Objective This study aimed to investigate and summarize magnetic resonance imaging (MRI) feature in patients with primary liver cancer (PLC) and radiation-induced liver injury RILI) after three-dimensional conformal radiotherapy (3D-CRT). Methods A total of 92 patients with PLC were encountered in our hospital between January 2023 and September 2025, and all received 3D-CRT therapy and underwent gadopentetate dimeglumine (Gd-DTPA)-enhanced MRI scan. MRI signal, dynamic contrast-enhancement patterns, distribution morphology, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values were recorded. Results By end of radiotherapy, RILI occurred in 22 cases (23.9%); tumor volume, doses of radiation, target volume and mean hepatic doses of radiation in patients with RILI were all greater than in those without RILI(P<0.05); percentages of hypointensity on T1-weighted imaging, hyperintensity on T2-weighted imaging, abnormal enhancement at arterial phase, decreased enhancement at portal venous phase and persistent hypointensity at delayed phase in lesions in patients with RILI were 77.3%, 86.4%, 81.8%, 72.7% and 68.2%, all significantly greater than 27.1%, 30.0%, 20.0%, 25.7% and 17.1%(P<0.05) in those without RILI; percentages of wedge-shaped distribution, insistency of enhanced area with radiotherapy dose distribution, distributed along hepatic segments or vascular courses and hyperintensity on DWI in patients with RILI were 86.4%, 90.9%, 68.2% and 81.8%, all much greater than 15.7%, 12.9%, 14.3% and 28.6%(P<0.05) in those without RILI; ADC value in patients with RILI was (1.5±0.2)×10^-3mm²/s, much greater than [(1.2±0.2)×10^-3mm²/s, P<0.05] in those without RILI. Conclusion Patients with PLC and RILI could have special MRI features, which might help clinicians make diagnosis and managements.

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

Objective The aim of this study was to investigate immunological response of infants born to hepatitis B viral infected mothers to hepatitis B vaccination and its influencing factors. Methods 86 HBV-infected pregnant women and their 86 infants were encountered in our hospital between January 2019 and December 2020, and out of the 86 hepatitis B viral carriers, 64 women received oral tenofovir at 28 gestational week for blocking hepatitis B viral mother-to-infant transmission until delivering. All infants received hepatitis B immunoglobulin and hepatitis B vaccine routinely, and were followed-up for three years. Serum HBsAg and anti-hepatitis B surface antigen antibody (HBsAb) were detected by ELIS, and serum HBV DNA loads was assayed by PCR. Results By delivery, serum HBV DNA loads transferred to negative in tenofovir-treated women, and by end of three-year follow-up, serum HBsAb positive in 82 infants(95.3%), including weak positive in 16 cases (19.5%) and strong positive in 66 cases (80.5%), and negative in 4 infants (4.7%) in the 86 infants; concomitant diabetes percentage in mother with their infants positive response was much lower than in those with weak response (12.1% vs. 31.2%), while birth weights and gestational weeks were significantly heavier than(3442.7±333.1 g vs. 3385.4±370.6 g)or longer than(39.3±1.2 w vs. 37.4±1.2 w) in weak responders (P<0.05); multivariate Logistic regression analysis showed that concomitant diabetes, low infant birth weight and short gestational weeks at birth were all the risk factors impacting immunological response (P<0.05). Conclusion Hepatitis B vaccination might fails in infants who have a hepatitis B viral infection mothers, the surveillance is important and should re-vaccinates sometimes.

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 To study the difference of magnetic resonance imaging（MRI） scan and enhanced features of patients with primary liver cancer （PLC） and focal nodular hyperplasia （FNH）. Methods 26 patients with FNH and 36 patients with PLC between July 2014 and June 2016 were enrolled in this study,and all of them finished MRI check-up. Lesion distribution and imaging manifestation were compared between the two lesions. Results The proportion of lesions in the left lobe and right lobe in FNH foci were 30.8% and 69.2%）,not statistically different as compared with PLC foci（38.9% and 61.1%,P>0.05）,while the foci under hepatic capsule in FNH was 46.2%,much higher than in PLC（16.7%,P<0.05）;the lesion diameters in FNH foci was （4.8±0.8） cm,not statistically different compared to PLC foci[（5.1±0.8）cm,P>0.05];plain scan results showed that the proportion of low and equal signal in T1 in FNH foci were 84.6% and 15.4%,no significant difference compared with PLC foci（88.9% and 11.1%,P>0.05）;the proportion of high and equal signal in T2 in FNH foci were 88.5% and 11.5%,not statistically significantly different as compared with PLC foci（91.7% and 8.3%,respectively,P>0.05）;Tumor lesions often showed long T1 and long T2 signals in necrotic area in PLC foci,while FNH exhibited a central stellate structure and a signal of long T1 and long T2;the proportion of central scar and feeding arteries in FNH foci were radiologically 65.4% and 46.2%,much higher than 8.3% and 8.3% in PLC foci （P<0.05）;the proportion thrombus in portal vein and cirrhosis in FNH foci were 0.0% and 7.7%,much lower than 25.0% and 55.6% in PLC foci（P<0.05）;the proportion of fast-in and fast-out enhancement and swollen lymph nodes in FNH were 88.5% and 0.0%,not significant different as compared with PLC foci （86.1%and 11.1%,respectively,P>0.05）. Conclusion MRI can clearly distinguish PLC and FNH,which can help the diagnosis in clinical practice.

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

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

Objective The aim of this study was to investigate the 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 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.

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 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 With the wide application of biologics, the hepatitis B virus (HBV) reactivation have been increasingly become a problem. The patients with HBV reactivation may suffer from liver failure, which might lead to death. The screening, prophylactic antiviral therapy and surveillance for the patients at a risk of HBV reactivation have become the consensus of major related guidelines. In this article, we reviewed the population risk stratification, mechanism by which the HBV reactivated, and the prophylactic antiviral agents.

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 Hilar cholangiocarcinoma (HCCA) is one of the common malignant tumors in biliary system. The reported cases of HCCA increases gradually as the intensive application of imaging examination. Due to the lack of specific manifestations in the early stage of the tumor, most patients are found to be with advanced disease, resulting in a low radical resection and poor prognosis. Therefore, early screening and diagnosis is the top priority for individuals with high risk factors. At present, the imaging detection has become an important means of diagnosis and differentiation of HCCA. In this article, we review the early imaging screening and diagnosis of HCCA.

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.

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 The aim of this study was to compare the efficacy of telbivudine (LdT) and tenofovir disoproxil fumarate (TDF) in blocking hepatitis B viral transmission from mother to infant in pregnant women with high serum hepatitis B virus (HBV) deoxyribonucleic acid (DNA) loads. Methods 85 pregnant female HBV carriers with serum HBV DNA >1×10⁶ IU/mL were recruited in this study, and randomly divided into two groups, receiving LdT (n=43) or TDF (n=42) at gestational 28 weeks. The antiviral regimen lasted to the delivery. Serum HBV DNA and/or HBsAg positive were defined as HBV infection. Results At the delivery, serum HBV DNA load and HBeAg level in LdT-treated women were (2.9±0.6)lg IU/mL and (939.5±286.6)S/CO, both not significantly different compared to 【(3.1±0.7)lg IU/mL and (940.7±285.6)S/CO, respectively, P>0.05】 in TDF-treated women, and serum HBsAg, ALT and AST levels in the two groups were not much different (P>0.05); in LdT group, the infant's gestational age was (39.4±1.2)w, the height was (50.9±2.8)cm, the head circumference was(33.8±1.3)cm, the body mass was (3087.9±471.5)g and the Apgar score at one minute was(9.5±0.4), all not significantly different compared to【(39.6±1.1)w, (51.2±3.1)cm, (33.9±1.5)cm, (3112.9±464.9)g and (9.6±0.6), respectively, P>0.05】 in TDF group; the infant's HBV infection was 2.3% vs. 2.4% in the two groups (P>0.05). Conclusion Both LdT and TDF could be orally given to pregnant women with high serum HBV DNA loads at gestation of greater than 28 weeks to block mother-to-child HBV transmission, and worth further clinical investigation.

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

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

Objective The aim of this study was to compare the curative efficacy of laparoscopic-choledochoscopic cholelithotomy and laparoscopic cholecystectomy (LC) in patients with gallbladder stones. Methods 78 patients with gallbladder stones were admitted to our hospital between February 2015 and February 2020, and out of them, 36 patients underwent laparoscopic-choledochoscopic cholelithotomy and 42 patients underwent LC. They were followed up for 12 months after surgery. Serum cortisol and C-reactive protein (CRP) levels were detected by ELISA or double-antibody sandwich immunoluminescence assay. Results The operation time and hospitalization cost in observation group were (53.3±17.7) min and (3.2±0.5) ten thousand yuan, significantly longer or higher than [(36.7±10.8) min and (2.3±0.4) ten thousand yuan, P<0.05], and the postoperative eating time and anal exhaust time were (2.8±0.9) h and (14.9±3.2) h, significantly shorter than [(3.3±0.7) h and (19.3±4.1) h, respectively, P<0.05] in the control; 3 days after surgery, serum CRP and COR levels in the observation group were (11.2±3.1) mg/L and (195.6±30.8) ng/mL, significantly lower than [(19.0±4.9) mg/L and (211.6±32.7) ng/mL, respectively, P<0.05] in the control; the ultrasonography 2 weeks after surgery showed that there were no residual stones in the observation group, and the gallbladder function was intact; at 3 months of follow-up, the incidence of complications, such as incision infection, abdominal distension and diarrhea, reflux gastritis, biliary hemorrhage and acute pancreatitis in the observation group was significantly lower than that in the control group (11.1% vs. 31.0%, P<0.05); at the end of 12-month follow-up, one patient (2.8%) had stone recurrence. Conclusion The application of laparoscopic-choledochoscopic cholelithotomy in the treatment of patients with gallbladder stone might be more beneficial to the recovery of gastrointestinal functions with less postoperative complications.