Objective The aim of this study was to observe the combination of glutathione and tiopronin in the treatment of patients with drug-induced liver injury (DILI). Methods 72 patients with DILI were enrolled in our hospital between December 2019 and August 2022, and were randomly divided into control (n=36) and observation (n=36) group, receiving tiopronin alone or tiopronin and glutathione combination treatment for two to four weeks. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were detected by thibabituric acid, xanthine oxidation or dithiobis-nitrobenzoic acid methods, respectively. Serum human heme oxygenase-1 (HO-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), IL-1β and C-reactive protein (CRP) levels were detected by ELISA. Results At the end of treatment, serum ALT and AST levels in the observation group were (40.6±11.5)U/L and (31.0±2.6)U/L, both significantly lower than [(64.6±13.9)U/L and (63.7±15.3)U/L, respectively, P＜0.05] in the control, while there were no significant differences respect to serum bilirubin and GGT levels in the two groups [(16.8±3.9) μmol/L and (59.2±13.3)U/L vs. (20.2±4.2)μmol/L and (60.8±14.7)U/L, respectively, P>0.05]; serum SOD, GSH-Px and HO-1 levels in the observation group were (82.4±12.7)U/L, (99.8±16.6)U/L and (256.7±20.8)U/L, all significantly higher than [(75.6±10.9)U/L, (80.6±15.4)U/L and (197.5±24.9)U/L, respectively, P＜0.05], while serum MDA level was (5.1±0.8)μmol/L, much lower than [(6.2±1.3)μmol/L, P＜0.05] in the control; serum IL-6, TNF-α, IL-1β and CRP levels were (5.1±1.7)pg/mL, (4.4±1.7)pg/mL, (11.2±4.1)ng/mL and (3.9±2.0)mg/L, all significantly lower than [(9.7±1.1)pg/mL, (10.2±1.8)pg/mL, (25.3±4.8)ng/mL and (13.6±2.9)mg/L, respectively, P＜0.05] in the control group. Conclusion The combination of glutathione and tiopronin in the treatment of patients with DILI could effectively improve liver function tests back to normal, which might alleviate body inflammatory and oxidative stress reactions, and warrants further clinical investigation.

The nonalcoholic fatty liver disease (NAFLD) is the most common liver diseases worldwide. Currently, due to the lack of effective drugs for treatment of NAFLD, the scholars recommend reducing body weight and improving metabolism through dietary interventions. In this paper, we summarize the research progress of NAFLD-related dietary interventions and the mechanisms by which they play roles in therapeutic effects in order to better guide clinical practice.

Objective This clinical trial was conducted to compare the anticoagulant efficacy and safety of nafmostat mesylate (NM) and heparin (HP) during double plasma molecular absorption system (DPMAS) treatment in patients with liver failure (LF). Methods 49 consecutive patients with LF or hyperbilirubinemia were encountered in You'an Hospital affiliated to Capital Medical University between April 2022 and March 2023, and all underwent at least twice DPMAS treatment. During the procedure, the anticoagulation was crossed by NM or HP once. The prothrombin time activity (PTA) and activated partial thromboplastin time (APTT) were monitored. Results Out of the 98 DPMAS treatment, the procedure successfully completed in 97 (99.0%), only discontinued once because of plugged pipes induced by insufficient anticoagulation of HP; the satisfactory anticoagulation rate in NM-managed group was 75.5%, significantly higher than 28.6%, and the over anticoagulation rate was 2.0%, much lower than 67.3%(P<0.05)in HP-intervened group; after the procedure, the PTA and APTT in NM anticoagulant group were 20.5(13.8, 38.0)% and 83.3(55.9, 138.8)s, significantly different compared to [19.5(14.6, 31.5)% and 400.0(303.3, 400.0)s, P<0.05] in HP anticoagulant group; there were no significant differences as respect to serum bilirubin, albumin levels and platelet counts between the two groups [(279.7±99.5)μmol/L, (24.4±4.2)g/L and 59.5(42.5, 119.0) ×10⁹/L vs. (271.7±98.1)μmol/L, 23.3(21.4, 26.6)g/L and 83.8±65.9×10⁹/L, respectively, P＞0.05]; 24 hours after DPMAS, the puncture skin haemorrhage was found in one case in HP anticoagulant group, and transient increased transmembrane pressure, or venous pressure or coagulation alert by the machine occurred in two cases in NM anticoagulant group. Conclusion The extracorporeal local anticoagulation of NM during DPMAS in patients with LF is efficacious and safer, and warrants further clinical investigation.

The Epstein-Barr virus (EBV) is one of the members of the human herpesvirus family, which might cause many diseases. The children with EBV infection often have liver injury, which is usually manifested as mild to moderate liver dysfunctions. In severe cases, it can develop into liver failure and even lead to death. Most children with acute EB viral infection recover after supportive treatment. However, in cases of chronic infection or post-transplant infection, the immunomodulatory therapy, chemotherapy, and even bone marrow transplantation may be required in addition to actively management of the underlying diseases. In this review, we describes the comprehensive updates of the epidemiology, pathogenesis, diagnosis, treatment and prognosis of children with liver injury associated with EBV infection.

Objective The aim of this study was to investigate the efficacy of entecavir in treatment of patients with chronic hepatitis B (CHB) and concomitant non-alcoholic fatty liver diseases (NAFLD). Methods 63 patients with CHB and 43 patients with CHB and NAFLD were recruited in this study between June 2019 and August 2021, and all patients received entecavir for anti-viral treatment for 12 months. The controlled attenuation parameter (CAP) of livers was detected byFibroscan-502. Serum HBV DNA loads were detected by fluorescence quantitative polymerase chain reaction. Serum alanine aminotransferase (ALT) levels were determined by automatic biochemical analyzer. Serum HBeAg and HBsAg were assayed by chemiluminescence method. Serum reactive oxide (ROS), adiponectin (ADPN) and tumor necrosis factor-α (TNF-α) levels were determined by ELISA. Results At the end of 6 month and 12 month anti-viral treatment, serum ALT normalization rates in patients with CHB were 69.8% and 92.1%, both significantly higher than 41.9% and 74.4% (P<0.05) in patients with CHB and NAFLD, while there were no significant differences respect to serum HBV DNA loss in the two groups (88.9% and 98.4% vs. 81.4% and 93.0%, respectively, P>0.05); at the end of 12 month treatment, serum ALT level in patients with CHB was (41.9±6.5)U/L, much lower than [(71.5±8.4)U/L, P<0.05] in patients with CHB and NAFLD, and the CAP of liver was (211.8±50.1)dB/m, much lower than [(288.0±13.4)dB/m, P<0.05] in patients with CHB and NAFLD; serum ROS and TNF-α levels in patients with CHB were (403.6±70.2)U/mL and (15.5±5.6)ng/L, both significantly lower than [(628.7±67.5)U/mL and (31.7±6.0)ng/L, respectively, P<0.05], while serum ADPN level was (17.7±1.2)ng/mL, much higher than [(11.5±1.8)ng/mL, P<0.05] in patients with CHB and NAFLD. Conclusion The existence of hepatic steatosis in patient with CHB and NAFLD might reduce the biochemical response to entecavir anti-viral therapy, which needs further investigation when the antiviral regimen is made in this setting.

Objective This study aimed to explore the mechanism of miR-556-3p in the development of hepatocellular carcinogenesis. Methods The miR-556-3p level in cancerous and its adjacent non-cancerous tissues from patients with hepatocellular carcinoma was detected by real-time fluorescence quantitative PCR, and the phosphatase and tensin homolog (PTEN) expression was revealed by immunohistochemistry. The expression patterns of PTEN/ protein kinase B(Akt) signaling pathway-related proteins were detected by Western blotting after transfection of HepG2 cells with miR-556-3p mimic, miR-556-3p NC, PTEN cDNA and PTEN siRNA. The proliferation ability of HepG2 cells was studied by CCK-8 method, the invasion ability of cells was determined by Transwell method, and the apoptosis was detected by flow cytometry. The regulatory roles of miR-556-3p on PTEN/AKT pathway in HepG2 cells were evaluated by bioinformatics. Results The miR-556-3p loads in cancerous tissues was significantly lower than that in para-neoplastic tissues (P<0.05), and the miR-556-3p loads in HepG2 cells was also significantly lower than that in LO2 cells (P<0.05); the luciferase analysis showed that PTEN was a direct target of miR-556-3p; the proliferation rate, invasion rate and apoptosis rate in miR-556-3p-transfected HepG2 cells decreased significantly than in miR NC-transfected cells (P<0.05); the PTEN overexpression reversed the growth inhibition and apoptosis induction of miR-556-3p in HepG2 cells; the miR-556-3p inhibited PTEN/AKT activation by targeting PTEN. Conclusions The miR-556-3p loads decrease in hepatocellular carcinoma tissues, and the miR-556-3p inhibits the proliferation and invasion, and induce apoptosis in HepG2 cells. The PTEN is regulated by miR-556-3p in HepG2 cells. These findings above suggest that miR-556-3p is closely related to the transformation of liver cells, which needs further verification.

Objective The aim of this study was to investigate the efficacy of triglyceride glucose index (TyG)in predicting severity of patients with non-alcoholic fatty liver diseases(NAFLD). Methods 44913 individuals who participated in health examinations at the Health Management Center, Hunan Provincial People's Hospital between January 2020 and December 2022 were enrolled. The diagnosis of NAFLD was made by ultrasonography, and the TyG index was calculated according to literature report. The univariate and multivariate Logistic regression analysis were applied to reveal the risk factors, and the area under receiver operating characteristic curve(AUC) was used to predict the diagnostic efficacy. Results Out of our 44913 participants, there were 15901 patients (35.4%) with NAFLD confirmed; the age, BMI, systolic blood pressure, diastolic blood pressure, serum triglyceride(TG), low density cholesterol(LDL-C), total cholesterol(TC), fasting plasma glucose(FPG), ALT levels and TyG index in patients with NAFLD were(45.9±13.6)years old, (26.5±3.0)kg/m², (129.9±15.9)mm Hg, (78.7±11.2)mm Hg, (2.5±2.4)mmol/L, (3.2±0.9)mmol/L, (5.2±1.0)mmol/L, (5.7±1.6)mmol/L, (38.6±36.1)U/L and (9.1±0.7), all significantly higher than [(40.9±13.8)years old, (22.3±2.7)kg/m², (119.0±15.9)mm Hg, (70.7±10.4)mm Hg, (1.3±1.0)mmol/L, (3.0±0.8)mmol/L, (4.9±0.9)mmol/L, (5.2±0.9)mmol/L, (21.0±19.4)U/L and (8.4±0.5), respectively, P＜0.001], while serum high density cholesterol(HDL-C) levels was (1.1±0.2)mmol/L, significantly lower than [(1.3±1.0)mmol/L, P＜0.001] in individuals without NAFLD; in patients with NAFLD, the systolic blood pressure,diastolic blood pressure,TG,ALT and TyG index in obese group were (133.3±15.3)mm Hg,(82.0±11.3)mm Hg,(2.7±2.5)mmol/L,(46.2±31.5)U/L and (9.2±0.7),all significantly higher than [(129.5±15.7)mm Hg, (78.2±10.9)mm Hg, (2.5±2.4)mmol/L, (37.7±41.0)U/L and (9.1±0.6), P＜0.05] in overweight group and [(125.9±16.4)mm Hg, (74.9±10.7)mm Hg, (2.2±2.3)mmol/L, (30.0±22.2)U/L and (9.0±0.6), P＜0.05] in normal body weight group; the age and serum HDL-C level in the obese group were (42.9±12.8)years old and (1.0±0.2)mmol/L,significantly lower than [(46.6±13.6)years old and (1.1±0.2)mmol/L,P＜0.05] in the overweight group and [(48.3±13.9)years old and (1.2±0.3)mmol/L,P＜0.05] in the normal body weight group; the systolic blood pressure,diastolic blood pressure,blood TG,ALT and TyG index in the overweight group were significantly higher than in the normal body weight group(P＜0.05),and the age and blood HDL-C level in the overweight group were significantly lower than in the normal body weitht group(P＜0.05); the FPG in the obese group was (5.8±1.6)mmol/L,significantly higher than [(5.7±1.5)mmol/L, P＜0.05] in the overweight group; the multivariate Logistic regression analysis showed that the older age, increased BMI, diastolic blood pressure, serum TG, FPG, TyG index, ALT and reduced HDL-C levels were the independent risk factors for NAFLD(P＜0.05), the OR= 1.023, 1.521, 1.014, 0.873, 0.972, 3.992, 1.019 and 0.404, respectively,with the TyG index having the highest OR value; the area under the ROC curve(AUC) by the TyG index for predicting NAFLD was 0.814[95%CI(0.810-0.817), P＜0.001], with an optimal cut-off value of 8.67, the sensitivity of 76.1%, and the specificity of 71.4%, respectively; the AUC by the TyG index combined with BMI and ALT in predicting NAFLD was 0.899[95%CI(0.896-0.901), P＜0.001]. Conclusion The TyG index is an independent risk factor for NAFLD,which has good predictive efficacy for NAFLD,and the predictive performance is enhanced when it combine with BMI and ALT levels. The TyG index might helpful for early diagnosis of NAFLD in outpatient and grassroots hospitals as it is economical,practical,and easy to calculate.

Objective This study was conducted to observe the virologic and biochemical response to entecavir and interferon-α(IFN-α) combination therapy in patients with chronic hepatitis B (CHB). Methods 69 patients with CHB were enrolled in our hospital between May 2019 and March 2022, and they were divided randomly into group A (n=35) and group B (n=34), receiving entecavir and FN-α combination or entecavir alone therapy for 12 months. Serum HBV DNA loads were detected by fluorescence quantitative PCR, and serum hyaluronic acid (HA), laminin (LN), collagen IV (CIV) and procollagen III (PIIIP) levels were detected by radioimmunoassay. Serum human pygopus homolog 2 (Pygo2), nuclear transcription factor κB (NF-κB), transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were detected by enzyme-linked immunosorbent assay. Results At the end of six and twelve month treatment, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) normalization rates in group A were 88.6% and 94.3%, both significantly higher than 67.6% and 73.5%(P＜0.05) in group B, while there was no significant difference as respect to serum HBV DNA loss (91.4% vs. 91.2, and 97.1% vs. 91.2%, respectively, P>0.05) between the two groups; at the end of twelve month treatment, serum ALT and AST levels in group A were (51.4±6.4)U/L and (47.5±5.2)U/L, significantly lower than [(67.7±7.4)U/L and (61.9±6.7)U/L, respectively, P＜0.05] in group B; serum HA and PC-Ⅲ levels in group A were (93.9±21.4)ng/mL and (87.3±15.8)ng/mL, significantly lower than [(125.3±24.3)ng/mL and (108.9±14.7) ng/mL, respectively, P＜0.05] in group B; serum NF-kB, TGF-β and Pygo2 levels in group A were (1.1±0.3)pg/mL, (3.4±1.1)pg/mL and (41.9±4.6)μg/L, all significantly lower than [(1.6±0.4)pg/mL,(4.3±1.3)pg/mL and (54.6±5.2)μg/L, respectively, P<0.05] in group B. Conclusion In clinical practice, the combination of entecavir and IFN-α treatment in dealing with patients with CHB could alleviate liver function injury, decrease serum liver fibrosis index and reduce inflammatory reaction, and have a good short-term efficacy.

Objective The aim of this study was to investigate the reasons of failed alcohol abstinence in patients with alcoholic liver diseases (ALD). Methods A total of 149 male patients with ALD or ALD with concomitant other liver diseases were admitted to our hospital between February 2021 and June 2022, and all were persuaded and encouraged for alcohol abstinence at first visit. The alcoholic behavior was evaluated by alcohol use disorders identification test (AUDIT), and the univariate and multivariate Logistic analysis was conducted for the factors of alcohol abstinence failure. Results The patients in our series included ALD in 88 cases, with concomitant chronic hepatitis B in 49 cases and with other liver diseases in 12 cases, characterized by mild liver disease in 27 cases, fatty liver in 36 cases, alcoholic hepatitis in 14 cases and liver cirrhosis (LC) or primary liver cancer (PLC) in 72 cases; at the end of three-month of follow-up, the alcohol abstinence failed in 53 cases (35.6%) and succeeded in 96 cases (64.4%); the ages, and the percentages of alcohol abuse longer than 30 yr, with concomitant other liver diseases and alcohol dependence in succeeded patients were (54.8±11.3)yr, 56.3%, 50.0% and 16.7%, significantly different compared to [(49.6±11.5)yr, 28.3%, 24.5% and 60.4%] in failed patients (P＜0.05); the percentages of mild liver diseases, fatty liver, alcoholic hepatitis and LC/PLC in succeeded patients were 17.7%, 15.6%, 6.3% and 60.4%, significantly different compared to 18.9%, 39.6%, 15.1% and 26.4% in failed patients (P＜0.05); the multivariate Logistic analysis showed that the alcohol dependence, simple ALD, mild liver diseases, fatty liver and alcoholic hepatitis were the main risk factors for short-term failed alcohol abstinence (P＜0.05). Conclusion More than one-third (35.6%) of patients with ALD or ALD with other liver diseases fail to abstain from drinking, and the alcohol dependence ALD alone and mild illness are the independent risk factors for abstinence failure.

Objective The aim of this study was to compare the antiviral efficacy of tenofovir amibufenamide to tenofovir disoproxil fumarate (TDF) in the treatment of patients with chronic hepatitis B (CHB). Methods 62 patients with CHB were enrolled in our hospital between August 2021 and February 2022, and were randomly divided into group A and group B, with 31 cases in each group, receiving tenofovir amibufenamide or TDF for 48 weeks. Serum HBV DNA loads were detected by real-time fluorescence quantitative PCR, serum HBsAg and HBeAg levels were detected by ELISA, and blood routine and serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were obtained to calculate fibrosis index based on 4 factor (FIB-4) and estimated glomerular filtration rate (eGFR). The liver stiffness measurement (LSM) was determined by liver transient elastography. Results At 24 weeks of treatment, serum ALT, AST levels and serum HBV DNA load in group A were (64.3±13.6)IU/L, (61.5±4.0)IU/L and (1.2±0.2)Ig IU/mL, and at the end of 48 week treatment, they were (40.1±3.8)IU/L, (39.4±3.3)IU/L and (0.9±0.2)In IU/mL, all not significantly different compared to [(67.2±3.8)IU/L, (65.3±4.2)IU/L and (1.2±0.3)Ig IU/mL, and (38.4±4.1)IU/L, (42.8±3.9)IU/L and (0.9±0.2)Ig IU/mL, respectively, P<0.05] in group B; the LSM, FIB-4 and eGFR in group A were (7.1±1.7)kPa, (2.0±0.4) and (101.3±7.9)mL/min/1.73 m², and (7.2±1.5)kPa, (1.6±0.3) and (100.9±8.2)mL/min/1.73 m², and they were (7.3±1.6)kPa, (2.2±0.5) and (95.6±8.0)mL/min/1.73 m²(P<0.05), and (7.1±1.6)kPa, (1.6±0.4) and (94.0±7.6)mL/min/1.73 m²(P<0.05), not but eGFR, significantly different compared to in group B. Conclusion The oral administration of tenofovir amibufenamide in the treatment of patients with CHB could obtain the same good antiviral efficacy, but might has less untoward impact on renal functions, and warrants further clinical investigation.

Objective The purpose of this study was to explore the predictive efficacy of serum interleukin-33 (IL-33) and procalcitonin (PCT) levels for bacterial infection in primary liver cancer (PLC) patients with fever after transcatheter arterial chemoembolization (TACE). Methods A total of 150 patients with PLC were enrolled in our hospital between April 2020 and April 2022, and all patients underwent TACE. The bacterial infection was diagnosed based on blood routine, serology, imaging and bacterial characterization. Serum IL-33 level was detected by ELISA. The receiver operating characteristic (ROC) curves were drawn by SPSS statistical software and the diagnostic performance was analyzed by the area under the ROC curve (AUC). Results Out of the 150 patients with PLC, the bacterial infection was diagnosed in 50 cases(33.3%) after TACE; the incidence of diabetes, tumor in TNM Ⅲ stage, the diameters of tumor greater than 5 cm and the multiple tumors in patients with bacterial infection were much higher than in patients without (P<0.05); serum PCT and IL-33 levels in patients with bacterial infection were (14.91±3.23) ng/mL and (42.2±8.5)pg/mL, significantly higher than [(0.06±0.01)pg/mL and (13.4±4.9)pg/mL, respectively, P<0.05] in patients without; the AUCs were 0.869(95%CI=0.804-0.898, P<0.001), 0.786(95%CI=0.712-0.849, P<0.001) and 0.895(95%CI=0.855-0.912, P<0.001) when serum PCT, IL-33 levels and combination of the two parameters were applied to predict bacterial infection in PLC patients with fever after TACE, suggesting the combination superior to serum PCT or IL-33 alone (Z=1.784, P=0.074) as the combination having the sensitivity of 0.770 and the specificity of 0.930. Conclusion The increased serum IL-33 and PCT levels might hint the bacterial infection in PLC patients with fever after TACE, and warrants further clinical investigation.

Objective The study was conducted to analyze the changes of thyroid functions and their impact on response to standardized therapy in patients with autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Methods 30 patients with AIH, 28 patients with PBC and 32 volunteers were recruited in our hospital between January 2020 and January 2022, and the patients with AIH or with PBC were treated by standardized immunosuppression or ursodeoxycholic acid therapy. Serum total-triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine T4 (FT4) and thyroid-stimulating hormone (TSH) levels were routinely detected. Serum anti-thyroglobulin antibodies (TRAb), thyroid-peroxidase antibody (TPO-Ab), anti-thyroglobulin antibodies (TGAb), thyroxine-binding globulin (TBG) and thyroglobulin (TG) were also determined by radioimmunoassay. Results Serum FT3 and FT4 levels in patients with AIH were (4.2±0.2)pmol/L and (13.8±1.9)pmol/L, and in patients with PBC were (4.3±0.3)pmol/L and (13.9±1.3)pmol/L, significantly lower than [(4.9±0.6)pmol/L and (15.9±4.2)pmol/L, respectively, P＜0.05], while serum TSH levels in patients with AIH and in with PBC were (3.8±1.2)mIU/L and (3.7±0.5)mIU/L, significantly higher than [(2.6±0.5)mIU/L, P＜0.05] in healthy volunteers; serum TPO-Ab and TG positive rates in patients with AIH were 33.3% and 26.7%, and in patients with PBC were 39.3% and 25.0%, all significantly higher than 9.4% and 3.1%(P＜0.05) in healthy individuals; at the end of one-year treatment, the response rates to treatment in patients with AIH was 66.7% and in patients with PBC was 75.0%; serum FT3 and FT4 levels in responders no matter in AIH or PBC were significantly higher than, while serum TSH levels as well as serum TPO-Ab and TG positive rates were much lower than in non-responders(P＜0.05). Conclusion The hypothyroidism could occur in patients with autoimmune liver diseases, which might influence the response to standardized therapy, and warrants clinical careful surveillance.

Objective The aim of this study was conducted to explore the clinical prediction of significant liver fibrosis by transient ultrasound elastography and the aspartate aminotransferase/platelet ratio index (APRI) combination in patients with autoimmune hepatitis (AIH). Methods 67 patients with AIH and 54 healthy individuals at physical examination were enrolled in our hospital between August 2019 and August 2022, and all received FibroScan detection for liver stiffness measurement (LSM) and blood routine for the calculation of APRI. The patients with AIH underwent liver biopsies. The receiver operating characteristic curve (ROC) was applied to analyze the diagnostic performance of APRI and LSM for predicting significant liver fibrosis (SLF, >=S2) in patients with AIH. Results Serum AST level in patients with AIH was (104.3±21.9)U/L, significantly higher than [(30.5±5.1)U/L, P<0.05], the APRI and LSM were (1.4±0.1) and (8.1±1.2)kPa, both significantly greater than [(0.4±0.1) and (4.3±0.7)kPa, P<0.05], while the peripheral blood platelet count was (157.8±23.1)×10⁹/L, significantly less than [(208.5±20.7)×10⁹/L, P<0.05] in the healthy control; the liver histopathological examination showed the liver fibrosis S0 stage in 10 cases, S1 in 17 cases, S2 in 19 cases, S3 in 13 cases and S4 in 8 cases in our series; the APRI and LSM in patients with liver fibrosis S4 were(2.1±0.3) and (13.9±2.8)kPa, in S3 were (1.8±0.2) and (11.2±2.1)kPa, and in S2 were (1.5±0.2) and (7.6±1.5)kPa, all significantly higher than(1.1±0.2) and (6.1±1.2)kPa in S1 (P<0.05) or (0.8±0.1) and (4.0±0.5)kPa in S0 (P<0.05); the ROC analysis showed that the AUC was 0.950, with the sensitivity (Se) of 95.0% and the specificity (Sp) of 85.2%, when the APRI (with the cut-off-value of 1.5) and the LSM (with the cut-off-value of 7.5 kPa) were combined in predicting SLF, much superior to that by APRI(with the Se of 90.0% and the Sp of 81.5%) or by the LSM(with the Se of 75.0% and the Sp of 96.3%)diagnosis. Conclusion The combination of LSM and APRI might a high diagnostic efficacy in predicting SLF in patients with AIH, and warrants further clinical investigation.

Objective The aim of this study was to explore the changes and clinical implications of urine microalbumin (U-mAl), peripheral blood neutrophil/lymphocyte ratio (NLR) and serum neutrophil gelatinase-associated lipocalin (NGAL) level in patients with cirrhosis and complicated hepatorenal syndrome (HRS). Methods 43 patients with cirrhosis and complicated HRS, and 43 patients with decompensated cirrhosis were admitted to our hospital between January 2020 and January 2022, and urine U-mAl level was detected by full-automatic specific protein analyzer. The peripheral blood lymphocyte count and neutrophil count were detected by full-automatic blood cell analyzer, and NLR was calculated. Serum NGAL level was detected by ELISA. The correlation was analyzed by Pearson’ and the diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curves. Results Urine U-mAl level, the NLR and serum NGAL level in patients with cirrhosis and HRS were(25.7±5.3)mg/24 h,(3.8±0.8) and (31.8±6.5) ng/mL, significantly higher than [(18.9±3.4)mg/24 h, (3.1±0.6) and (26.1±4.8) ng/mL, respectively, P＜0.05] in patients with decompensated cirrhosis; urine U-mAl level was positively correlated to NLR or serum NGAL level (r=0.470, r=0.476, both P<0.001), and the NLR was also positively correlated to serum NGAL level (r=0.752, P<0.001) in patients with cirrhosis and HRS; the AUCs were 0.741, 0.733 and 0.734 (P＞0.05), as urine U-mAl equal to 25.0 mg/24 h, the NLR equal to 3.5 and serum NGAL level equal to 29.2 ng/mL were set as the cut-off-value, in predicting HRS in patients with cirrhosis, while the AUC was 0.870, with the sensitivity of 0.973 and the specificity of 0.767 when the three parameters was combined to predict (Z=3.047, Z=3.039, and Z=2.806, all P<0.01). Conclusion The detection of urine U-mAl level, peripheral blood NLR and serum NGAL level might be an easy way to predict the occurrence of HRS in patients decompensated liver cirrhosis, and worthy of further investigation.

Objective This study was conducted to report the 120-week prognosis of serum HBsAg positive patients with chronic renal failure (CRF) after renal transplantation (RT). Methods The clinical data of 69 patients with serum HBsAg positive and CRF were retrieved. The patients were encountered in our hospital between January 2018 and September 2021, and all underwent RT, 26 of whom receiving liver from serum HBsAg positive donors, and followed-up for 196 weeks (with mean of 120 weeks). After RT, all patients took entecavir for antiviral treatment and standardized immunosuppression therapy. Results The incidence of delayed graft function recovery (DGF) occurred in 3 cases(4.4%) after RT in our series, and at the end of follow-up, 67 patients (97.1%) survived; at follow-up 24 week, 48 week, 96 week and 168 week, there were no significant differences as respect to serum ALT, AST and creatinine levels between 26 patients receiving livers from serum HBsAg positive and 43 patients receiving liver from serum HBsAg negative donors, or between 17 recipients with baseline serum HBV DNA positive and 52 recipients with HBV DNA negative (P＞0.05). Conclusion Under the protection of regular antiviral therapy, the recipients with serum HBsAg-positive might survive long-termly with relatively normal liver and renal function tests, even with livers from serum HBsAg-positive donors. The baseline serum HBV DNA loads of the recipients, the donor's serum HBsAg status, and the immunosuppressants administered after RT might not impact the outcomes of recipients in this setting.

Objective The aim of this study was to investigate the efficacy of transcatheter arterial chemoembolization (TACE) with CalliSpheres drug-loaded microspheres followed by radiofrequency ablation (RFA) in the treatment of patients with primary liver cancer (PLC). Methods 79 patients with PLC were enrolled in our hospital between January 2019 and January 2021, and were divided into observation (n=43) and control group (n=36), receiving TACE with CalliSpheres drug-loaded microspheres followed by RFA, or the routine TACE followed by RFA. All patients were followed-up for two years. The disease control rate in the two groups after treatment was evaluated according to the Response Evaluation Criteria in Solid Tumors. Serum alpha-fetoprotein (AFP) and human heat shock protein 90α (HSP90α) levels were detected by electrochemiluminescence analyzer. Results At the end of one month after treatment, the complete remission, partial remission, stable disease and the total disease control rate in the observation group were 23.3%, 46.5%, 16.3% and 86.1%, while they were 11.1%, 36.1%, 19.4% and 66.7% in the control, with the latter significantly different (P<0.05) between the two groups; at the end of three months after treatment, serum AFP and HSP90α levels in the observation group were (87.5±14.5)μg/L and (126.1±13.3)ng/mL, both significantly lower than [(164.6±17.2)μg/L and (150.8±19.7)ng/mL, respectively, P<0.05] in the control; during the period of treatment, the incidence of side effects in the two groups were 48.8% and 50.0%, not significantly different (P>0.05); the one-year survival rates in the observation and control groups were 83.7% and 72.2%, not significantly different (P>0.05), while the two-year survival rates were 69.8% and 47.2%, significantly different (P<0.05). Conclusion The TACE with CalliSpheres drug-loaded microspheres followed by RFA has a definite efficacy in the treatment of patients with PLC, which might prolong the survival rates.

Objective The purpose of this study was to explore clinical implications of peripheral blood mononuclear cell (PBMC) human telomerase reverse transcriptase (hTERT) mRNA and serum angiopoietin-2 (Ang-2) and intercellular adhesion molecuLe-1 (ICAM-1) levels in patients with liver failure (LF). Methods 74 patients with LF, including subacute liver failure (SALF) in 13 cases, acute-on-chronic liver failure (ACLF) in 39 cases and chronic liver failure (CLF) in 22 cases, were admitted to our hospital between January 2019 and May 2021, and 30 healthy individuals who had physical examination in our hospital during the same period were selected as the control group. The PBMC hTERT mRNA was assayed by PCR, and serum Ang-2 and ICAM-1 levels were detected by ELISA. Results The PBMC hTERT mRNA, serum Ang-2 and ICAM-1 levels in patients with LF were (0.9±0.3), (1344.6±55.3)ng/L and (540.2±22.4)ng/ml, significantly higher than [(0.4±0.1), (1062.5±36.2)ng/L and (167.3±15.6)ng/ml, respectively, P<0.05] in the healthy control; the PBMC hTERT mRNA, serum Ang-2 and ICAM-1 levels in patients with SALF were (1.5±0.6), (1507.8±38.2)ng/L and (647.3±26.2)ng/ml, all significantly higher than [(1.2±0.4), (1398.6±35.8)ng/L and (582.7±24.1)ng/ml, respectively, P<0.05] in patients with ACLF or [(0.7±0.2), (1280.5±46.3)ng/L and (468.9±20.3)ng/m, respectively, P<0.05] in patients with CLF; at the end of one to three month treatment, three patients with SALF, five patients with ACLF and four patients with CLF died in our series. Conclusion The PBMC hTERT mRNA as well as serum Ang-2 and ICAM-1 levels in patients with LF increase, which might be helpful in judging the severity of the entity and warrants further clinical investigation.

Objective The aim of this study was to observe the efficacy and peripheral blood regulatory B cell subset changes in patients with autoimmune hepatitis (AIH) undergoing magnesium isoglycyrrhizinate and standard immunosuppressive therapy. Methods 108 patients with AIH were encountered in our hospital between April 2017 and April 2022, and were randomly divided into control (n=54) and observation (n=54) group, receiving standard immunosuppression treatment or oral magnesium isoglycyrrhizinate at base of it for six month. Serum immunoglobulin levels were detected by immunoturbidimetry, and peripheral blood B cell and regulatory B cell subsets were detected by FCM. Results At the end of six-month treatment, the biochemical response rate in the observation group was 85.2%, much higher than 66.7%(P＜0.05) in the control; serum ALT, AST and ALP level were (51.2±7.6)U/L, (46.2±8.6)U/L and (67.4±2.4)U/L, all significantly lower than[(80.3±8.5)U/L, (75.7±6.4)U/L and (89.7±2.6)U/L, respectively, P<0.05] in the control; there were no significant differences as respect to serum IgG, IgM and globulin levels between the two groups (P>0.05); the percentages of peripheral blood CD19⁺B cell, CD19⁺IL-10⁺B cell, CD19⁺CD24^hiCD38^hi regulatory B cell and CD19⁺CD24^hiCD27⁺ regulatory B cell were (7.1±2.6)%, (0.6±0.2)%, (2.9±1.0)% and (5.7±1.3)%, all significantly higher than [(5.2±1.8)%, (0.4±0.1)%, (2.2±0.9)% and (4.3±1.2)%, respectively, P<0.05], while the percentages of blood CD19⁺CD27⁺CD38⁺⁺ plasma cell and CD19⁺CD27^-CD38^-/+ naïve B cell were (4.2±1.2)% and (56.2±7.9)%, both much lower than [(6.5±1.7)% and (70.5±7.4)%, P<0.05] in the control. Conclusion The administration of standardized immunosuppressant and magnesium isoglycyrrhizinate combination therapy in the treatment of patients with AIH is efficacious, with a promising biochemical response, which might be related to the roles on modulation of peripheral blood regulatory B cells.

Objective The aim of this study was to investigate the evaluation of hepatic steatosis by controlled attenuation parameter (CAP) of ultrasonic transient elastography in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 78 patients with NAFLD were enrolled in our hospital between May 2020 and May 2022, and they all received liver ultrasonography and ultrasonic transient elastography for CAP. The receiver operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was calculated to evaluate the efficacy of CAP in predicting the degree of hepatic steatosis in patients with NAFLD. Results The liver ultrasonography showed that out of the 78 patients with NAFLD in our series, there were mild hepatic steatosis in 41 cases, moderate hepatic steatosis in 23 cases and severe hepatic steatosis in 14 cases; serum ALT and AST levels in patients with severe liver steatosis were (77.2±14.9) U/L and (59.1±11.7)U/L, significantly higher than in patients with moderate or in patients with mild liver steatosis; serum triglyceride level and the CAP in patients with severe liver steatosis were (3.5±0.7)mmol/L and (317.7±27.6)dB/m, both significantly higher than in patients with mild or in patients with moderate, while serum high-density lipoprotein cholesterol level was (0.8±0.4)mmol/L, much lower than in patients with mild or in patients with moderate liver steatosis; with the CAP>280.4dB/m as the cut-off value for the diagnosis of moderate hepatic steatosis in patients with NAFLD, the AUC, sensitivity (Se) and specificity (Sp) were 0.783 (95%CI: 0.669-0.896), 78.3% and 75.6%, and with the CAP>309.1 dB/m as the cut-off value for the diagnosis of severe hepatic steatosis, the AUC was 0.696 (95% CI: 0.515-0.876), with the Se of 78.6% and the Sp of 69.6% (P<0.05). Conclusion The application of CAP obtained by ultrasonic transient elastography might help assess more accurately the severity of liver steatosis in patients with NAFLD.

Objective The study was conducted to assess the prediction of non-alcoholic fatty liver diseases (NAFLD) in patients with type 2 diabetes mellitus (T2DM) by neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) . Methods 110 patients with T2DM and 121 patients with T2DM and NAFLD were included in the Department of Endocrinology, Second Provincial People's Hospital between January 2021 and October 2022, and the NAFLD was proven by ultrasonography. The blood routine was checked-up. The risk factors of T2DM with NAFLD were assessed by multivariate Logistic analysis, and predictive efficacy was evaluated by ROC curve. Results The body mass index in patients with T2DM and concomitant NAFLD was (25.4±3.5)kg/m², much greater than [(23.2±3.1)kg/m², P<0.05], while the course of disease was 5.0(2.0, 8.0)yr, significantly shorter than [8.0(3.0, 13.0)yr, P<0.05] in patients with T2DM; serum alanine aminotransferase, aspartate aminotransferase, glutamyl transpeptidase, uric acid, triglyceride and total cholesterol levels in patients with T2DM and NAFLD were all significantly greater than in patients with T2DM, while serum high density lipoprotein cholesterol level was much lower than in patients with T2DM (P＜0.05); the blood lymphocyte count in patients with T2DM and NAFLD was (1.7±0.4)×10⁹/L, much lower than [(2.2±0.6)×10⁹/L, P<0.05], while the NLR and PLR were (2.4(1.8, 3.2)) and (126.1(93.3, 157.8)), both significantly greater than [1.5(1.2, 2.3) and 89.6(66.9, 116.5), respectively, P<0.05] in patients with T2DM; the Logistic analysis showed that the BMI, NLR and PLR were the risk factors for coincidence of NAFLD in patients with T2DM (P＜0.05); the ROC analysis demonstrated that the sensitivities and the specificities by NLR and PLR in prediction of NAFLD in patients with T2DM were 64.5% and 75.0%, and 71.9% and 65.4%, respectively. Conclusion The surveillance of NLR and PLR, easily accessible, in patients with T2DM might help screen preliminarily NAFLD, and warrants further clinical investigation.

Objective Nonalcoholic fatty liver diseases (NAFLD) is a kind of liver injury caused by metabolic stress. With the prevalence of obesity and metabolic syndrome (MetS), the NAFLD has become the most popular chronic liver disease in China. Betatrophin is a newly discovered glycoprotein closely related to glucose and lipid metabolism and insulin resistance (IR), which may be closely related to the onset and progression of NAFLD. This article reviewed the role of betatrophin in the process and development of NAFLD.

Objective The purpose of this study was to investigate the impact of hyperuricemia on virological response to sofosbuvir/daratavir therapy in patients with chronic hepatitis C (CHC). Methods 200 patients with CHC, including 38 patients with hyperuricemia, were recruited in our hospital between June 2018 and June 2023, and all received sofosbuvir/daratavir therapy for 24 weeks. The patients with CHC were followed-up for 24 weeks after discontinuation of the antiviral treatment. Results The body mass index, serum triglyceride level and the controlled attenuation parameter of liver in patients with hyperuricemia were (26.9±3.5)kg/m², (2.8±0.5)mmol/L and (273.5±15.3)dB/m, all significantly higher than (24.2±2.5)kg/m²,(1.9±0.6)mmol/L and (236.8±16.1)dB/m, respectively, P<0.05] in 162 patients with normal serum uric acid levels; the rapid virological response (RVR) and early virological response (EVR) in patients with hyperuricemia were 78.9% and 84.2%, both significantly lower than 96.9% and 100.0% (P<0.05) in patients with normal serum uric acid levels, while there were no significant differences as respect to the end of treatment virological response (94.7% vs. 100.0%) and the sustained virological response (97.4% vsl 100.0% (P>0.05) between the two groups; generally, serum uric acid levels in 16 male and 22 female patients with hyperuricemia at presentation decreased at the end of antiviral treatment, and the percentages of patients with decreased serum uric acid levels was 93.7% in male and 72.7% in female patients. Conclusion The hyperuricemia in patients with CHC might interfere with the early virological response to direct acting agent therapy, but do not impact the sustained virological response, and serum uric acid levels in most patients with hyperuricemia will return to normal.

Objective The aim of this experiment was to investigate the inhibitory effect of apoptosis stimulating protein 2 of P53 (ASPP2) recombinant adenovirus (ASPP2-ad) on hepatocellular carcinogenesis induced by diethylnitrosamine (DEN) in mice. Methods The mouse liver cancer model was established by intraperitoneal injection of DEN at dose of 25 mg·kg^-1 and drinking water with 0.005% of DEN. The experiment was divided into two groups with 10 mice in each group, receiving DEN or DEN and ASPP2-ad combination intervention. The formation of liver cancer in mice was observed by ultrasonography. The number of liver tumors was recorded, and the expression of Ki67 was detected by immunohistochemistry. Serum IL-1β, IL-6, KC, IL-2 and TNFα levels were detected by flow multiprotein quantification technology. The protein expressions of AFP, caspase3, cyclin D1, PCNA, p-IKK, IKK, p-IκB, IκB, p-p65 and p65 were observed by Western blot, and the Nfatc1 mRNA level was assayed by real-time quantitative PCR. Results After 24 weeks of DEN induction, the number of liver tumors in DEN-intervened group was (9.9±1.9), significantly greater than in the DEN and ASPP2-ad combination intervened group; the number of Ki67 positive cells in DEN-intervened group was (91.4±9.1), significantly greater than in DEN/ASPP2-ad-intervened group; the survival rate in the DEN-intervened group was 65.2%, significantly lower than 90.0%(P <0.05)in DEN/ASPP2-ad-intervend group (P <0.05); serum ALT and AST levels were (271.5±143.8)U/L and (299.3±221.4)U/L, both significantly higher than in DEN/ASPP2-ad-intervend group; serum IL-6 and TNFα levels in DEN/ASPP2-ad-intervend group were (8.1±1.6)MFI and (8.1±1.0)MFI, both much lower than in DEN-intervened group; the cancerous AFP, Cyclin D1 and PCNA expression became weaker, the p-IKK, p-IκB and p-p65 expression down-regulated, the p-IKK/IKKα, p-IκB/IκB and p-p65/p65 ratio down-regulated, the Nfatc1 expression weaker, while the caspase-3 expression intensified (P<0.05) in DEN/ASPP2-ad-intervend group. Conclusion The ASPP2-ad could remarkably inhibit DEN-induced inflammatory proliferation reaction and the occurrence of liver cancer, which might be related to the regulation of NF-κB signal pathway, and warrants further investigation.

Objective This clinical trial was conducted to investigate the efficacy of camrelizumab and apatinib combination in the treatment of patients with advanced hepatocellular carcinoma (HCC). Methods A total of 117 patients with advanced HCC were admitted to the first affiliated Hospital of Xinjiang Medical University between June 2019 and October 2021, and 65 patients were treated with camrelizumab and apatinib combination, and 52 patients were treated by apatinib alone. All patients were followed-up for one year. The therapeutic efficacy was evaluated according to mRECIST, the progression-free survival (PFS) and its influencing factors were analyzed by Kaplan-Meier method, and the prognostic factors of PFS were analyzed by multivariate COX regression. Results The objective remission rate (ORR) and the disease control rate (DCR) in patients with combination treatment were 44.7% and 66.2%, both significantly greater than 15.4% and 42.3% in the apatinib-treated patients (P<0.05); at the end of three-month treatment, the blood platelet count in patients with combination treatment was 81.0(51.5, 145.5)×10⁹/L, much lower than [107.0(69.5, 191.0)×10⁹/L P<0.05] in patients with apatinib treatment alone; the PFS in patients with combination treatment was 10.6 (95%CI:9.986-11.16) months, significantly longer than 7.9 (95%CI:6.84-8.944) months in the apatinib-treated group (Log-rank=12.807,P<0.05); the performance status (PS), Child-Pugh score, CNLC stage, liver cirrhosis, portal vein tumor thrombus and transarterial chemoembolization (TACE) were the prognostic factors impacting PFS, and the multivariate COX regression analysis showed that the Child-Pugh grade B (HR=2.379,P=0.021) and portal vein tumor thrombus (HR=3.481,P=0.003) were the independent risk factors for PFS, while the TACE (HR=0.528, P=0.034) was an independent protective factor for PFS in patients with advanced HCC. Conclusion The combination of camrelizumab and apatinib in treating patients with advanced HCC could effectively improve the clinical efficacy, with an obvious prolonged survival period. For patients with high tumor load, the auxiliary TACE might help raise better clinical benefits.

The Chinese Society of Hepatology of the Chinese Medical Association invited relevantexperts to revise and update the Guideline of Prevention and Treatment of Nonalcoholic Fatty Liver Disease(2018Version) and renamed it as (Version 2024) Guideline for the Prevention and Treatment of MetabolicDysfunction-associated (non-alcoholic) Fatty Liver Disease. Herein, the guiding recommendations on clinicalissues such as screening and monitoring, diagnosis and evaluation, treatment and follow-up of metabolicdysfunction-associated fatty liver disease are put forward.

Objective The aim of this study was to investigate the twenty-four month follow-up efficacy for patients with chronic hepatitis C (CHC) after sustained virological response (SVR) to different direct-acting antiviral agents (DAAs) treatment regimen. Methods 123 patients with CHC were enrolled in our hospital between January 2018 and December 2020, and were divided into three groups, receiving sofosbuvir/velpatasvir (SOF/VEL) in 52 cases, elbasvir/grazoprevir (EBR/GZR) in 43 cases, and ledipasvir/sofosbuvir (LDV/SOF) in 28 cases. The antiviral regimen lasted for 12 weeks and all patients were followed-up for 24 weeks. Serum HCV RNA loads were detected by real-time fluorescence quantitative RT-PCR. The rapid virological response (RVR), early virological response (EVR), end of treatment virological response (ETVR) and SVR were recorded in three groups. Results The RVR in SOF/VEL-, EBR/GZR- and LDV/SOF-treated patients were 96.2%, 93.0% and 92.9%, the EVR were 98.1%, 97.7% and 96.4%, the ETVR and SVR in all patients were 100.0%, not significantly different among the three groups ( all P＞0.05); during the treatment, the incidences of untoward effects, such as nausea, fatigue and dizziness, in the three groups were 13.5%, 11.6% and 21.4%, not significant different among them (P＞0.05); 7, 7 and 5 patients with SVR in the three groups lost, all other patients with SVR were followed-up for 24 months, and no relapse or liver cancer were found. Conclusion All the antiviral regimen, with different DAAs have good efficacy as HCV GT1b infection is common in China, and no relatively long-term relapse.

Nonalcoholic steatohepatitis (NASH),with pathological characteristics of hepatic steatosis, ballooning, and lobular inflammation, reflects the chronic liver disases induced by metabolic stress. Here, we summarize the regulatory effect of gut microbia-derived butyrate on the docosahexaenoic acid (DHA) metabolic phenotype of hepatic mononuclear phagocyte system through HDAC/12/15-LOX/maresin signaling. Its role in NASH amelioration is further reviewed on the basis of proinflammatory mediators/maresins rebalancing and spontaneous resolution of inflammation.

Objective The purpose of this study was to summarize the clinical features of Klebsiella Pneumonia (KP)-induced bacterial liver abscess (PLA). Methods 110 patients with PLA were encountered in our hospital between January 2017 and May 2022, and all patients were treated by needle puncture and drainage under US guidance at base of intravenous administration of antibiotics. Serum high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and fibrinogen (Fib) levels were detected. Results Out of the 110 patients with PLA, the bacteria culture found positive in 70 (63.6%) patients, including KP in 48 cases (68.6%), Escherichia Coli in 7 cases (10.0%), Streptococcus in 4 cases (5.7%), Staphylococcus in 3 cases (4.3%), Enterococcus Faecalis in 3 cases (4.3%), Enterococcus Faecalis in 2 cases (2.8%) and others in 3 cases (4.3%); the KP-induced PLA (KPLA) accounted for 68.6% (48/70), and non-KP-induced PLA (N-KPLA) for 31.4% (22/70); the age of patients with KPLA was 58(49,66)yr, much younger than [65(61, 74)yr, P<0.05] in patients with N-KPLA; there were significant differences as respect to the incidences of concomitant diabetes, biliary operation histories and biliary infections between the two groups (56.2%, 8.3% and 14.6% vs. 22.7%, 27.3% and 45.4%, P<0.05); the sCr, serum hs-CRP, PCT and Fib levels in patients with KPLA were 88.7(60.8, 115.4)μmol/L, 170.5(86.3, 240.5)mg/L, 20.2(9.8, 31.5)ng/L and 6.4(5.0, 7.8)g/L, all significant different compared to [100.3(62.3, 145.0)μmol/L, 132.6(60.6, 181.2)mg/L, 26.8(13.4, 40.6)ng/L and 5.3(4.3, 7.1)g/L] in patients with N-KPLA(P<0.05); the imaging scan found that the incidences of thin wall of intrahepatic abscess, separated abscess and liquidation of abscess in patients with KPLA were 83.3%, 62.5% and 97.9%, all much higher than 54.5%, 31.8% and 72.7%(P<0.05) in patients with N-KPLA; the short-term recovery rate in the 48 patients with KPLA was 70.8%, a little bit higher than 59.1% in patients with N-KPLA, and the hospital stay were 20(15, 28)d and 22(16, 28)d(P>0.05) between the two groups. Conclusion The common pathogen of PLA is KP, followed by Escherichia Coli. The clinicians should take the clinical features of PLA, especially those with KP infections, might help making an appropriate measures to deal with it.

Objective The aim of this study was to investigate the risk factors of re-bleeding in hepatitis B viral infection-induced liver cirrhosis (LC) complicated with esophagogastric varices bleeding (EGVB) within 1 year after gastroscopic sclerotherapy and tissue glue injection therapy. Methods A total of 137 patients with hepatitis B LC and EGVB were enrolled in our hospital between June 2016 and March 2021, and all patients underwent gastroscopic sclerotherapy and tissue glue injection therapy. They were all followed-up for 1 year to observe the occurrence of postoperative re-bleeding. The risk factors of re-bleeding were analyzed by multivariate Logistic regression analysis. Results Among the 137 patients with cirrhosis and EGVB, 28 patients (20.4%) died of emergent bleeding; out of the 109 survivals within 1 year of follow-up, the postoperative re-bleeding occurred in 42 cases (30.7%); there were significant differences between patients with re-bleeding and without re-bleeding as respect to Child-Pugh class (P=0.001), severity of esophageal varices (P=0.027), ascites volume (P=0.016) and malnutrition (P=0.009, P<0.05); the Logistic regression analysis showed that poor Child-Pugh class (OR=1.863), severe esophageal varices (OR=2.028), large volume of ascites (OR=1.797) and moderate to severe malnutrition (OR=1.589) were the independent risk factors for re-bleeding within 1 year after endoscopic therapy. Conclusion The patients with hepatitis B LC and EGVB after gastroscopic therapy could have high risk for re-bleeding within one year, and the careful intervention to these risk factors might decrease the incidence of re-bleeding and increase the survival rates of them.

Objective This study was conducted to investigate double endoscopic surgery in the treatment of patients with gallbladder stones (GS) and extrahepatic bile duct stones (EBDS). Methods 76 patients with GS and EBDS were encountered in our hospital between January 2020 and December 2022, 42 patients in the observation group received laparoscopic cholecystectomy (LC) five days after endoscopic retrograde cholangiopancreatography (ERCP) for the removal of common bile duct stones, and 34 patients in the control underwent traditional open surgery. The pain was evaluated by visual analogue scale (VAS), and serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP) and cortisol (Cor) levels were detected by ELISA. The white blood cell counts (WBC) were detected by full-automatic blood cell analyzer. Results The stone clearance rates in the two groups were both 100.0%; the operation time, intraoperative blood loss and VAS score at day 3 after surgery in the observation were(96.8±7.4)min,(25.7±5.3)ml and (2.8±0.7), significantly shorter or less than [(120.1±9.6)min, (46.0±6.8)ml and (3.5±0.6), respectively, P＜0.05] in the control; seven days after operation, serum AST and ALT levels were (40.5±3.9)U/L and (43.1±4.9)U/L, both significantly lower than [(50.2±5.0)U/L and (56.9±6.0)U/L, P＜0.05] in the control; serum TNF-α, IL-6, CRP, Cor levels and WBC counts were (1.5±0.3)ng/L, (10.8±2.0)ng/L, (13.4±2.5)mg/L, (224.7±28.1)mmol/L and (9.8±1.3)×10⁹/L, all significantly lower than [(2.7±0.5)ng/L, (16.1±2.5)ng/L, (22.0±4.9)mg/L, (262.4±31.8)mmol/L and (12.0±1.5)×10⁹/L, respectively, P＜0.05] in the control; post-operationally, the incidence of complications in the observation group was 7.2%, much lower than 23.5%(P＜0.05) in the control. Conclusion The double endoscopic surgery could effectively improve perioperative indexes, promote postoperative recovery, relieve stress response and reduce the complications in patients with GS and EBDS.