lipopolysaccharide (LPS) and D-galactosamine (D-Gal). Liver tissue PANoptosis associated protein expression, such as receptor-interacting serine-threonine kinase 1(RIPK1), gas derivative D protein (GSDMD), Caspase-3, Caspase-8 and mixed lineage kinase domain protein (ML) were detected by Western blot. Results Liver histopathological examination showed that disordered intrahepatic parenchymal cell arrangement, with lamellar cell necrosis, a large number of blood cell exudation, and inflammatory cell infiltration in ALF group, while liver tissue damage alleviated in ACY1215-intervened group; serum ALT, AST and total bilirubin levels in ALF group were (3279.8±639.0)U/L,(2510.1±383.2)U/L and (85.5±6.8)μmol/L, while they all decreased to [(987.6±254.3)U/L, (426.3±105.6)U/L and (38.1±8.9)μmol/L, respectively, P<0.05] in ACY1215-intervened group; intrahepatic tissue PANoptosis-related protein, such as RIPK1, GSDMD, Caspase-3, Caspase-8 and MLKL intensified in ALF group, while they all obviously weakened in ACY1215-intervened group (P<0.05). Conclusion Histone deacetylase inhibitor ACY1215 could play a protective role in mice with ALF, probably by regulating PANoptosis-related protein expression.

Objective The aim of this study was to compare conventional ultrasonography and contrast-enhanced ultrasonography(CEUS) in assessing stent function in patients with cirrhotics with portal hypertension (PH) after transjugular intrahepatic portosystemic shunt (TIPS) treatment. Methods 80 patients with hepatitis B-induced liver cirrhosis (LC) with PH were encountered in our hospital between November 2021 and October 2024, and all underwent TIPS routinely. Patients received digital subtraction angiography (DSA), conventional ultrasonography and CEUS examinations after surgery. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate diagnostic efficacy, and diagnostic consistency was assessed by Kappa analysis. Results By end of six months after TIPS, DSA found stent function normal in 73 cases(91.3%) and disabled stent function in 7 cases (8.7%) in the 80 patients with LC; conventional ultrasound found disabled stent function in 5 cases and CEUS found in 6 cases; the AUC was 0.857(95%CI:0.761-0.925)by conventional ultrasound in judging stent function disable, with sensitivity(Se), specificity(Sp), accuracy(Ac), positive predictive value (PPV) and negative predictive value (NPV) of 57.1%, 98.6%, 95.0%, 80.0% and 96.0%, and the AUC was 0.929(95%CI:0.848-0.974)by CEUS, with Se, Sp, Ac, PPV and NPV of 71.4%, 98.6%, 96.3%, 83.3% and 97.3%, respectively, with the consistence satisfactory (Kappa>0.640). Conclusion We recommend conventional ultrasonography for assessing stent function in patients with cirrhotic portal hypertension after TIPS, and CEUS could be done unless necessary.

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 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 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 The aim of this study was to investigate impacting factors of poor response to immunosuppressive therapy in patients with autoimmune hepatitis (AIH). Methods 57 patients with AIH were enrolled in this study between January 2022 and June 2023, and all received liver biopsies. All patients were treated by prednisone or prednisone with combination of azathioprine. Blood biochemical indexes and immunoglobulin levels were routinely detected. Serum autoimmune antibodies were assayed by Western blot. Impacting factors of response was analyzed by multivariate Logistic regression. Results By end of one-year treatment, the complete response (CR) rate to immunosuppressive therapy in the 57 patients with AIH was 75.4%; ages, percentages of liver cirrhosis, ascites and Child-Pugh score in patients with partial response (PR) were 57(44, 62)yr, 64.3%, 42.8% and 10(8, 12)points, all significantly greater or higher than [53(41, 60)yr, 18.6%, 11.6% and 6(5, 8)points, respectively, P<0.05] in those with CR; PLT counts and serum albumin level in patients with PR were 81(67,105)×10⁹/L and 32.3(30.0, 36.7)g/L, both significantly lower than [131(96, 210)×10⁹/L and 36.8(34.5, 39.5)g/L, respectively, P<0.05], while total serum bilirubin (TSB) level, international normalized ratio of prothrombin time, serum IgM and IgG levels in patients with PR were 56.9(30.1, 132.5)μmol/L,1.3(1.1, 1.6),14.0(12.3, 16.7)g/L and 17.7(14.5, 19.4)g/L, all much higher than [34.3(16.7, 67.9)μmol/L, 1.1(1.0, 1.2),11.2(9.4, 13.2)g/L and 12.5(10.7, 14.6)g/L, respectively, P<0.05] in those with CR; there were no significant differences as respect to interfacial hepatitis, Rosette-like manifestations, plasma cell infiltration and bile duct damages between the two groups (P>0.05);multivariate Logistic regression analysis showed that liver cirrhosis (OR=6.283, 95%CI:1.728-10.769,P=0.002), TSB (OR=11.158, 95%CI:2.200-18.758, P=0.001) and serum IgG level (OR=16.894, 95%CI:4.118-30.018, P<0.001) were the independent factors impacting response to immunosuppressive therapy. Conclusion Clinicians should take some impacting factors into consideration when immunosuppressive therapy is administered in patients with AIH, and optimization of treatment might carry out as necessary as possible.

Objective The aim of this study was to investigate influencing factors on postoperative stone residual and recurrence in patients with intrahepatic bile duct stones (IHBDS) after partial hepatectomy (ph) and cholangioenterostomy. Methods 50 patients with IHBDS were encountered in our hospital between January 2019 and January 2022, all underwent PH and choledochojejunostomy and were followed-up for one year. Serum C-reactive protein (CRP) and interleukin- 6 (IL-6) levels were detected by ELISA. Multivariate Logistic regression analysis was applied to predict impacting factors of stone residual or recurrence. Results By end of one-year follow-up, stoneresidual was found by imaging in 10 cases (20.0%) among our 50 patients with IHBDS; at baseline, percentages of bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture in patients with residual stone or recurrence were 60.0%, 60.0% and 80.0%, all much higher than 20.0%, 20.0% and 35.0% (P<0.05) in patients without; at presentation, white blood cell count, serum CRP, GGT and IL-6 levels in patients with stone residual were (7.9±0.9)×10⁹/L, (52.7±4.6)mg/L, (252.7±27.4)U/L and (92.5±14.3)μg/L, all significantly higher than [(4.6±0.8)×10⁹/L, (25.6±3.0)mg/L, (143.5±26.0)U/L and (65.3±15.2)μg/L, respectively, P<0.05] in patients without; multivariate Logistic regression analysis showed that bilateral lobe bile stone, common bile duct diameter ≥15 mm and biliary stricture were all the independent risk factors for stone residual or recurrence(OR=3.536, OR=3.695,OR=3.404, respectively, P<0.05). Conclusion The main problem after PH and cholangioenterostomy in patients with IHBDS is stone residual or recurrence, and how to tackle it still need further clinical investigation.

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.