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 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 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 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 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 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.

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

Objective 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.

Vascular inteventional therapy has played an important role in patients with unresectable primary liver cancer（PLC）,while the effect of vascular interventional therapy is closely related to the choice of embolic materials. We reviewed the characteristics and the clinical application of common embolic materials used in vascular inteventional therapy.

Mitochondrial creatine kinase（MtCK） located in the space between inner membrance and outer membrance of intracellular mitochondria. Creatine kinase is a member of the creatine kinase isozyme. The mainly physiological function of MtCK is to provide the energy for muscle contraction through the creatine phosphate shuttle mechanism under aerobic condition， which plays an important role in mitochondrial respiratory control. Recently，over expression of ubiquitous MtCK（uMtCK） is found in malignant tumors with especially poor prognosis. The molecular biology mechanism of the over expression in malignant tumors is well studied and the scholars find that uMtCK might be useful in the diagnosis of malignant tumors. Meanwhile，molecular biology studies shows that over expression of uMtCK promotes malignant tumors growth though resisting apoptosis. We reviewed the role and molecular biologic mechanism of mitochondrial creatine kinase in the diagnosis of malignant tumor.

Wilson's disease (WD) is an autosomal recessive genetic disease characterized by abnormal copper metabolism, which can cause secondary damage to pathological organs, mainly liver and brain. The current basic treatment for patients with WD is based on medicines that increase excretion of copper from the body,such as chelators or zinc salts, etc. The choices of these agents should be based on patients' clinical manifestations and tolerance to them owing to side effects, physicians' experience and the cost and availability of them. The treatment of WD remains challenging for its side effects, compliance problems and life-long treatment. The shortage of donor liver, high cost, and the need for sustained immunosuppressive therapy after operation restrict the application of liver transplantation. Therefore, new treatment or methods, especially ones with better safety and permanent cure, are also attracting more and more attention. Therefore, this article systematically reviews the current research progress in treatment of patients with WD.

There are normal physiological changes in the liver functions during pregnancy. Nevertheless, 3% of pregnant women have liver dysfunction. Pregnancy-specific liver disease is the main cause of abnormal liver function. About 0% to 25% of pregnant women die from pregnancy-specific liver disease. It is particularly important to improve clinician’s recognition of this entity. We reviewed the literature on pregnancy-specific liver disease in recent years and the progress in the pathogenesis, diagnosis and treatment of some pregnancy-specific liver diseases was summarized in this paper, in order to provide reference for its diagnosis and treatment.

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 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 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 establish a rapid and efficient liquid chromatography tandem mass spectrometry(LC-MS/MS) for simultaneous determination of 15 bile acids in mouse liver tissues. Methods The activated charcoal was utilized to prepare bile acid-free liver, which served as the biological matrix for the preparation of standard and quality control samples. The mouse liver tissue was homogenized, and a basic acetonitrile solution, including 5% NH₄OH was added to precipitate proteins. The proteins were separated on an Agilent Poroshell 120 EC C18 column (100 mm×4.6 mm,2.7 μm) by using ²H₄-DCA, GUDCA-d₅, and LCA-d₄ as internal standards. The mobile phase is ammonium acetate aqueous solution and methanol acetonitrile mixed solution for gradient elution, the column temperature was 30℃, the flow rate was 0.3mL/min, and the injection volume was 2 μL. The electrospray ion source (ESI) was operated in negative ion mode, and in multiple reaction monitoring (MRM). Results The linearity of the 15 bile acids was good with R² greater than 0.993, the limits of determination were less than 2 ng/mL, and the matrix effects were 90.76%-109.25%; the intra-day and inter-day accuracy and precision were less than 15%, and the stability was good under 4℃ for 24 h, repeated freeze-thaw, and freeze-storage for one month, meeting the analytical requirements of biological samples; the detection of mouse liver tissues showed that both unconjugated BAs and conjugated BAs (G-BAs, T-BAs) were dominated by maternal CA, with the highest content of TCA; the concentration of unconjugated BAs was (723.89±50.65) ng/mL, significantly higher than that of G-BAs [(56.90±11.28) ng/mL, P<0.001]; the concentration of T-BAs was (40322.90±14034.80)ng/mL, significantly higher than unconjugated BAs (P＜0.001), and also significantly higher than G-BAs (P＜0.001). Conclusion The LC-MS/MS method we established is sensitive, accurate, reliable, and suitable for the determination of bile acids concentrations in mouse liver tissues, which might help for further studies.

Objective We explored the effect of nursing care and its impact on rehabilitation in patients with primary liver cancer （PLC） after transhepatic arterial chemoembolization （TACE） in order to provide guidance for improving the life quality of patients. Methods 50 patients with moderate and advanced PLC underwent TACE with hepatic artery perfusion of raltitrexed，and we carried out holistic nursing，including psychological，febrile，dietary，abdominal and local nursing post-operatively for them. We also measured blood liver function indexes and alpha-fetoprotein（AFP） before and after the treatment. Results Four weeks after TACE， serum alanine transaminase，aspartic transaminae，total bilirubin and albumin levels decreased from（43.58±10.15）U/L，（41.25±11.34）U/L，（22.46±6.49） μmol/L and （35.32±4.12） g/L at admission to （38.23±7.86） U/L，（38.56±8.49）U/L，（16.84±10.16） μmol/L and（31.49±5.48） g/L，post-operatively，all no significant difference（P>0.05）；serum AFP decreased from（1215.46±125.14） ng/mL to（811.27±165.28） ng/mL（P＜0.01）；The white blood cell counts decreased in two （4%），fever in two （4%），psychological stress in three（6%），local pain in six（14%），and nausea/vomiting in eight（16%），suggesting the improvement by nursing care in this setting. Conclusions TACE with raltitrexed in treatment of patients with PLC is effective，and the postoperative nursing care might reduce the occurrence of complications，which greatly improve the postoperative rehabilitation of patients.