Objective The aim of this study was to explore gene polymorphisms of human leukocyte antigen (HLA) and apolipoprotein E (ApoE)in pathogenesis of chronic hepatitis B (CHB) . Methods 79 patients with CHB and 100 chronic HBV carriers were enrolled in our hospital between April 2021 and April 2024, and peripheral bloodgene polymorphisms of HLA (HLA-DQA1, HLA-DQB1, HLA-DRB1)and ApoE were detected by direct gene sequencing. Results The frequencies of HLA-DQA1*0102 and HLA-DRB1*15 allelesin patients with CHB were 13.9% and 5.7%, significantly lower than 25.0% and 14.5% (P<0.05), while the frequencies of HLA-DQA1*0501, HLA-DQB1*0301, HLA-DRB1*03 and HLA-DRB1*07 alleleswere 20.3%, 31.7%, 9.5% and 15.8%, significantly higher than 12.5%, 20.5%, 4.0% and 7.5% in HBV carriers (P<0.05); the frequencies of ε2/3 genotype and ε2 allele of ApoE gene in patients with CHB were 15.2% and 8.2%, significantly higherthan 5.0% and 3.0% in HBV carriers (P<0.05). Conclusion The gene polymorphisms of HLA and ApoE are related to pathogenesis of chronic hepatitis B. Individuals carrying HLA-DQA1*0102 and HLA-DRB1*15 alleles might protect the infection from episode, while carrying HLA-DQA1*0501, HLA-DQB1*0301, HLA-DRB1*03 and HLA-DRB1*07 allelesand/or ApoE ε2 allele might have more chances to breakout.

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.

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 Sarcopenia is defined as loss of systemic skeletal muscle mass and functions. It may affect the physiological functions and leads to the declined quality of life, and even death. Sarcopenia occurs in up to 70% of patients with advanced liver diseases, which is associated with untoward clinical outcomes and poor prognosis. At present, most treatments are based on nutrition and exercise, however, there is still a lack of effective targeted molecular therapy. This review summarizes the pathogenesis of sarcopenia in liver diseases, in order to identify potential biomarkers for treatment and improve the clinical prognosis.

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 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.

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 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 clinical efficacy of tenofovir amibufenamide (TMF) and tenofovir alafenamide fumarate (TAF) in rescue treatment of entecavir (ETV)-treated patients with chronic hepatitis B(CHB) and low-level viremia (LLV). Methods 68 patients with CHB were enrolled in our hospital between January 2022 and January 2024, the enrolled patients were all ETV-treated for at least 12 months, showing poor virological response with LLV and were randomly assigned to receive TMF or TAF for 48 weeks. Liver stiffness measurement (LSM) was evaluated by ultrasonic liver transient elastography, serum HBV markers, biochemical parameters and HBV DNA loads were routinely detected. Serum laminin(LN),collagen type Ⅳ(Ⅳ-C), precollagen-Ⅲ (PC-Ⅲ)and hyaluronic acid(HA)levels were assayed by ELISA. Results By end of 48 week treatment, LSM as well as serum HA, LN, Ⅳ-C and PCⅢ levels in TMF-treated patients were (6.8±1.2)KPa, (171.2±25.9)ng/mL, (147.5±42.3)ng/mL, (174.3±46.3)ng/mL and (56.8±12.4)ng/mL, all not significantly different as compared to [(6.9±1.2)KPa, (175.2±34.6)ng/mL, (148.2±46.3)ng/mL, (175.4±42.1)ng/mL and (55.5±19.5)ng/mL, respectively] in TAF-treated patients (P>0.05); serum bilirubin, ALT and AST levels in TMF-treated patients were (16.4±1.4)μmol/L, (40.3±4.8)U/L and (32.4±5.1)U/L, all not significantly different as compared to [(17.3±1.2)μmol/L, (41.8±4.5)U/L and (36.9±4.9)U/L, respectively] in TAF-treated patients (P>0.05); virological and biochemical response rates in the two groups were not significantly different as serum HBV DNA transferred to negative and serum ALT level returned to normal(P>0.05) in all patients. Conclusion As for patients with CHB and poor response to ETV treatment, rescue antiviral therapy with TMF or TAF is both satisfactory, with complete virological response, and the long-term efficacy should be followed-up in the future.

Objective The aim of this study was to investigate 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.

Objective To explore the efficacy of fenofibrate and bicyclol combination in the treatment of patients with non-alcoholic fatty liver diseases (NAFLD) and its influence on hepatic peroxisome proliferator-activated receptor gammaγ₂ (PPARγ₂) mRNA level. Methods 66 patients with NAFLD were admitted to our hospital between February 2018 and December 2019, and were randomly divided into control group (n=33) and observation group (n=33), receiving bicyclol or bicyclol and fenofibrate combination for three months. The curative effect in the two groups after treatment were compared. The liver biopsies were performed, and hepatic PPARγ₂ messenger ribonucleotide (mRNA) were assayed by PCR. Serum cytokines and peripheral blood T lymphocyte subsets were compared. Results At the end of the treatment, the total effective rate in the observation group was 97.0%, which was much higher than that in the control group (66.7%, P<0.05); the relative level of PPARγ₂ mRNA in liver tissues in the observation group was (1.5±0.1), significantly higher than in the control; serum tumor necrosis factor-α (TNF-α) level was (26.4±3.1) pg/mL, significantly lower than , serum IL-6 level was (35.94.9) ng/L, significantly lower than (46.45.8) ng/L, P<0.05], and serum high-sensitivity C-reactive protein (hs-CRP) level was (5.1±1.4) mg/L, much lower than in the control; the percentage of peripheral blood CD3⁺ cells was (80.2±11.5)%, significantly higher than , the percentage of peripheral blood CD4⁺ cells was (44.7±5.8) %, significantly higher than , and the ratio of CD4⁺/CD8⁺ cells was (1.5±0.4), significantly higher than in the control.Conclusion The oral administration of fenofibrate and bicyclol combination in the treatment of patients with NAFLD has a short-term efficacy, which might be related to the increased hepatic PPARγ2 mRNA levels and the reduction of serum cytokine levels.

Objective To investigate the therapeutic efficacy of polyene phosphatidylcholine in patients with anti-tuberculosis agents-induced liver injury and its effect on serum heme oxygenase (HO-1), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) levels. Methods 78 patients drug-induced liver injury (DILI) during anti-tuberculosis therapy for pulmonary tuberculosis were enrolled in our hospital between March 2018 and March 2019, and were randomly divided into control and observation group with 39 in each, receiving diammonium glycyrrhizinate or polyene phosphatidylcholine orally for 12 weeks. Serum interleukin-6, IL-1β and tumor necrosis factor-α(TNF-ɑ) as well as serum HO-1, GSH-Px and SOD levels were detected.Results At the end of 12 week observation, serum level of alanine aminotransferase (ALT) in the observation group was (28.1 ± 20.5) U/L, which was significantly lower than that in the control group [(59.4 ± 22.7) U/L, P <0.05], and serum level of aspartate aminotransferase (AST) in the observation group was (345.1 ± 17.3) U/L, which was significantly lower than that in the control group [(45.1 ± 17.3) U/L, P <0.05]; serum TNF-ɑ level inthe observation group was (7.4 ± 1.5) pg/mL, which was significantly lower than that in the control group [(10.3 ± 1.8) pg/mL, P <0.05], and serum IL-1β level in the observation group was (13.7 ± 2.1) ng/mL, which was significantly lower than that in the control group [(34.2 ± 4.8) ng / mL, P <0.05]; serum HO-1 level in the observation group was (294.1 ± 16.9) U/L, which was significantly higher than that in the control group [(198.8 ± 17.2) U/L, P <0.05], and serum level of SOD was (544.2 ± 13.3) U/L, which was significantly higher than that in the control group [(421.0 ± 12.8) U/L, P <0.05]. Conclusion The administration of polyene phosphatidylcholine in the treatment of patients with DILI caused by anti-tuberculosis medicine is efficacious, which could significantly increase serum HO-1 and SOD levels, and reduce oxidative stress response, and needs further clinical investigation.

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.

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 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 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 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 Ferroptosis is a newly discovered mode of cell death, which is caused by the abnormal increase of intracellular iron ion levels, resulting in the imbalance of redox, lipid peroxidation of cell membrane, and finally cell death owing to cell membrane rupture. At present, the central link of ferroptosis is iron metabolism and reactive oxygen metabolism. Ferroptosis can affect the occurrence and development of a variety of diseases, such as neurodegenerative diseases, tumors, ischemia-reperfusion injury, immunoimbalance diseases, etc. Increasing numbers of studies have shown that the characteristics of ferroptosis, such as iron overload and accumulation of lipid reactive oxygen species, occur in the development many liver diseases. Ferroptosis can affect the progression of liver diseases by regulating the intracellular iron ion levels and lipid peroxidation degree.In this review, we put emphasis on the research progress of ferroptosis in liver diseases.

Objective The aim of this study was to investigate combination of Xuezhikang, a herbal medicine compound, and atorvastatin in treatment of patients with non-alcoholic fatty liver disease (NAFLD) and hyperlipidemia. Methods 124 patients with NAFLD and hyperlipidemia were enrolled in our hospital between January 2022 and July 2024, and were randomly assigned to receive atorvastatin in 63 cases in control, or receive Xuezhikang at base of atorvastatin in another 61 cases in observation for 24 weeks. Fasting insulin was assayed by immunoassay, and HOMA-IR and HOMA-β were calculated. Serum tumor necrosis factor(TNF-α), interleukin -6(IL-6) and IL-8 levels were detected by ELISA. Results By end of 24-week treatment, serum ALT, AST and GGT levels in the observation group were (36.5±3.3)U/L, (32.7±2.8)U/L and (46.4±4.7)U/L, all significantly lower than [(62.8±3.6)U/L, (58.9±3.2)U/L and (64.1±5.3)U/L, respectively, P<0.05] in the control; there were no significant differences as respect to serum TC, TG, LDL-C and HDL-C levels in the two groups (P>0.05); serum FINS and HOMA-IR were (5.3±1.5)μU/ml and (2.7±0.8), both much lower than [(6.4±1.2)μU/ml and (4.1±1.3), respectively, P<0.05], while HOMA-β was (92.3±15.4), much greater than [(77.2±13.7), P<0.05] in the control; serum TNF-α, IL-6 and IL-8 levels were (15.5±6.3)pg/ml, (16.2±5.1)ng/L and (5.5±1.1)μg/L, all significantly lower than [(27.6±6.8)pg/ml, (26.6±5.8)ng/L and (7.2±1.4)μg/L, respectively, P<0.05] in the control group. Conclusion Application of Xuezhikang with combination of atorvastatin in treatment of patients with NAFLD and hyperlipidemia could improve liver function test normal, which might be related to modulation of glycolipid metabolism and inhibition of cytokine reactions.

Objective This study was conducted to explore the functional enrichment pathways and key genes in hepatocarcinogenesis. Methods We downloaded liver transcriptome data from the Gene Expression Database (GEO) at different stages of hepatitis B infection to hepatocellular carcinoma occurrence. Genes were categorized into different modules by weighted gene co-expression network analysis (WGCNA), and genes in different modules were enriched and analyzed. Important gene levels were further validated by GEO dataset. Results A total of 6145 differential genes were involved in the construction of WGCNA, which categorized genes into nine modules. The evolutionary trajectory from early liver lesions to tumorigenesis was further analyzed, e.g., a linear activation of pathways related to cell proliferation, DNA damage repair, and cellular senescence during the process from normal tissues to oncogenesis; a gradual suppression of pathways related to liver function, such as lipid metabolism and coagulation was found with disease progression; and activation of immune-related pathways was also revealed during the period of chronic inflammation prior to tumors, with a gradual convergence to an inhibitory state in the later stage; Three important senescence-related genes, e.g., CCNA2, UBE2C and ANAPC1, were identified, and the levels of the 3 genes were validated in an external dataset. Our further analysis demonstrated that the levels of the 3 genes were strongly associated with poor prognosis of patients with hepatocellular carcinoma. Conclusion By through bioinformatics analysis, we identify potential pathways and important genes involved in hepatocarcinogenesis, which might provide potential targets for diagnosis and therapeutic intervention in the future.

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.

Patients with chronic liver diseases are inclined to have malnutrition that would increase the risks of poor prognosis,but the mechanism of malnutrition in liver disease is still not well known. The individualized nutritional intervention and nutrients supplement are also hard to be quantitative assessed. In this review,the common assessment methods of malnutrition,nutrient and metabolic features in patients with chronic liver diseases,and advances of nutritional therapy in liver diseases are reviewed,so as to give some enlightenment to the clinical nutrition intervention in chronic liver diseases.

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 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 observe the curative effect of CT-guided one-step percutaneous transhepatic cholangial drainage (PTCD) in the treatment of patients with malignant obstructive jaundice (MOJ). Methods 60 patients with MOJ were enrolled in our hospital between January 2017 and December 2019, and they were divided randomly into control (n=30) and observation group (n=30). The patients were given PTCD under the guidance of X-ray fluoroscopy in the control or CT-guided one-step puncture in the observation. Results During the operation, the one-time success rate of puncture in the observation group was significantly higher than that in the control group (96.7% vs. 43.3%, P<0.05), the fluoroscopy time was significantly shorter than that in the control group [(13.6±2.1) s vs. (32.6±4.1) s, P<0.05], the total puncture time was significantly shorter than that in the control group [(48.9±10.3) s vs. (92.3±13.6) s, P<0.05], and the radiation exposure dose was significantly less than that in the control group [(2.5±0.3) mGy vs. (5.8±1.1) mGy, P<0.05]; at the end of two weeks after the surgery, total serum bilirubin level in the observation group decreased from (241.8±83.6) μmol/L to (109.8±45.6) μmol/L, that in the control decreased from (242.4±91.2)μmol/L to (108.4±61.9)μmol/L, and there were no significant differences respect to other liver function tests between the two groups (P>0.05); at the end of three month, the post-operational complications such as biliary infection, bleeding, liver abscess and peritonitis in the observation was 3.3%, significantly lower than 26.6% in the control(P<0.05). Conclusion CT-guided one-step PTCD in dealing with patient with malignant obstructive jaundice could improve the puncture successfully, which might be applied in clinical practice overwhelmingly.

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 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.

Objective This clinical trial aimed to compare the efficacy of lorazepam and oxazepam in treatment of patients with alcoholic liver diseases (ALD) and alcohol withdrawal syndrome (AWS). Methods A total of 127 patients with ALD and AWS were enrolled in our hospital between November 2017 and November 2020, and were randomly divided into control (n=63) and observation group (n=64), receiving lorazepam and oxazepam, respectively, for seven days. The scores of alcohol withdrawal syndrome scale (AWSS) and self-rating anxiety scale (SAS) score were evaluated. Serum hyaluronic acid (HA), laminin (LN), type III procollagen N-terminal peptide (PC-III) and type-IV collagen (IV-C) were detected by ELISA. Results At the end of 7 day treatment, the efficient rate in observation group was 96.9％, significantly higher than 81.0％ in the control (P<0.05); at presentation, the AWSS and SAS, serum alanine transaminase (ALT), aspartate aminotransferase (AST), glutamyl transpeptidase (GGT),total bilirubin (TBIL) and alkaline phosphatase (ALP) as well as HA, LN, PC-Ⅲ and IV-C levels were not significantly different between the two groups(P>0.05); after treatment, the AWSS and SAS in observation were (9.5±2.4) and (30.8±6.4), significantly different as compared to in the control; serum ALT, AST, GGT, TBIL and ALP levels were (30.5±8.1)U/L, (71.6±15.3)U/L, (466.1±22.7)U/L, (23.5±6.5)μmol/L and (82.3±12.4)U/L, all much lower than in the control; serum HA, PC-Ⅲ and IV-C levels were (116.8±18.3)μg/L,(123.1±12.3)μg /L and (80.2±11.6)μg /L, significantly lower than in the control. Conclusion The clinical efficacy of oxazepam is good in treatment of ALD patients with complicated AWS, which could improve clinical symptom and anxiety relieving.