Objective The aim of this study was to summarize the ultrasonographic and biochemical features of patients with non-alcoholic heterogeneous fatty liver (NAHFL). Methods 90 patients with NAHFL and 30 healthy persons were enrolled in our hospital between January 2016 and December 2018, and ultrasonography and blood biochemical indicators were carried out. Results Out of the 90 patients with NAHFL, 23 cases (25.6%) belonged to type I (local invasive type), 29 cases (32.2%) belonged to type II (segmental infiltration type) and 38 cases (42.2%) belonged to type III (diffuse heterogeneous infiltration) type); serum transferrin (SF) level in patients with type II fatty liver was (254.2±98.7) μg/L, significantly higher than [(175.1±98.4) μg/L, P<0.05] in healthy control; the fasting blood glucose level in patients with type III fatty liver was (6.37±0.79) mmol/L, significantly higher P<0.05] in the control, and HbA1c was than in the control, blood uric acid level was (418.3±40.5)μmol/L, significantly higher than in the control, and SF was (287.3±105.1) mg/l, significantly higher than in the control; serum AST level in patients with type II fatty liver was (51.5±13.4) IU/L, significantly higher than in the control, serum GGT level was (59.3±31.2) IU/L, significantly higher than in the control, blood TC in patients with type III fatty liver was (4.7±0.8) mmol/L, significantly higher than in the control, blood TG was (3.2±1.5) mmol/L, significantly higher than in the control, serum AST was (60.2±18.7) IU/L, significantly higher than , serum ALT was (54.2±29.8) IU/L, significantly higher than , and serum GGT level was (59.3±31.2) IU / L, significantly higher than in the control. Conclusion Ultrasonography might show a characteristic features in patients with NAHFL, and the diagnosis might be made at the base of blood analysis in clinical practice.

Objective Hepatocellular carcinoma (HCC) is one of the most common liver malignancies in the world. The etiology and molecular events HCC are still unclear. We tried to identify the key pathogenic gene, the cell division cycle 20 (CDC20) by comprehensive bioinformatics, which was related to the pathogenesis of HCC with certain underlying molecular mechanism. Methods We downloaded GSE36376 gene expression profile from Gene Expression Omnibus (GEO) database, found 433 samples, of which 240 HCC tissues and 193 of normal liver tissues, and were analyzed by comprehensive bioinformatics. The R software in RStudio was applied to screen the differential gene expression (DEG) in HCC and normal liver tissues, and the protein-protein interaction (PPI) network of DEG was constructed from the STRING database. The Metascape online tool was applied to carry out enrichment analysis, at the same time, the MCODE was used to identify Hub gene. Results The GSE36376 data was screened to get 706 DEGs, among them, a total of 554 down-regulated genes and 152 up-regulated genes were identified; the significant up-regulated genes were UBE2C, CDC20, COL4A1, NUSAP1, HSP90AB1, and CDKN3 from the PPI network; the Metascape enrichment analysis showed that in the GO biological process, it was mainly concentrated in the small molecule catabolism, the monocarboxylic acid metabolism, the steroid metabolism, the cofactor metabolism, the drug catabolism, the primary alcohol metabolism, and the effects of toxic substances; it also involved the organic anion transport, monosaccharide metabolism, aromatic amino acid family metabolism, detoxification, primary alcohol catabolism, and organic cyclic compound catabolism, etc; as for the KEGG signal pathway, it was mainly focused on carbon metabolism, fatty acid degradation, complement and coagulation cascade, tryptophan metabolism and peroxisomes, etc; the Hub genes were UBE2C, CDC20 and HSP90AB1 from MCODE. Conclusion The CDC20 gene obtained by comprehensive bioinformatics is a key gene for pathogenesis of HCC, which might be important for early diagnosis and therapeutic target.

Objective The aim of this study was to investigate the liver pathological features of patients with drug-induced liver injury(DILI). Methods Thirty-eight patients with DILI was encountered in our hospital between January 2017 and December 2020, and all were evaluated by structured expert opinion process(SEPO)and underwent liber biopsies. The diagnostic performance of DILI-pathological scroring system (DILI-PSS) was verified by the area under the receiver operating characteristic curve (AUROC). Results Out of the 38 patients with DILI, 14 patients (36.8%) had taken chemical medicines and biological products, 12 patients (31.6%) had taken Chinese herbal medicines, 9 patients (23.7%) had taken Chinese herbal, chemical medicines and biological products, and 3 patients (7.9%) had taken dietary supplements; the pathological examination showed that hepatic steatosis in 20 cases(52.6%), hepatic cholestasis in 22 cases(57.9%), bile duct damage in 15 cases(39.4%), eosinophil immersion in 11 cases(28.9%), hepatocellular wreaths in 9 cases (23.7%), and granuloma in 6 cases (15.8%); the AUROC was 0.775 with 95% confidence interval of 0.669-0.880 (P<0.05), and the sensitivity of 81.6% and the specificity of 65.8% when the DILI-pathological scroring system (DILI-PSS) was applied to predict the diagnosis. Conclusion The application of DILI-PSS might help diagnose patients with DILI, which needs further clinical investigation.

Primary liver cancer （PLC） is one of the most common malignant tumors in China. Early diagnosis of liver cancer is crucial for the outcome of patients with PLC. Protein induced by vitamin K absence or antagonist II（PIVKA-II） is a new serum tumor marker documented in recent years. It has a diagnostic value for hepatocellular carcinoma,reportedly better than the widely used serum tumor marker alpha-fetoprotein （AFP）. In this paper,we reviewed the progress of PIVKA-II in the fundamental research and clinical application.

Objective Liver is an important organ for the metabolism of sex hormones, lipids and other substances. Male patients with chronic liver disease often suffer from a variety of dysfunctions, such as sex hormone metabolism, glucose and lipid metabolism and mental and psychological disorder. Erectile dysfunction is easy to occur, which affects the physical and mental health and the family life of patients.Existing studies have shown that the prevalence of male erectile dysfunction in patients with chronic liver disease was 24.6% to 85%, the prevalence in chronic hepatitis patients was 8.6% to 78%, and in patients with cirrhosis was 41.2% to 92%.In this paper, we reviewed the incidence, impacting factors, possible pathogenesis, and treatment of erectile dysfunctions in male patients with chronic liver disease.

Objective The aim of this study was to summarize the magnetic resonance imaging (MRI) characteristics of patients with wall-thickening gallbladder carcinoma. Methods A total of 60 patients with gallbladder diseases were admitted to our hospital between January 2019 and December 2020, and all patients underwent MR scan and surgical cholecystectomy or radical cholecystectomy. Results The gallbladder width and gallbladder wall thickness in 21 patients with wall-thickening gallbladder carcinoma were (3.5±0.4)cm and (1.5±0.2)cm, significantly larger than in 39 patients with chronic cholecystitis, and the incidences of blurred interface with adjacent tissues, biliary obstruction, gallbladder wall stiffness, irregular gallbladder morphology and incomplete gallbladder mucosal line in patients with thick-thickening gallbladder carcinoma were 61.9%, 76.2%, 71.4%, 85.7% and 95.2%, all significantly higher than 0.0%, 10.3%, 2.6%, 25.6% and 0.0%, respectively, in patients with chronic cholecystitis (P＜0.05). Conclusion MRI is high valuable in diagnosis and differentiation of patients with wall-thickening gallbladder carcinoma, which has some characteristic features for clinicians to make medical plan early for them.

Objective The aim of this study was to investigate the diagnostic efficacy of ¹⁸F-FDG PET/CT scan in patients with intrahepatic cholangiocarcinoma (ICC).Methods 107 patients with ICC and 107 healthy persons underwent ¹⁸F-FDG PET/CT scan between January 2017 and January 2020, and the TNM staging of tumor was evaluated and the standard uptake value maximum (SUVmax) was culculated. All patients received tumor resection.Results The SUVmax in patients with ICC stage Ⅰ was (4.1 ± 1.1), in patients with stage Ⅱ was (7.2 ± 1.5), and in patients with stage Ⅲ was (9.3 ± 1.8), all significantly higher than [(2.0 ± 0.9) , P<0.05] in healthy persons; the FDG PET/CT scan showed TNM stage Ⅰ in 35 cases, stage Ⅱ in 47 cases, and stage Ⅲ in 25 cases, and the post-operational histopathological examination demonstrated TNM stage Ⅰ, stage Ⅱ and stage Ⅲ were34 cases, 48 cases and 24 cases, respectively; the sensitivity (Se) of ¹⁸ F - FDG PET/CT scan in the diagnosis of patients with ICC TNM stage Ⅰ was 0.968, the specificity (Sp) was 0.500,the accuracy (Ac) was 0.914, the positive predictive value (PPV) was 0.938, and the negative predictive value (NPV) was 0.667, in the diagnosis of patients with ICC TNM staging Ⅱ, the Se was 0.976, the Sp was 0.667, the Ac was 0.956, the PPV was 0.976, and the NPV was 0.667, and in the diagnosis of patients with ICC TNM staging Ⅲ, the Se was 0.955, the Sp was 0.667, the Ac was 0.920, the PPV was 0.955, and the NPV was 0.667.Conclusion The application of ¹⁸F-FDG PET/CT scan is helpful for the diagnosis and assessment of TNM stage in patients ICC.

Objective The incidence rate of nonalcoholic fatty liver disease (NAFLD) is increasing. It might progress to the end-stage liver disease. However, there is still no specific treatment for this entity. Therefore, the establishment of representative animal models reflecting disease characteristics has become especially important. Although there are many different disease models, there is still a lack of NAFLD model which could cover the whole spectrum of this entity in human. In this paper, we reviewed the current progress on NAFLD model, focusing on animal model, 2D cell model, 3D liver model and their advantages and disadvantages.

Objective To systematically evaluate the efficacy and safety of tauroursodeoxycholic acid and ursodeoxycholic acid combination in the treatment of patients with nonalcoholic fatty liver disease （NAFLD）. Methods We searched CNKI,VIP,WanFang Data,CBM,PubMed,The Cochrane Library,EMbase database and retrieved randomized controlled trials （RCT） on the observation of tauro ursodesoxycholic acid and ursodeoxycholic acid combination in the treatment of patients with NAFLD since inception of database. Meta analysis was performed by using RevMan 5.3 software. Results A total of 682 NAFLD patients were included in 6 RCT studies,and 342 in the observation group were treated by tauro ursodesoxy cholic acid and polyene phosphatidyl choline,and 340 in the control group were treated by ursodeoxycholic acid and polyene phosphatidyl choline combination. The Results showed that the overall effective rate [RR=1.10,95%CI（1.03,1.18）,P=0.004],serum ALT reduction [MD=13.34,95%CI（12.20,14.48）,P<0.00001],AST reduction [MD=11.29,95%CI（5.85,16.72）,P<0.0001], GGT reduction [MD=22.54,95%CI（20.75,24.33）,P<0.00001],TG reduction[MD=0.48,95%CI（0.25,0.70）,P<0.0001],LDL-C reduction [MD=0.67,95%CI（0.51,0.83）,P<0.00001] and BMI reduction [MD=1.57,95%CI（1.29, 1.84）,P<0.00001] as well s HDL-C elevation [MD=0.23,95%CI（0.18,0.27）,P<0.00001] in the observation group in the treatment of patients with NAFLD were significantly superior to those in the control group; however,there was no significant difference between the two groups as respect to serum TC reduction [MD=0.30,95%CI（-0.03,0.64）,P=0.08] and the incidence of adverse reactions [RR=1.00,95%CI（0.41, 2.47）,P=1.00];the improvement of hepatic steatosis was also not significantly different between the two groups [RR=2.2,95%CI（0.97,4.98）,P=0.06]. Conclusion The efficacy of tauro ursodesoxy cholic acid combined with polyene phosphatidyl choline in the treatment of patients with NAFLD is good based on the domestic studies,which might be at a low level observations.

Objective The aim of this study was to investigate the CT imaging feature in patients with non-alcoholic fatty liver diseases (NAFLD) with different traditional Chinese medicine (TCM) syndrome.Methods 240 patients with NAFLD were enrolled in our hospital between January 2017 and January 2020, and the TCM syndrome were determined. All patients underwent CT scan.Results The percentage of mild fatty liver by CT diagnosis in patients with liver depression and spleen deficiency was 88.9%, significantly higher than 17.6%, 25.8%, 6.5% and 0.0%(P＜0.05) in patients with damp phlegm and internal resistance syndrome, damp heat and internal gathering syndrome, phlegm and blood stasis syndrome and liver and kidney deficiency syndrome; the percentage of severe fatty liver in patients with liver and kidney deficiency syndrome was 85.7%, and that in patients with phlegm and blood stasis syndrome was 51.6%, significantly higher than 0.0% in patients with liver depression and spleen deficiency, 8.8% in with damp phlegm and internal resistance and 15.7% in damp heat and internal gathering syndrome(P＜0.05); the CT score in patients with liver depression and spleen deficiency was (42.4±4.7)HU and the CT score in patients with damp phlegm and internal resistance was(37.0±5.6)HU, both significantly higher than [(32.0±5.8)HU, (27.0±6.2)HU and (22.8±7.9)respectively, P＜0.05】 in patieHU,nts with damp heat and internal gathering, in with ph legm and blood stasis syndrome and in with liver and kidney deficiency syndrome, while the liver/spleen ratio were (0.8±0.1) and (0.7±0.2),significantly higher than【(0.6±0.1), (0.5±0.1) and (0.4±0.1), respectively, P＜0.05】 in patients with damp phlegm and internal resistance, in patients with damp heat and internal gathering and in with liver and kidney deficiency syndrome.Conclusion The CT imaging of patients with NAFLD with different TCM syndromes is characteristic, which might help the TCM doctors to deal with the entity appropriately in clinical practice.

Objective The aim of this study was to investigate the application of preoperative bile CT value in the diagnosis of patients with gallbladder muddy stones.Methods 72 patients with routine imaging false-negative gallbladder muddy stones and 40 patients undergoing gallbladder excision due to liver surgery were enrolled in Hepatobiliary Surgery of PLA General Hospital between September 2018 and September 2020, and all patients underwent abdominal CT scan. Serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) levels were obtained. The area under the receiver operating characteristic curve (AUC) was applied to predict the diagnostic value.Results There were no significant differences in changes of liver function tests and blood parameters between the two groups (P>0.05); the bile CT value in gallbladder stone group was significantly higher than that in control group [(66.01±18.24) Hu vs. (25.40±8.23) Hu, P<0.05; there was no significant differences as respect to serum cytokines and PCT levels; the ROC curves analysis showed that the AUC, sensitivity and specificity were 0.954, 92.3% and 91.0%, respectively as the bile CT value greater than 25.60 Hu was set as the cut-off-value for the diagnosis of gallbladder muddy stones.Conclusion The imaging examination shows that bile CT value in patients with false-negative gallbladder muddy stones is significantly higher than that in the subjects with normal gallbladder without stone. The accuracy of bile CT value is relatively higher in the diagnosis of gallbladder muddy stones.

Objective The aim of this study was to compare the therapeutic efficacy of magnesium isoglycyrrhizinate and compound glycyrrhizin monoamine in treatment of patients with drug-induced liver injury (DILI). Methods A total of 102 patients with DILI were enrolled in our hospital between January 2018 and January 2020, and were randomly divided into observation and control group, with 51 cases in each group. The patients in the observation were treated by intravenous administration of magnesium isoglycyrrhizinate, those in the control were treated by intravenous compound glycyrrhizin monoamine, and the regimen lasted for 14 to 28 days. Serum laminin (LN), hyaluronidase (HA), procollagen-III (PC-III) and collage type IV (IV-Col) were detected by radioimmunoassay. Serum superoxide dismutase (SOD), nitric oxide (NO), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by ELISA. Results At the end of the treatment, serum ALT and AST levels in the observation group were (42.7±12.5)U/L and (38.2±9.4)U/L, both significantly lower than [(64.5±21.9)U/L and (55.6±15.2)U/L, respectively, P＜0.05] in the control; serum HA, PC-III and IV-Col levels were (138.2±21.5)mg/L, (85.6±17.4)μg/L and (141.5±16.4)μg/L, all significantly lower than [(182.1±23.9)mg/L, (123.8±19.4)μg/L and (175.4±18.7)μg/L, respectively, P＜0.05]; serum SOD and NO levels were (90.3±10.1)U/L and (79.8±9.3)μmol/L, both significantly higher than [(74.9±8.6)U/L and (54.0±7.9)μmol/L, respectively, P＜0.05], while serum IL-6 and TNF-α levels were (11.2±2.5)pg/mL and (26.4±3.6)ng/L, both significantly lower than [(16.8±2.7)pg/mL and (41.3±5.9) ng/L, respectively, P＜0.05] in the control. Conclusion The therapeutic efficacy of magnesum isoglycyrrhizinate is promising in dealing with patients with DILI, which could effectively improve serum biochemical indexes normal and alleviate oxidative stress.

Objective The aim of this study was to summarize manifestations of hepatic hemangioma (HH) by using grayscale ultrasound, color Doppler flow imaging (CDFI) and contrast-enhanced ultrasound (CEUS), in order to help clinicians making diagnosis. Methods 62 patients with HH were encountered in Jingmen People's Hospital, affiliated to Jingchu Institute of Technology between January 2022 and August 2024, all patients underwent grayscale ultrasound, CDFI and CEUS examination, and underwent surgical resection. Results Tumor resection completed successfully in all the 62 patients with HH in our series, and histopathological examination diagnosed cavernous hemangioma in 44 cases, sclerosing hemangioma in 7 cases, vascular endothelial cell tumor in 6 cases and capillary hemangioma in 5 cases; ultrasonography showed that the size of HH lesions in this group ranged from 1.5 to 84 cm, with an average of (4.6 ± 1.3) cm, and the lesions presented irregular edges and non-spherical shapes; the lesion presented as enhanced echo or uneven echo distribution; CDFI examination demonstrated the lesions presented as spotted short columnar blood flow signals, with blood flow phenomena found within and around the vascular tumor; CEUS examination showed a slightly hyperechoic nodule in the liver, which appeared as a nodular ring-shaped high-intensity enhancement at arterial phase, subsequently, the contrast agent cleared or manifested as a slightly hyperechoic nodule in the liver; at portal and delayed phases, the contrast agent gradually filled the center, showing high-intensity enhancement. Conclusions The HH is relatively easy to diagnose by gray scale and color Doppler ultrasonography, and for some lesions that are difficult to determine, CEUS examination might be used to help further clarify the diagnosis.

Objective Liver fibrosis is caused by excessive deposition of extracellular matrix in liver tissues due to repeated liver injuries and hypoxia injury is a part of liver injury. Hypoxia inducible factor-1 α (HIF-1α) is a key transcription factor in response to hypoxia stress, and its expression in liver fibrotic tissues and activated HSCs is significantly increased. At present, a number of HIF-1α dependent genes and related signaling pathways have been studied to confirm that the changes of these genes and pathways are related to the development of liver fibrosis, suggesting that HIF-1α may play a key role in liver fibrosis. In this review, the mechanism of HIF-1α-related signaling pathway in the development of liver fibrosis and the synthesis and degradation of HIF-1α from the upstream are described.

Objective The aim of this study was to investigate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters in the differential diagnosis of small benign and malignant liver space-occupying lesions (LSOL). Methods 83 patients with LSOL were admitted to our hospital between March 2020 and March 2022, the patients included had their liver lesions less than 3 cm, and all underwent DCR-MRI scan to obtain the volume transfer constant (Ktrans), rate constant (Kep), extravascular extracellular volume fraction (Ve) and initial area under the curve (IAUC) by Tissue4D software automatically at region of interest. The diagnosis was pathologically confirmed from post-operational or fine needle aspiration tissues. The diagnostic efficacy was assessed by the receiver operating characteristic (ROC) curves. Results Out of the 83 patients with LSOL, the pathological examination found benign lesions in 38 cases and malignant ones in 45 cases; the Krans, Kep, Ve and IAUC in malignant lesions were (0.4±0.2)min^-1, (0.9±0.3)min^-1,(0.5±0.2) and (37.2±7.1), all significantly greater than [(0.1±0.1)min^-1, (0.4±0.2)min^-1, (0.3±0.1) and (11.1±2.9), respectively, P<0.05] in their adjacent liver tissues, and also much greater than [(0.2±0.1)min^-1, (0.4±0.3)min^-1, (0.3±0.2) and (22.1±5.7), respectively, P<0.05] in benign lesions; the ROC analysis showed that the combination of Krans, Kep, Ve and IAUC in differentiating small intrahepatic LSOL was much superior to any parameter alone, with the AUC of 0.920, the sensitivity of 95.0%, and the specificity of 78.5%(P<0.05). Conclusion The DCE-MRI quantitative parameters are efficacious in the differential diagnosis of small benign and malignant intrahepatic LSOL.

Objective The aim of this study was to compare the efficacy of glycyrrhizic acid diamine and compound glycyrrhizin in the treatment of patients with drug-induced liver injuries (DILI). Methods 97 tumor patients with DILI caused by cyclophosphamide were encountered in Nantong Tumor Hospital between July 2018 and January 2021, and were randomly divided into control group (n=47) and observation group (n=50), receiving compound glycyrrhizin or glycyrrhizic acid diamine, respectively for six months. Serum malonaldehyde (MDA), reduced glutathione (GSH), superoxide dismutase, (SOD) and advanced protein oxidation products (APOPs) levels were detected by purine oxidase; Serum interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), nitric oxide (NO) and macrophage migration inhibitory factor (MIF) levels were determined by ELISA. Results At the end of six month observation, serum bilirubin, ALT and GGT levels in the observation group were(12.3±1.5)μmol/L, (34.9±9.5)U/L and (36.9±8.8)U/L, significantly lower than [(21.7±3.1)μmol/L, (75.3±18.2)U/L and (74.2±15.2)U/L, respectively, P＜0.01] in the control; serum TNF-α, IL-6 and MIF levels were (4.1±0.8)ng/ml, (17.6±5.3)pg/ml and (6.0±0.5)ng/mL, significantly lower than [(5.9±1.2)ng/ml,(28.8±6.1)pg/ml and (10.7±0.9)ng/mL, respectively, P＜0.01] in the control group; serum MDA and APOPs levels were (4.3±0.7)μmol/L and (2.4±0.2)μmol/L, significantly lower than [(6.4±1.2)μmol/L and (4.3±0.5)μmol/L, P＜0.01], while serum SOD and GSH levels were (83.6±7.9)U/L and (7.6±1.5)μmol/L, significantly higher than [(75.2±9.2)U/L and (6.4±1.2)μmol/L, P＜0.01] in the control; at the end of one-year follow-up, 25 patients(25.8%) died of malignant tumors in our series. Conclusion The oral administration of glycyrrhizic acid diamine in the treatment of patients with DILI caused by cyclophosphamide is convenient and seems to be more efficacious compared with compound glycyrrhizin, which could improve liver function index normal and inhibit the inflammatory reactions and oxidative stress.

Objective Bile acid(BA) is synthesized in the liver and is the major component of bile. BAs accumulates in serum and liver when BAs secretion is impaired, which is followed by liver injury. The molecular mechanism of cholestasis has been extensively studied, however, it remains controversial. Recent studies showed that BAs might induce hepatocyte injury under pathological conditions, and the mechanism involved inflammatory response induced by stressed hepatocytes. In this article, we reviewed recent advances in the pathogenesis of liver injury induced by BAs and we focused on how BAs induce the activation of inflammatory cytokines that further induce the aggregation of immune cells. Based on these pathogenesis, we tentatively point out a number of novel treatments for cholestatic liver damage.

Objective To search for differential genes in cancerous tissues of patients with hepatocellular carcinoma (HCC) based on TCGA database. Methods We search the differential genes in patients with HCC from TCGA database, and draw the survival curve according to the levels of differential genes by using fdr=0.05 and lgFC=1 as the screening basis. Results We successfully got the clinical and pathological materials of 374 cancerous tissues and 50 adjacent non-cancerous tissues from the TCGA-LIHC database; the total survival in patients with high risk was significantly lower than that in patients with low risk; we found the significant higher levels DNTM1, PRIM1 and UCK2 genes to screen and verify in TCGA database, and the results showed that many abundant signaling pathway, suggesting that DNTM1, PRIM1 and UCK2 were related to the survival of patients with HCC. Conclusion The UCK2, PRIM1 and DNTM1 genes are up-regulated and CYP2C9 gene is down-regulated in liver cancerous tissues by through TCGA database screening and verification, which might help the clinicians to deal with them in clinical practice.

Objective The aim of this study was to evaluate the clinical application of contrast-enhanced ultrasonography (CEUS) in guiding liver biopsy in patients with space-occupying lesions (SOL). Methods The clinical data of 80 patients with SOL encounted in our Department of Ultrasound were retrospectively analyzed, and all underwent liver biopsy under US guidance. Before the liver biopsies, the CEUS was done in 50 cases, and the routine gray-scale US examination was performed in 30 cases. The diagnostic efficacy was compared between the two groups. Results The proportion of demonstrated necrotic areas in lesions in patients receiving CEUS was significantly increased (56.0% vs. 30.0%, P = 0.024), and the successful puncture rate in obtaining sampling was significantly higher (100.0% vs. 90.0%, P=0.022) as compared with those having gray-scale ultrasound scan; there was no significant difference in puncture times between the two groups (3.0±0.8 vs. 2.9±0.8, P=0.590); the sensitivity, specificity and accuracy by CEUS guidance were 97.8%, 100%, and 98.0%, significantly higher than in gray-scale ultrasound guidance (80.8%, 75.0% and 80.0%, respectively, all P< 0.05); no severe bleeding, pneumothorax, bile leakage and other complications occurred in all patients in the two groups. Conclusion The liver biopsies under CEUS guidance in patients with SOL could improve the puncture success and diagnostic efficacy, which warrants further clinical 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 explore the diagnostic performance of multimodal magnetic resonance imaging (MRI) in differentiating dysplastic nodules (DN) and small hepatocellular carcinoma (sHCC) in patients with liver cirrhosis (LC). Methods 71 patients with LC with intrahepatic nodules were encountered in our hospital between December 2016 and December 2021, and all underwent multimodal MRI, with the dynamic enhancement (DCE-MRI) parameters, the apparent diffusion coefficient (ADC), pure diffusion coefficient (D) and pseudo diffusion coefficient (D*) recorded. The golden diagnosis was based on fine needle aspiration or post-operational histopathological examination. Results Among the 71 patients, the sHCC was diagnosed in 45 cases (63.4%), and the DN was found in 26 cases (36.6%); the ADC, D and D * in sHCC foci were (0.81±0.19)×10^-3mm² / s, (0.91±0.21)×10^-3mm² / s and (46.26±10.13)×10^-3mm² / s, significantly lower than [(1.34±0.33)×10^-3mm² / s, (1.22±0.24)×10^-3mm² / s and (80.69±13.24)×10^-3mm²/s, respectively, P＜0.05 ] in DN lesions; the ROC analysis showed that when the cut-off values of D, D * and ADC in diagnosing sHCC were set as 1.14×10^-3mm² / s, 62.40×10^-3mm² / s and 0.96×10^-3mm²/s, the AUC were 0.911 (95% CI: 0.820-0.966), 0.809 (95% CI: 0.699-0.893) and 0.984 (95% CI: 0.920-0.999). Conclusion The multimodal MRI has high diagnostic efficacy in differentiating DN and sHCC in patients with LC, which might provide evidence for appropriate management for the patients.

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 nonalcoholic fatty liver disease (NAFLD) is considered to be the metabolic disorders in liver and is closely related to obesity, insulin resistance (IR), type 2 diabetes mellitus (T2DM) and hyperlipemia, etc. The prevalence of NAFLD among adults worldwide is about 25% and it is to believe increasing year by year. The NAFLD is an important causes of liver cirrhosis, liver cancer and liver transplantation. A large number of studies have shown that thyroid hormone (THs) plays an important role in hepatic lipid metabolism and IR, and the thyroid hormone receptor agonists are expected to become new medicines for the treatment of patients with NAFLD. In this review, we mainly discuss the progress of THs in patients with NAFLD.

Objective To estimate the effectiveness and safety of magnesium isoglycyrrhizinate injection （MIG） for the treatment of patients with cirrhosis. Methods All the randomized controlled trials（RCT） about the effectiveness and safety of MIG for the treatment of patients with cirrhosis were collected by searching databases including Pubmed，Embse，Cochrane library，CBM，Wanfang，CNKI and VIP. The screening of literatures，extraction of information and evaluation of the risk of bias were accomplished by two independent reviewers. Statistical analyses were performed with RevMan 5.2 software. Results A total of 9 RCTs involving 576 patients were included，while the methodology of the included studies was of low quality. The meta-analysis showed that the clinical effective rate of MIG used alone or in combination with other liver-protecting agents was significantly higher than in other hepatoprotective drugs （RR: 1.23，95%CI: 1.07 to 1.42，P<0.01） and （RR:1.31，95%CI: 1.13 to 1.51，P<0.01） with remarkably improved liver function and no severe side effects. Conclusion MIG injection is superior to other hepatoprotective drugs for liver cirrhosis with fewer side effects. However，more controlled trials of high quality are required to further assess the effectiveness and safety of MIG for patients with cirrhosis.

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

Objective To compare the value of contrast-enhanced CT and contrast-enhanced ultrasonography in the diagnosis of patients with focal liver lesions. Methods 81 patients with focal liver lesions were recruited in our hospital between March 2012 and May 2015. All the patients underwent contrast-enhanced CT check-up and contrast-enhanced ultrasonography. The imaging characteristics and the imaging parameters of ultrasonic contrast of benign and malignant liver lesions were recorded. Then，a comparison of the diagnostic efficacy of the two Methods was conducted. Results This study included 41 patients with hepatocellular carcinoma（HCC） and 40 with benign liver lesions. The quantitative analysis of the Results of contrast-enhanced ultrasonography revealed that time to peak，rise time and mean transit time in patients with malignant liver lesions were significantly shorter than those in patients with benign lesions [（33.2±5.8） s vs. （48.6±13.2） s，（24.1±4.9） s vs. （38.7±11.5） s，（108.5±21.3） s vs. （156.7±35.6） s，respectively，P<0.05 for all]，while the perfusion index in patients with malignant liver lesions was significantly higher than that in patients with benign lesions[（145.3±39.2） vs.（83.6±17.9），P<0.05]；The sensitivity，specificity，and accuracy of the contrast-enhanced ultrasonography were 97.1%， 92.3% and 96.3%，while those of contrast-enhanced CT were 80.3%（P<0.05），91.2%（P>0.05）and 85.2%（P<0.05）. Conclusion Contrast-enhanced ultrasonography could provide abundant imaging information of hepatic lesions in terms of morphology and data measurement，with high sensitivity and diagnostic accuracy in diagnosis of patients with liver lesions.