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 The purpose of this study was to observe the effect of Mongolian medicine Erligen II on carbon tetrachloride-induced liver fibrosis in rats and explore its possible acting mechanism. Method 58 male SD rats were randomly divided into control, model, low-, moderate- and large-dose of Mongolian medicine Erligen II-intervened groups, and the fibrosis model was established by 40% CCl₄ olive oil solution injection for 8 weeks. Four weeks after modeling, the rats in model group were given intragastrically once daily at different dose of Erligen- II , and in the control group were given the same dose of normal saline for 5 weeks. The pathological changes were observed by HE and Masson staining of liver tissue, and the expression of α-SMA, collagen I and collagen III in liver tissue were detected by immunohistochemistry.Results Serum levels of ALT, AST and HA in moderate dose of Erligen- II-intervened group decreased greatly compared to those in model (P <0.05) , and serum levels of ALT, AST, bilirubin, HA, PIIINP and CIV in large dose of Erligen- II-intervened group decreased significantly compared to those in the model (P<0.05) ; the hepatic expression of α-SMA in control, moderate and large dose of Erligen- II were (0.0±0.0), (4.9±1.0) and (3.4±0.9),significantly weaker than 【(6.1±1.2),P＜0.05】 in model, and that of collagen III were (2.4±1.3), (5.0±2.4) and (3.7±1.8), significantly weaker than 【(6.4±2.4), P＜0.05】 in the model; the hepatic expression of collagen I in the control and in large dose of Erligen- II were (2.1±0.2) and (3.3±1.0), significantly weaker than 【(6.0±2.5), P＜0.05】 in the model; the hepatic fibrosis improved greatly in moderate and large dose Erligen- II groups compared to in the model.Conclusions Mongolian medicine Erligen II has a protective effect on CCl₄-induced liver fibrosis in rats, which might be related to the inhibition of HSC activation and reduction of ECM synthesis.

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

Objective The aim of this study was to investigate the influencing factors of disease control after ultrasound-guided 125I radioactive seed implantation for patients with hepatocellular carcinoma (HCC). Methods 84 patients with HCC were admitted to our hospital betweenJuly 2017 and August 2021, and all patients received ultrasound-guided intrahepatic 125I radioactive seed implantation with particle activity of 0.6-0.8 mCi and the tumor matched peripheral dose (MPD) of 110-160 Gy. The CT or MRI scan was performed 2 months after the operation and the short-term efficacy was evaluated according to RECIST standard version 1.1. The multivariate Logistic regression analysis was applied to screen for independent factors impacting disease control (the sum of complete response, partial response and disease stable). Results The intratumorous implantation of radioactive125I seeds was successfully finished in our 84 patients with HCC; at the end of two months after surgery, the imaging showed disease control in 69 cases (82.1%), including complete remission in 15 cases (17.9%), partial remission in 47 cases (56.0%) and disease stable in 7 cases (8.3%), with disease progression in 15 cases (17.9%); the univariate Logistic regression analysis showed that the proportions of Child-Pugh class B, BCLC stage C, tumor diameter > 5 cm and the received irradiation dose of 90% target volume (D90 dose) < 110 Gy in thedisease control group were 40.0%, 43.5%, 40.9% and 28.6%, all significantly lower than 60.0%, 56.5%, 59.1% and 71.4% in the disease progression group (P<0.05); the multivariate Logistic regression analysis showed that the D90 dose was an independent factor impacting disease control in patients with HCC after ultrasound-guided radioactive125I seed implantation (OR=344.350, P<0.05). Conclusion The sufficient irradiation dose is necessary in patients with unresectable HCC receiving intratumorous radioactive125I seed implantation in order to gain therapeutic efficacy, which needs further clinical investigation.

In view of the high prevalence of diabetes mellitus in patients with liver cirrhosis and the increasing trend of non?alcoholic fatty liver disease?associated cirrhosis, the diagnosis and treatment of diabetes mellitus in patients with liver cirrhosis are becoming widespread concerns. Therefore, the Chronic Disease Management Branch, China Pharmaceutical Biotechnology Association, organized multidisciplinary experts from gastroenterology, infective disease, endocrinology, etc, to draw up expert consensus on the management of diabetes mellitus in patients with liver cirrhosis, with focusing on the classification and management of hyperglycemia in cirrhotic patients. The consensus summarizes the prevalence, pathogenesis, clinical setting and prognosis of the concomitant diabetes mellitus in patients with liver cirrhosis, and definitely puts forward a proposal regarding "hepatogenous diabetes" as one of the four subtypes of diabetes mellitus in cirrhotic patients, and further recommends the basic principles for diagnosing and monitoring diabetes mellitus and the selection of antidiabetic drugs based on liver functions in patients with liver cirrhosis.

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

Objective 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 analyze the risk factors of non-alcoholic fatty liver diseases (NAFLD) in physical examination individuals. Methods 1742 persons received physical examination in our hospital between January 2018 and January 2020, and 485 individuals were eligible for this study based on inclusion and exclusion criteria. The NAFLD was found by ultrasonography in 78 cases and not in 407 cases. The visceral adipose tissue (VAT)was obtained by CT scan, and fasting plasma glucose (FPG) and other common blood parameters were assayed. The risk factors for NAFLD was analyzed by univariate and multivariate Logistic regression. Results The incidences of concomitant blood hypertension, diabetes and hyperlipidemia in patients with NAFLD were 29.5%, 35.9% and 51.3%, much higher than 18.7%, 23.8% and 23.6% (P<0.05), the body mass index, waist and hip circumference were (25.1±1.)kg/m², (90.4±6.3)cm and (101.3±8.4)cm, much higher than [(22.4±1.1)kg/m², (81.6±5.7)cm and (95.7±6.2)cm, respectively, P<0.05] in persons without NAFLD; serum TG, LDL-C and VAT were (2.9±0.3)mmol/L,(3.7±0.4)mmol/L and (146.3±12.1)cm², significantly higher than [(1.6±0.2)mmol/L, (3.1±0.2)mmol/L and (70.5±4.6)cm², respectively, P<0.05] in persons without NAFLD; serum ALT, FPG and UA levels were (56.6±11.7)u/L, (5.8±0.7)mmol/L and (387.8±36.3)μmol/L, all significantly higher than [(32.4±3.1)u/L, (5.1±0.4)mmol/L and (313.6±51.4)μmol/L, respectively, P<0.05] in persons without NAFLD; the multivariate Logistic regression analysis showed that the increased BMI, elevated VAT, concomitant blood hypertension, and elevated serum TG, LDL-C, ALT and UA levels were all the independent risk factors, while the increased serum HDL-C level was the protective factor for the existence of NAFLD. Conclusion The prevalence of NAFLD in physical examination individuals is relative high, and some increased body health, blood and imaging parameters hints its existence, and warrants further check-up.

Objective The aim of this clinical observation was to investigate the efficacy and safety of CT-guided percutaneous transhepatic choledochoscopic lithoteipsy (PTCSL) and dual-frequency laser lithotripsy (DFLL) combination in the treatment of patients with recurrent hepatolithiasis. Methods A total of 60 patients with recurrent hepatolithiasis were admitted to our hospital between September 2017 and February 2020, and 31 patients in group A received CT-guided PTCSL and DFLL and 29 patients in group B underwent open choledochofiberscope and DFLL. Serum cortisol (COR) and epinephrine (EP) were detected. Results The operation time, exhaust time, first defecation time and postoperative hospitalization stay in group A were(89.7±10.1)min, (30.3±3.6)h, (2.3±0.3)d and (6.9±1.1)d, all significantly shorter than [(101.9±12.2)min, (34.7±4.1)h, (2.7±0.4)d and (11.8±1.6)d, respectively, P＜0.05], while blood loss was (40.2±8.8)ml, much less than [(97.4±10.6)ml, P＜0.05] in group B; at the end of seven days after operation, the white blood cell counts, neutrophil percentage, serum COR and EP levels were (9.7±1.0)×10⁹/L, (67.8±5.9)%, (310.1±30.7)mmol/L and (210.7±22.8)pg/mL, significantly lower than [(11.8±1.3)×10⁹/L, (76.4±7.1)%, (385.5±34.4)mmol/L and (247.3±23.1), respectively, P＜0.05] in group B; serum ALT, AST, ALP and bilirubin level were (39.7±3.7)U/L, (39.9±4.1)U/L, (80.1±8.5) and (19.4±1.8)μmol/L, significantly lower than [(45.6±5.1)U/L, (45.5±5.1)U/L, (85.9±6.8) and (23.0±3.4), respectively, P＜0.05] in group B; the incidence of postoperative complications was 9.7%, significantly lower than 41.4% (P<0.05) and the stone residual rate was 6.5%, significantly lower than 31.0% in group B(P＜0.05). Conclusion CT-guided (PTCSL) and DFLL combination could reduce surgical damage, accelerate postoperative recovery of gastrointestinal functions with low stone residual rate, which might be related to less oxidative stress and inflammatory reaction.

Objective The aim of this study was to investigate the efficacy of lauromacrogol or anhydrous ethanol sclerotherapy under the guidance of color Doppler ultrasound (US) in patients with liver-kidney cysts. Methods 72 patients with liver-kidney cysts were encountered in our hospital between January 2019 and December 2020, and they all underwent cyst puncture under US guidance and sclerotheray. Out of them, 36 patients had lauromacrogol, and another 36 patients had ethanol sclerotherapy. They all were followed-up for six months. Results At the end of six month follow-up, the disappearance or obvious shrink of liver and kidney cysts in lauromacrogol-treated patients was 94.4%, not significantly different compared to 91.7% in patients with ethanol sclerotherapy(P>0.05); at one, three and six month after operation, the cyst reduction rates in lauromacrogol-treated patients were(67.5±8.1)%, (81.6±5.5)% and (95.2±4.9)%, all significantly lower than [(53.9±6.4)%, (73.2±4.7)% and (85.6±3.5)%, respectively, P＜0.05] in ethanol-treated patients; the incidences of side effects, such as fever, drunkenness-like reaction and nausea in lauromacrogol-treated patients was 8.3%, significantly lower than 27.8%(P＜0.05) in ethanol-treated patients. Conclusion The anhydrous ethanol or lauromacrogol sclerotherapy under US guidance in the treatment of patients with liver-kidney cysts is efficacious, and we recommend lauromacrogol sclerotherapy because of its high reduction rates of cysts and low incidences of adverse reactions.

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

Objective The aim of this study was to summarize the imaging features of multi-slice spiral CT (MSCT) in patients with gallbladder adenomyosis and in patients with gallbladder carcinoma. Methods 113 patients with gallbladder adenomyosis and 78 with gallbladder carcinoma were enrolled in our hospital between September 2015 and September 2020, and all patients underwent MSCT and ultrasonography. The histophthological examination was performed after surgery. Results The consistency of diagnosis by MSCT based on postoperative histopathological examination (Kappa=0.749) was stronger than that by ultrasonography (Kappa=0.577); the accuracy rate by MSCT scan in the diagnosis of patients with gallbladder adenomyosis was higher than that by ultrasonography(88.0% vs. 79.6%, P<0.05); the diagnosis of special, local gallbladder adenomyosis, by MSCT was also higher than that by ultrasonography (97.1% vs. 82.9%, P<0.05); the CT scan showed that the percentages of smooth gallbladder walls, RAS sinus display and clear boundary between liver and gallbladder in patients with gallbladder adenomyosis were 36.3%, 36.3% and 69.0%, all significantly higher than 9.0%, 6.4% and 38.5% in patients with gallbladder carcinoma (P<0.05). Conclusion The diagnostic accuracy of patients with gallbladder adenomyosis by MSCT is relatively high, and its imaging feature might help discriminate gallbladder adenomyosis from cancer.

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 clinical implication of peripheral blood T lymphocyte subset changes in patients with syphilis and hepatitis B or hepatitis C coinfection. Methods 93 patients with treponema pallidum (TP) syphilis were admitted to our hospital between January 2016 and June 2020, including syphilis infection in 61 cases, syphilis with hepatitis B virus infection in 21 cases and syphilis with hepatitis C virus infection in 11 cases. 84 healthy persons were selected as the control. The peripheral blood T lymphocyte subsets was assayed by FCM. Results The percentages of peripheral blood CD3⁺, CD4⁺, CD4⁺CD45RO⁺ and CD8⁺CD45RA⁺ cells as well as the ratio of CD4⁺/CD8⁺ cells in patients with syphilis were(52.2±8.5)%,(40.3±5.7)%,(18.1±3.9)%, (12.4±3.7)% and (1.2±0.3), all significantly lower than [(69.1±7.6)%,(50.7±6.9)%,(20.6±4.7)%,(16.2±4.3)% and (1.9±0.5), respectively, P＜0.05], while the percentages of peripheral blood CD8⁺, CD4⁺CD45RA⁺ and CD8⁺CD45RO⁺ cells were all significantly higher than those in healthy control [(32.4±7.3)%, (24.7±6.5)% and (8.7±1.5)% vs. (26.2±5.4)%, (21.8±6.2)% and (5.4±1.1)%, respectively, P＜0.05]; there were significant differences as respect to the percentages of peripheral blood CD8⁺, CD4⁺CD45RA⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺, CD8⁺CD45RO⁺ cells and the ratio of CD4⁺/CD8⁺ cells among patients with TP, with TP and chronic hepatitis B (CHB), and with TP and chronic hepatitis C (CHC, P＜0.05), the percentages of CD8⁺, CD4⁺CD45RA⁺ and CD8⁺CD45RO⁺ cells in patients with TP and CHB and patients with TP and CHC were all significantly higher than those in patients with TP(P＜0.05), while the ratio of CD4⁺/CD8⁺ cells, and the percentages of blood CD4⁺CD45RO⁺ and CD8⁺CD45RA⁺ cells were all significantly lower than those in patients with TP (P＜0.05); there were no significant differences respect to the percentage of blood CD8⁺, CD4⁺CD45RA⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺ and CD8⁺CD45RO⁺ cells and the ratio of CD4⁺/CD8⁺ cells between patients with TP and CHB, and those with TP and CHC (P＞0.05). Conclusion The percentages of peripheral blood CD3⁺, CD4⁺, CD8⁺, CD4⁺CD45RA⁺, CD8⁺CD45RO⁺, CD4⁺CD45RO⁺, CD8⁺CD45RA⁺ and the ratio of CD4⁺/CD8⁺ cells in patients with TP change greatly, and those in patients with TP and HBV or HCV mixed infection change even significantly, which needs further clinical investigation.

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

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

Objective The aim of this study was to summarize the experience about endoscopic management of cirrhotics with superior esophageal variceal bleeding(SEVB). Methods 25539 patients with gastroesophageal varices (GEV) were encountered in our hospital between January 2010 and January 2020, out of them, 12 patients(0.4‰)had SEVB and all underwent endoscopic management (urgent in 5 cases and non-urgent in 7 cases). Results The etiology of the 12 patients with SEVB included hepatitis B cirrhosis in 5 cases, hepatitis C cirrhosis in 4 cases, alcoholic liver cirrhosis in 2 cases and unknown cause cirrhosis in 1 case; 11 patients had obvious clinical manifestations, such as hematemesis, melena, hematochezia or peripheral circulation disorder; 5 cases had successful hemostasis immediately with urgent endoscopic management, and 6 of 7 had with non-urgent management(P>0.05); the endoscopic variceal ligation(EVL) therapy was done in 9 cases, sclerotherapy in 1 case, EVL combined with tissue glue injection in 1 case and EVL combined with sclerotherapy and tissue glue injection in 1 case; the adverse reactions occurred after endoscopic management in 7 cases; 8 patients were followed-up for (31.0±28.5)m, and 1 patient had recent rebleeding and 5 patients had long-term rebleeding; out of 7 patients followed-up after treatment, 1 patient had splenectomy and 2 patients had splenectomy and pericardial devascularization; the all-cause mortality in our series was 42.9%. Conclusion The EVL is the first choice for patients with SEVB with high immediate hemostasis, but a poor long-term prognosis. It is necessary to reduce portal hypertension in combination with other treatments to decrease the risk of long-term rebleeding and death.

Objective The purpose of this experiment was to explore the roles of microRNA(miR)-122 in the pathogenesis of liver fibrosis by in vitro and by in vivo. Methods The liver fibrosis model was established in C57BL/6 mice by intraperitoneal injection of carbon tetrachloride and also in HSC-T6 cells in vitro by incubation with 10 ng/ml transforming growth factor-β1 (TGF-β1). The miR-122 agomir and miR-122 mimics were transfected to overexpress miR-122 in mice and in hepatic stellate cells. The total RNA and whole protein were extracted for RT-PCR and Western-blot detection of miR-122, α-smooth muscle actin (α-SMA), type I collagen (Collagen Ⅰ), tissue inhibitor of metalloproteinase 1 (TIMP-1), and platelet-derived growth factor (PDGF). The proliferation of HSC-T6 cells was detected by CCK-8. Results The expression of α-SMA in the liver tissue in the model animal was significantly higher than that in the control group (9.92±2.12 vs. 1.12±0.54, P<0.01), while the miR-122 level was significantly lower than that in the control group (0.95±0.31 vs. 2.07±0.28, P<0.01); in mice with carbon tetrachloride-induced liver fibrosis, the miR-122 level in the miR-122 agomir-transfected group was significantly higher than that in the miR-122 agomir control-transfected group (6.27±1.73 vs. 2.78±0.21, P < 0.01); the α-SMA, type I collagen, TIMP-1 and PDGF protein expression in the miR-122 agomir-transfected group were significantly decreased; in TGF-β1-intervened HST-T6 cells, the α-SMA expression increased as the prolongation of TGF-β1 treatment (0h:0.61±0.02, 12 h:0.69±0.05, 24 h:0.75±0.01, 48 h:1.01±0.03, P＜0.05), while the miR-122 levels decreased (0 h:0.72±0.05, 12 h:0.45±0.01, 24 h:0.37±0.03, 48 h:0.29±0.08, P＜0.05); the miR-122 level in the miR-122 mimics-transfected cells greatly increased as compared with the miR-122 negative control-transfected cells (178.45±30.62 vs. 12.18±2.39, P＜0.01); the Western blot showed that the expression of α-SMA protein was significantly down-regulated in the miR-122 mimics-transfected group; in TGF-β1-intervened HST-T6 cells, the proliferation activity greatly decreased in the miR-122 mimics-transfected group as compared to that in miR-122 negative control-transfected group (P＜0.05). Conclusion The miR-122 levels down-regulate in liver fibrosis, and overexpression of it might inhibit the activation and proliferation of hepatic stellate cells, and probably inhibit the occurrence and development of liver fibrosis.

Objective The aim of this study was to investigate the value of total liver volume (TLV)/spleen volume (SV) ratio by multislice CT calculation in diagnosis ofpatients with liver cirrhosis (LC). Methods 138 cirrhotic patients and 130 patients with benign liver diseases or healthy persons were admitted to our hospital between October 2016 and October 2019, and all underwent dynamic contrast-enhanced multi-slice spiral CT scan. The TLV, right liver volume (RV), left inner lobe volume(LMV), left outer lobe volume (LLV), cauda lobe volume (CV), SV as well as TLV/RV ratio, TLV/LMV ratio, TLV/LLV ratio, TLV/CV ratio and TLV/SV ratio were calculated by software. Results The TLV, RV and LMV of liver in patients with LC were (1078.2±315.7) cm³, (543.8±186.5) cm³ and (163.6±73.7) cm³, significantly smaller than [(1470.4±199.7) cm³, (933.3±174.1) cm³ and (216.2±40.1) cm³, respectively, P<0.05], while the LLV and SV were (327.8±121.9) cm³ and (863.4±396.8) cm³, both significantly larger than [(275.9±65.7) cm³ and (256.3±81.7) cm³, respectively,P<0.05] in the control; the TLV / RV ratio in patients with LC was 2.0±0.9, significantly higher than [1.6±0.7, P<0.05], while the TLV / LLV ratio, TLV / CV ratio and TLV / SV ratio were (3.3±1.5), (25.3±12.4) and (1.3±0.6), all significantly lower than [(5.3±2.5),( 32.8±16.1) and (5.7±2.4), respectively, P<0.05] in the control; there were no significant differences in CV and TLV/LMV ratio between the two groups (P>0.05). Conclusion The calculation of TLV/SV by multislice spiral CT scan might help diagnose LC in clinical practice.

Objective The aim of this study was to investigate the modified endoscopic nosal biliary drainage (ENBD) through gallbladder approach in the treatment of patients with small-diameter common bile duct stones (CBDS). Methods A retrospective analysis was conducted, including 54 patients with small-diameter CBDS encountered in the hospital between December 2015 and June 2018 (control group) and other 54 cases presented between July 2018 and December 2020 (observation group). All patients underwent laparoscopic cholecystectomy (LC), followed by common bile duct exploration and ENBD, and the difference was the common nasal biliary drainage (NBD) was applied in the control and the modified NBD in the observation. Serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected routinely. Results The postoperative drainage volume of bile and extubation time of nasobiliary ducts in the observation were (281.6±52.5)mL and (5.9±1.3)d, significantly greater or longer than [(228.7±53.2)mL and (4.0±1.4)d, respectively, P＜0.05], while the hospital stay was (6.1±1.1)d, significantly shorter than [(8.1±1.3)d, P＜0.05] in the control group; the incidences of post-operational complications, such as pancreatitis, bile leakage and slippage of nasobiliary ducts in the observation was 7.4%, significantly lower than 25.9%(P＜0.05) in the control; one week after operation, serum CRP, IL-6 and TNF-α levels in the observation were (42.8±11.1)mg/L, (3.2±0.8)ng/L and (1.0±0.8)ng/L, significantly lower than [(73.7±17.4)mg/L, (4.9±1.2)ng/L and (1.8±0.9)ng/L, respectively, P＜0.05] in the control group. Conclusion Compared with the ordinary NBD tube, the application of modified NBD tube could reduce the risk of slippage, improve the drainage of bile and shorten the postoperative recovery in patients with small-diameter CBDS.

Objective The aim of this study was to investigate the clinical efficacy of tolvaptan and concentrated ascites reinfusion (CAR) in the treatment of patients with liver cirrhosis-induced refractory ascites (RA). Methods 93 patients with liver cirrhosis-induced RA were encountered in our hospital between September 2019 and September 2022, and were randomly divided into control (n=46) and observation group (n=47), receiving CAR or oral tolvaptan after CAR. The observation lasted for 7 days. Blood urea nitrogen (BUN), serum creatinine (sCr) and serum sodium levels were detected by fully automatic biochemical analyzer. The diameter of portal vein (DPV), diameter of splenic vein (DSV), portal vein flow (PVF) and splenic vein flow (SVF) were measured by ultrasonography. Results At treatment day 7, the 24-hour urine volume in the observation group was (1957.5±50.3) mL, significantly greater than [(1316.2±49.1) mL, P<0.05] in the control group, and the body weight, abdominal circumference and ascites depth were (58.1±7.2)kg, (80.6±4.7)cm and (16.5±4.2)mm, all significantly less than [(65.4±7.8)kg, (88.1±4.5)cm and (42.7±5.3)mm, respectively, P<0.05] in the control; serum BUN and sCr levels in the observation group were (6.2±1.4)mmol/L and (114.2±9.7)μmol/L, much lower than [(6.9±1.6)mmol/L and (129.4±10.3)μmol/L, P<0.05] in the control, while there were no significant differences respect to liver function tests between the two groups (P>0.05); serum sodium level was (144.3±1.1)mmol/L, much higher than [(138.1±1.0)mmol/L, P<0.05] in the control; the PVF was (994.3±195.7)mL/min, much lower than [(1175.2±210.6) mL/min, P<0.05] in the control, while there were no significant differences respect to DPV, DSV and SVF between the two groups (P>0.05). Conclusion The oral administered tolvaptan at base of CAR in dealing with patients with liver cirrhosis-induced RA could help subside ascites, improve the renal function tests and serum sodium levels, and warrants further clinical observation.

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

Objective The aim of this study was to investigate the distribution of hepatitis C virus (HCV) genotypes among people in different regions, ethnic groups and transmission risk factors in China. Methods Papers on the studies of HCV genotypes in China were searched in Wanfang and NCBI database, and the data was classified by different regions, ethnic groups, and transmission risk factors. The data was analyzed by meta-analysis to observe the distribution of genotypes. Results In China, the HCV genotype 1 was the most prevalent, the HCV genotypes were mainly genotype 1 (52.7%-79.7%) and genotype 2 (13.9-44.9%) in the northern region, the HCV genotypes were mainly genotype 1 (51.7%-79%) in the southeast region, and the genotype 6 was widely distributed in Hong Kong (31.3%), Guangdong (23.1%), Fujian (21.8%) and Macau (20.6%); the HCV genotypes were mainly genotype 1 (19.7%-73.4%) and genotype 3 (13.4%-58.5%) in the southwest region; the main genotypes distributed in the western region were genotype 1 (53.6%-66.8%), genotype 2 (15.8%-32.1%) and genotype 3 (12.8%-15.8%); the proportion of genotype 2 in Korean nationality was (22.4%, P<0.001), in Uyghur(13.1%, P<0.001) and in Kazakh (18.5%, P<0.05), and the proportion of genotype 3 in Uyghur was 16.6%,significantly higher than 9.4% of the Han nationality 42.2%, significantly higher than that in Han (P<0.001); the proportion of genotype 3 in persons with intravenous drug use was 31.1%, significantly higher than with blood transmission infected (4.5%, P<0.001) or sexual transmission infected (24.1%, P<0.05), and the proportion of genotype 6 infection in intravenous drug users was 26.7% , significantly higher than by blood transmission infection (4.1%, P<0.001) or by sexual transmission infection (15.1%, P<0.001); the proportion of type 3 and type 6 in individuals with HCV/HIV mixed infection were higher than that in with HCV infection alone (all P<0.001). Conclusion There are differences in the distribution of HCV genotypes among individuals in different regions, in different ethnic groups and with different transmission routs.

Objective The purpose of this clinical trial was to investigate the auxiliary treatment of a herbal compound, Ganshuang granule, with entecavir for patients with chronic hepatitis B (CHB). Methods 60 patients with CHB were enrolled in our hospital between January 2019 and January 2021, and were randomly divided into control and observation groups, with 30 cases in each. The patients in the control group received entecavir, and those in the observation were treated with entecavir and a herbal compound, Ganshuang granule, for 48 weeks. The AST to platelet ratio index (APRI), fibrosis 4 score (FIB-4) were obtained, and the liver stiffness measurement (LSM) was determined by FibroTouch scan. Serum interleukin-6(IL-6), transforming growth factor-beta (TGF-β), platelet-derived growth factor (PDGF) and C-reactive protein (CRP) levels were assayed by ELISA. Results At the end of 48 week treatment, serum ALT and AST levels in the observation group were significantly lower than in the control group (P<0.05); serum HBV DNA loss in the two groups were both 100.0%, and serum HBeAg negative rates were both 0.0% (P>0.05); the APRI, FIB-4 and LSM in the observation group were (1.02±0.23), (4.38±0.77) and (7.73±1.53), all significantly lower than [(1.30±0.33), (5.26±0.85) and (9.68±2.02), respectively, P<0.05] in the control; serum IL-6, TGF-β, PDGF and CRP levels in the observation were much lower than in the control (P<0.05). Conclusion The auxiliary treatment of Ganshuang granule at base of entecavir antiviral therapy could significantly improve biochemical response in patients with CHB, which might be related to the anti-fibrotic effect and inhibition of body inflammatory reaction of the herbal compound.

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

Objective Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adults all over the world. Sarcopenia is a syndrome caused by continuous loss of skeletal muscle mass, strength, and functions. As sarcopenia progresses, lean body mass may decrease while fat mass increases, resulting in sarcopenic obesity. Sarcopenic obesity is associated with NAFLD and its development. Although most of the previous studies have demonstrated the positive correlation between sarcopenia and NAFLD, the difference in diagnostic methods of sarcopenia and NAFLD leads to difficulties in interpretation and application. This review mainly discusses the impact of sarcopenic obesity on NAFLD and the diagnosis and treatment strategies when the two coexist.

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

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

Objective The aim of this study was to investigate oral maintaining treatment of propranolol after endoscopic variceal ligation (EVL) and somatostatin combination for emergent hemostasis in patients with esophagogastric variceal bleeding (EVB). Methods 116 cirrhotics with EVB were admitted to our hospital between January 2021 and December 2023, and were randomly divided into control (n=57) and observation (n=59) groups. All patients in the two groups underwent EVL and intravenous administration of octreotide for emergent hemostasis, and those in the observation received oral propranolol for maintaining treatment after operation. Portal vein flow (PVF) and splenic vein flow (SVF) were detected by ultrasonography, and hepatic venous pressure gradient (HVPG) was calculated after transjugular vein intubation. Plasma prothrombin time (PT) and fibrinogen (FIB) levels were routinely obtained. Results One week after treatment, the hemostasis rate in observation and control group were 94.9% and 96.5% (P>0.05), and three patients died in the observation and 2 died in the control; there were no significant differences as respect to bleeding cessation times [(63.5±2.1)vs. (62.3±3.6)h], blood transfusion [(3.9±0.8)U vs. (4.1±1.2)U], hospital stay [(10.4±1.7)d vs. (10.5±2.9)d] and medical costs [(10.8±2.0)thousand yuan vs. (10.8±2.0)thousand yuan] between the two groups (P>0.05); after treatment, PVF, SVF and HVPG in the observation were (541.5±108.6)ml/min, (289.7±53.4)ml/min and (13.5±3.1)mmHg, all significantly lower than [(616.4±112.7)ml/min, (306.4±56.3) ml/min and (14.6±3.8)mmHg, respectively, P＜0.05] in the control; plasma PT was (14.1±1.1)s and FIB levels was (2.7±0.8)g/L, both not much different as compared to [(14.0±1.2)s and (2.8±0.6)g/L] in the control (P＜0.05); the 3-month and 6-month re-bleeding rates in the observation group were 5.4% and 10.7%, both not significantly different compared to 7.3% and 14.6% in the control group (P>0.05). Conclusion Oral maintaining treatment of propranolol after emergent hemostasis in patients with EVB could reduce portal hypertension, which might reduce re-bleeding and needs long-term investigation.

Objective Dietary copper restriction has long been considered an important treatment for patients with hepatolenticular degeneration (HLD). However, evidence supporting this approach is limited. There are no published randomised controlled trials for the recommendation due to rarity of the disease and variable presentation. This review summarized current knowledge on the absorption and regulation of copper in humans and its relevance to patients with HLD. Studies have demonstrated that as the level of dietary copper increases, the proportion absorbed decreases. This observation implies that ‘high copper' foods that HLD patients are generally advised to avoid would need to be consumed in large amounts to impact markedly on the quantity absorbed. Dietary copper restriction is unlikely to reduce the amount absorbed significantly and is not only difficult to manage but restricts food supply unnecessarily, detracting from the provision of substrates essential for improving nutritional status in a nutritionally compromised group. Medical management for HLD is effective in compliant patients, allowing stabilization of the liver disease. Based on current evidence, dietary copper restrictions in stable HLD patients who are adherent to medical therapy are unnecessary with two food exceptions (shellfish and liver organ).

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 spontaneous bacterial peritonitis (SBP) is one of the most common complications in patients with cirrhosis, with high clinical incidence, rapid disease development and high mortality. The clinical manifestations of SBP are often not very typical, and the diagnosis of celiac infection is mainly based on the white blood cell counts in celiac fluid. The treatment is mainly empirical antibiotic administration and intestinal flora modulation. Early diagnosis and active intervention are of great importance to improve the prognosis and reduce the mortality, but there are still some great challenges in the diagnosis, treatment and prevention of the entity, which require in-depth study to further solve the relevant problems, so as to guide the clinical practice and improve the patient's prognosis.