Acute-on-chronic liver failure (ACLF) is one of the leading causes of mortality among patients with chronic liver disease. Potentially reversible, ACLF requires precise clinical classification to facilitate accurate diagnosis, targeted treatment, and comprehensive management. Based on the latest research findings and clinical evidence, the Severe Liver Disease and Artificial Liver Group and the Nutrition and Regeneration in End-Stage Liver Disease Group, Chinese Society of Hepatology, Chinese Medical Association, together with multidisciplinary experts, have jointly compiled China's first guideline for the diagnosis and treatment of ACLF. The guideline aims to provide guidance for the diagnosis, treatment, and individualized management of patients with ACLF in clinical practice.

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

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

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

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

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

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

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

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

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

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

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

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

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

Objective The aim of this study was to investigate the efficacy of one-step and step-by-step laparoscopic cholecystectomy (LC) in the treatment of patients with gallbladder stones and common bile duct stones. Methods 152 patients with gallbladder stones and common bile duct stones were admitted to our hospital between January 2016 and June 2019, 87 patients received one-step surgery, e.g., LC and laparoscopic common bile duct exploration (LCBDE), and 65 patients received step-by-step surgery, e.g., endoscopic retrograde cholangiopancreatography/papillary endoscopic sphincterotomy (ERCP/EST) and afterward LC.Results The total surgical time and postoperative catheter placement rate in patients with one-step surgery were (156.3±42.6)min and 98.9%, significantly longer or higher than [(124.4±31.4)min and 15.4%, P<0.05] in patients receiving step-by-step surgery, while the hospital stay and hospitalization cost were (14.4±3.9)d and (27.9±7.0)thousand yuan, significantly shorter or lower than(18.7±4.2)d and(31.24±5.8)thousand yuan (P<0.05) in the latter; there were no statistically significant differences in the surgical success rate and stone clearance rate between the two groups (95.4% vs. 93.1% and 100.0% vs. 96.9%, respectively, P>0.05); the incidence rate of reflux cholangitis in one-step-treated patients was significantly lower than step-by-step surgery-treated patients (0.0% vss 7.7%, P<0.05), while there was no significant difference in the total incidence of complications between the two groups (19.5% vs. 32.1%, P>0.05).Conclusion Both the one-step and step-by-step with patients with gallbladder surgery are efficacious in dealing stones and common bile duct stones, and under some circumstances, the one-step surgery might eradicate the stones rapidly and get a good efficacy.

Objective The aim of this study was to investigate the short-term efficacy of different statins in treatment of patients with nonalcoholic fatty liver disease (NAFLD) and hyperlipidaemia. Methods 52 patients with NAFLD and hyperlipidaemia were encountered in our hospital between September 2019 and May 2021, and were divided into two groups, with 26 cases in each group, receiving pitavastatin or atorvastatin treatment for six months. The homeostasis model assessment-insulin resistance index (HOMA－IR) were obtained, and serum tumor necrosis factor-α ( TNF-α) , interleukin-6 (IL－6) , IL-8 and high-sensitivity C-reactive protein (hs-CRP) were detected by ELISA. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were recorded by FibroTouch. Results At the end of 6 months of treatment, the HOMA-IR, total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL- C ) levels in the pitavastatin-treated patients were (2.1±0.5), (3.5±0.4)mmol/L, (2.4±0.3)mmol/L and (2.2±0.5)mmol/L, significantly lower than [(2.5±0.4), (4.2±1.0)mmol/L, (2.9±0.4)mmol/L and (2.9±0.7)mmol/L, respectively, P＜0.05], while serum high density lipoprotein cholesterol (HDL－C) level was (1.6±0.4)mmol/L, significantly higher than [(1.3±0.3)mmol/L, P＜0.05] in atorvastatin-treated patients; there were no significant differences respect to serum cytokine levels between the two groups(P＞0.05); the CAP in the pitavastatin-treated patients was (258.4±6.3)dB/m, much lower than [(267.7±10.2)dB/m, P＜0.05] in atorvastatin-treated patients; there was no significant difference as respect to liver parenchymal echo manifestations (P＞0.05). Conclusion The statins could alleviate insulin resistance, reduce blood lipid levels and inhibit inflammatory reactions in patients with NAFLD and hyperlipidaemia, and the administration ofpitavastatinseems promising, and warrants further investigation.

Objective The aim of this study was to summarize the efficacy of ursodeoxycholic acid (UDCA) in the treatment of patients with primary biliary cholangitis (PBC) and cirrhosis and its effect on serum nuclear factor-related factor 2 (Nrf2) and hemeoxygenase-1 (HO-1) levels. Methods 31 patients with PBC and 34 patients with primary biliary cirrhosis (Child A in 15, Child B in 12 and Child C in 7 cases) were recruited in our hospital between January 2017 and January 2020, and 43 healthy persons were selected as control group. The patients with cholangitis and cirrhosis were all treated with UDCA for 12 months. Serum malondialdehyde (MDA), superoxide dismutase (SOD), Nrf2 and HO-1 levels were detected. Results At presentation, serum GGT and ALP levels in patients with primary biliary cirrhosis were (389.4±29.7)U/L and (457.9±73.8)U/L, both significantly higher than [(173.5±16.4)U/L and (298.3±52.1)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; at the end of 12 month treatment, serum GGT and ALP levels in patients with primary biliary cirrhosis were(174.1±10.4)U/L and (144.6±24.5)U/L, still significantly higher than [(72.6±7.1)U/L and (95.7±11.6)U/L, respectively, P<0.05] in patients with primary biliary cholangitis; serum Nrf2, HO-1, MDA and SOD levels in healthy individuals were (182.3±30.6)U/L, (12.2±2.1)U/L, (4.1±0.7)mol/L and (102.3±17.8)U/mL; at 12 month observation, serum Nrf2, HO-1 and MDA levels in patients with primary biliary cirrhosis were (712.6±100.1)U/L, (25.1±4.3)U/L and (7.6±1.3)mol/L, all significantly higher than [(665.3±90.5)U/L, (21.3±3.8)U/L and (6.5±1.1)mol/L, respectively, P<0.05], while serum SOD level was (80.6±14.5)U/mL, significantly lower than [(90.8±15.6)U/mL, P<0.05] in patients with primary biliary cholangitis; there were no significant differences as respect to serum Nrf2, HO-1, MDA and SOD levels in cirrhotics with Child class A, B and C(P＞0.05). Conclusion The continuous administration of UDCA could improve the liver function test normalization in patients with PCB and cirrhosis, which might be related to the amelioration of cholestasis, inhibition of oxidative stress, and increase serum Nrf2 and HO-1 levels.

Objective The aim of this study was to analyze the clinical and imaging feature in patients with focal nodular hyperplasia of the liver (FNH) . Methods A total of 96 patients with FNH were encountered in our hospital between March 2020 and March 2023, and all underwent color Doppler ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI). The diagnosis was made based on histo-pathological examinations. Results Among the 96 patients with FNH, the upper abdominal fullness and discomfort was found in 19 cases (19.8%), hepatitis B carriers in 8 cases (8.3%) , serum alpha-fetoprotein (AFP) negative in 95 cases (99.0%) and slightly elevated in 1 case (1.0%), slight serum alanine aminotransferase and/or aspartate aminotransferase level elevation in 14 cases (14.6%) ; the pathological examination diagnosed typical FNH in 86 cases (89.6%) and non-typical FNH in 10 cases (10.4%); the abdominal color Doppler ultrasonography showed most of the lesions with clear boundaries, low echo area in 79 cases, even echo in 13 cases, high echo in 4 cases, and abundant blood flow signals in 57 cases; the CT imaging showed that there were slightly low-density or isodensity or uniform density nodules, with clear boundary from the surrounding liver parenchyma, and uniform enhancement at arterial phase in 83 cases, and without enhancement in 13 cases; out of the 38 patients underwent upper abdominal MRI scan, showed equal or low signals of the lesions on T1WI, equal or high signals on T2WI, with clear boundaries, and the lesions were obviously enhanced at arterial phase, equal or slightly high signals at portal venous phase and reduced enhancement at delayed phase. Conclusion There is a lack of specific clinical and imaging manifestations in most patients with FNH, and the biopsies or even direct surgery might be the optimal choice at this scenario.

Objective The aim of this study was to investigate the guidance of real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging for ablation area in patients with primary liver cancer(PLC)during microwave ablation (MWA) therapy. Methods A total of 102 patients with PLC were encountered in Meizhou People's Hospital between February 2017 and February 2021, and were randomly divided into observation (n=51) and control group (n=51). They were all treated with MVA. In the control group, the conventional contrast-enhanced ultrasonography was applied to evaluate the ablation area, while in the observation group was evaluated by real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging navigation combination. All patients were followed-up for one year, and the one-year overall survival rate in the two groups were recorded and compared. Results The complete ablation rate and supplemental ablation rate in the observation group were 94.1% and 19.6%, significantly higher than 78.4% and 3.9% in the control (P<0.05); after MWA, theincidence of ablation-related complications, such as bleeding, infection, adjacent organ injuries, bile leakage and pleural effusion or ascites in the observation was 17.7%, not significantly different compared to 21.6% in the control (P＞0.05); at the end of one-year follow-up, therecurrence of intrahepatic tumor in the observation was 10.0%, significantly lower than 28.0% in the control group (x²=5.26, P=0.02); the one-year overall survival rate in the observation was 96.0%,significantly higher than 84.0%(Log-Rank x²=22.159, P＜0.001) in the control. Conclusion The guidance of ablation area by real-time contrast-enhanced ultrasonography and 3D ultrasound fusion imaging navigation combination could help evaluate the ablation efficacy of MWA in patients with PLC, and warrants further clinical investigation.

Objective This study was conducted to evaluate blood supply and hepatic arterial embolization (HAE) efficacy by enhanced computed tomography (CT) in patients with hepatic hemangioma (HH). Methods 127 consecutive patients with HH were encountered in our hospital between December 2017 and January 2021, and all patients underwent CT plain and enhanced scan to measure arterial phase enhancement ratio and evaluate blood supply of HH. All patients were treated with HAE, followed-up for 3 years, and reduction rate of tumor size and arterial phase enhancement rate of HH were compared. Results Of 127 patients with HH, enhanced CT scan found rich blood supply lesions in 54 cases and poor blood supply lesions in 73 cases; of 54 lesions with rich blood supply, uniform enhancement at arterial stage in 18 cases, uneven enhancement in 25 cases, continuously enhanced at venous and delayed stage, and not enhanced at three-stages in 11 cases; enhancement rate at arterial stage in HH lesions with rich blood supply was(43.1±13.6)%, much higher than [(16.5±3.7)%, P＜0.05] in lesions with poor blood supply, and percentage of greater than 10 cm lesions was 9.3%, much lower than 64.4%(P＜0.05) in lesions with poor blood supply; by two and three years of follow-up, reduction rates of tumors with rich blood supply were(32.6±7.1)% and (53.9±10.2)%, and reduction rates of arterial stage enhancement were (21.8±2.4)% and (27.5±3.1)%, all significantly higher than [(21.5±4.9)% and (34.7±6.9)%, and (14.2±2.5)% and (19.6±2.7)%, P＜0.05] in lesions with poor blood supply. Conclusion Efficacy of HAE in dealing with HH with rich blood supply is better than those with poor blood supply, and evaluation of blood supply of HH by CT enhanced scan before operation might help make choice of measures and warrants further investigation.