Objective The aim of this study was to summarize the clinical features, treatment and prognosis of patients with Fitz-Hugh-Curtis syndrome. Methods The clinical data of 7 patients with Fitz-Hugh-Curtis syndrome in our hospital between January 2016 and April 2021 were retrospectively summarized, including general feature, symptoms and signs, laboratory test results, initial diagnosis, imaging manifestation, gynecological examination, treatment and outcomes. Results All the 7 patients were young women, with the onset of acute abdominal pain; the hepatic capsule enhancement in arterial phase, the uniform enhancement or weakening of liver capsule and liver parenchyma in portal phase and delayed phase were observed in all the 7 cases by abdominal contrast-enhanced CT scan; the acute cholecystitis in 2 cases, acute pancreatitis in 2 cases, and peptic ulcer in 1 case were initially diagnosed before abdominal CT scan; the vaginal secretion examination showed the chlamydia trachomatis in 4 cases; all the 7 patients were treated with ceftriaxone, doxycycline and/or metronidazole combination for two weeks, and all of them recovered. Conclusion In young women at reproductive age with sexual life, the acute onset of persistent epigastric pain or right epigastric pain might hints the Fitz-Hugh-Curtis syndrome, and the diagnosis could be made by gynecological and imaging examination.

Objective Non-alcoholic fatty liver diseases (NAFLD) is the most prevalent chronic liver disease worldwide at present, and the main mechanisms involved in the pathogenesis include insulin resistance, oxidative stress and so on. Different serum markers are closely related to the pathogenesis of NAFLD, but there is no clear conclusion yet. This article reviewed the important role of different serum markers in patients with NAFLD.

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 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 clinical features of patients with benign recurrent intrahepatic cholestasis (BRIC). Methods The clinical manifestations, laboratory tests, imaging, pathological examinations, and genetic analysis in three patients with BRIC in Zhongshan Hospital, Fudan University, were retrospectively reviewed. Results The three patients were all male and their initial onset ages were below 20 year old; the common symptoms of the patients were jaundice and pruritus, and two of them also experienced abdominal distension, irregular defecation, and appetite loss; serum total bilirubin, direct bilirubin, ALP and TBA levels increased significantly, while serum GGT, ALT and AST levels stayed normal or increased slightly during the disease attack duration; no abnormal intrahepatic and extrahepatic bile ducts were found in magnetic resonance cholangiopancreatography (MRCP) examination, but obvious cholestasis of hepatocytes and capillary bile duct embolism were observed in liver histopathology; the ATP8B1 gene mutation sites with functional prediction of "potentially harmful" or "likely pathogenic" in pathogenic classification were all detected in three patients; all patients were excluded from other known causes of cholestasis, and the disease was recurrent, but with self-limiting. Conclusion The BRIC is rarely reported and its pathogenesis remains unclear currently. The clinical diagnosis might be made based on clinical manifestations, ancillary tests, and pathological findings after excluding other common causes of liver damage. For patients with high suspicion of BRIC, the genetic tests should be performed as early as possible to clarify the diagnosis and guide the management.

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 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 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 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 compare the clinical efficacy of laparoscopic puncture drainage (LPD) and laparoscopic incision drainage (LID) in treatment of patients with bacterial liver abscess (BLA). Methods 63 patients with BLA were admitted to our hospital between January 2019 and December 2020, and were divided into observation (n=32), underwent LPD, and control group (n=31), underwent LID. They were all followed-up for 3 months after surgery. Serum interleukin 6 (IL-6), C-reactive protein (CRP)and procalcitonin (PCT) levels were detected. Results All but one patients in the observation group who died from concomitant diabetes and pulmonary infection recovered in the two groups; the hospitalization stay and medical cost in the observation group were (14.2±2.3)d and (13.0±2.0) thousand yuan, both significantly shorter or lower than [(16.1±2.5)d and (16.0±3.0)thousand yuan, respectively, P＜0.05], while the body temperature normal and hepatic abscess disappearance time were (2.3±0.4)d and (10.3±1.5)d, both significantly longer than [(1.7±0.4)d and (8.4±1.2)d, respectively, P＜0.05] in the control; there were no significant differences respect to serum ALT, AST, GGT and albumin levels, as well as serum CRP, PCT, IL-6 levels or white blood cell counts between the two groups at presentation or after surgery (P＞0.05). Conclusion The clinical efficacy of laparoscopic puncture drainage and laparoscopic incision drainage in dealing with patients with BLA is comparable, but the former is more beneficial to accelerate recovery of patients.

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.

Portopulmonary hypertension （PPHTN） is defined as the development of pulmonary arterial hypertension associated with increased pulmonary vascular resistance complicating portal hypertension, with or without advanced liver disease. The presence of PPHTN markedly increases mortality. No effective medical therapies are currently available and liver transplantation is the only accepted treatment at the time. This review stresses on the epidemiology, pathophysiology, clinical presentation, diagnosis, treatment and the prognosis of PPHTN.

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 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 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 analyze the triggering factors and impacting factors of prognosis in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). Methods A retrospective analysis was performed on 96 patients with HBV-ACLF between January 2019 and December 2021, and all patients received comprehensive internal medicine supporting therapy at base of entevavir antiviral treatment. The patients were followed-up for 90 days. The univariate and multivariate Logistic regression analysis were applied to reveal the risk factors that impacted the prognosis. Results The triggering factors in our series included self-discontinuation of antiviral therapy in 53 cases (55.2%), hepatitis H or hepatitis E co-infection in 11 cases (11.4%), complicated bacterium infection in 9 cases (9.4%), exhausted in 7 case (7.3%), binge in 6 case (6.2%), drug-induced liver injuries in 5 cases (5.2%) and cryptogenic in 5 cases (5.2%); at the end of 90 day observation, 69 patients survived and 27 patients died; the median ages in dead patients was 50(41, 69)yr, significantly older than [39(33, 58) yr, P<0.05] in survived patients, the incidences of complication, such as gastrointestinal bleeding (GIB), hepatic encephalapathy (HE) and acute kidney injury (AKI), were 14.8%, 29.6% and 44.4%, significantly higher than 1.4%, 5.8% and 14.5% (P<0.05) in the survivals, and serum bilirubin level was 532(204, 780)μmol/L, significantly higher than [302(80, 416)μmol/L, P<0.05], the INR was 3.0(2.0, 3.4), significantly higher than [2.1(1.5, 2.6), P<0.05] and the MELD score was 26(18, 37), significantly higher than [20(10, 29), P<0.05] in the survivals; the multivariate Logistic regression analysis showed that the ages [OR=1.04(95%CI:1.02-1.08)], GIB[OR=1.51(95%CI:1.23-0.79)], HE [OR=0.50(95%CI:0.22-0.78)], INR[OR=1.52(95%CI:1.22-0.73)] and the MELD score [OR=2.44(95%CI:1.63-3.75)] were the independent risk factors for poor prognosis in patients with HBV-ACLF. Conclusion The predisposing factors of patients with HBV-ACLF mainly include inappropriate discontinuation of nucleos(t)ide , other heparnavirus infections and bacterial infections. The clinicians should take the risk factors ,such as elderly age, GIB, HE, and MELD scores into consideration and deal with them carefully to improve the prognosis.

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 purpose of this study was to investigate the prevalence of serum anti-mitochondrial antibody-M2 (AMA-M2) antibody in physical examination individuals. Methods 18515 serum samples were collected from the Physical Examination Center, Shanghai General Hospital between May 2012 and December 2014. Serum AMA-M2 was quantitatively detected by ELISA, and blood biochemical parameters were assayed. Results Among 18515 screened people, 245 persons (1.3%) were serum AMA-M2 positive, of which 97 were men and 148 were women, with the ratio of men to women of about 1∶1.5, and the highest positive rate (28.6%) was found in 46 to 55 year old age group(n=70); serum alkaline phosphatase levels increased in 12 persons with serum AMA-M2 positive, who met the diagnostic criteria of primary biliary cholangitis (PBC); serum ALP level in 54 persons with higher serum AMA-M2 (＞150U/ml) was (92.8±85.6 U/L), and serum GGT level was (84.3±118.5 U/L, significantly higher than [(67.7±38.3U/L) and (39.1±61.8U/L), respectively, P<0.05] in 191 individuals with low serum AMA-M2. Conclusion It is not uncommon that serum AMA-M2 antibody is positive in healthy people, and early screening serum AMA-M2 antibody is helpful for early diagnosis of PBC.

Objective The aim of this study was to summarize the clinical features of patients with primary hepatic neuroendocrine neoplasm (PHNEN). Methods The clinical manifestations, laboratory tests, imaging, pathological examination and clinical outcomes in four patients with PHNEN encountered in our hospital were summarized by retrospective analysis. Results The age of the four female patients was 56 (40-73) years; there were no symptoms in 2 cases and abdominal pain in 2 cases; serum ALT levels were 28.3(18.0-49.8)U/L, bilirubin levels were 11.5(9.5-16.3)μmol/L, neuron-specific enolase levels were 44.1(20.2-77.1) ng/ml; the abdominal CT scan showed multiple lesions in all cases, and in contrast-enhanced scan, different degrees of ring or uneven enhancement in the arterial phases, and decreased enhancement in the venous phase; all diagnoses were confirmed by pathological examination, and surgical operation, interventional therapy and chemotherapy were given in 3 cases, and one case did not receive any treatment; during the follow-up period of 11 to 81 months, 2 cases died and 2 cases still survived. Conclusion The PHNEN is a rare tumor in clinic, and lacks of specific laboratory and pathological markers. It should be considered after excluding other liver tumors. Early detection and several therapy combination are recommended to improve the prognosis.

Objective The aim of this study was to investigate the modified endoscopic nosal biliary drainage (ENBD) through gallbladder approach in the treatment of patients with small-diameter common bile duct stones (CBDS). Methods A retrospective analysis was conducted, including 54 patients with small-diameter CBDS encountered in the hospital between December 2015 and June 2018 (control group) and other 54 cases presented between July 2018 and December 2020 (observation group). All patients underwent laparoscopic cholecystectomy (LC), followed by common bile duct exploration and ENBD, and the difference was the common nasal biliary drainage (NBD) was applied in the control and the modified NBD in the observation. Serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were detected routinely. Results The postoperative drainage volume of bile and extubation time of nasobiliary ducts in the observation were (281.6±52.5)mL and (5.9±1.3)d, significantly greater or longer than [(228.7±53.2)mL and (4.0±1.4)d, respectively, P＜0.05], while the hospital stay was (6.1±1.1)d, significantly shorter than [(8.1±1.3)d, P＜0.05] in the control group; the incidences of post-operational complications, such as pancreatitis, bile leakage and slippage of nasobiliary ducts in the observation was 7.4%, significantly lower than 25.9%(P＜0.05) in the control; one week after operation, serum CRP, IL-6 and TNF-α levels in the observation were (42.8±11.1)mg/L, (3.2±0.8)ng/L and (1.0±0.8)ng/L, significantly lower than [(73.7±17.4)mg/L, (4.9±1.2)ng/L and (1.8±0.9)ng/L, respectively, P＜0.05] in the control group. Conclusion Compared with the ordinary NBD tube, the application of modified NBD tube could reduce the risk of slippage, improve the drainage of bile and shorten the postoperative recovery in patients with small-diameter CBDS.

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

Objective The aim of this study was to analyze the diagnostic performance of high-frequency and color Doppler ultrasonography in judging the benign and malignant gallbladder polyps. Methods 71 patients with polypoid lesions of gallbladder (PLG) were encountered in our hospital between April 2019 and April 2022, and all patients underwent HD11-type high-frequency and SONOLINE Premier color Doppler ultrasonography. All patients received laparoscopic cholecystectomy (LC) and histopathological examination was performed after operation. Results Out of the 71 patients with PLG, the histopathological examination showed that the benign lesions were found in 67 cases and the adenocarcinoma was found in 4 cases; the high-frequency and color Doppler ultrasonography demonstrated the benign gallbladder polyps in 66 cases(98.5%), and that was 64 cases (95.5%) by high-frequency ultrasonography or 63 cases (94.0%) by color Doppler ultrasonography(P>0.05); the sensitivity, specificity and accuracy were 98.5%, 100.0% and 98.6% by the high-frequency and color Doppler ultrasonography combination detection with the Kappa of 0.881, much excellent compared to 95.5%, 75.0% and 94.4% by high-frequency ultrasonography (Kappa=0.571) or 94.0%, 75.0% and 93.0% by color Doppler ultrasonography (Kappa=0.510). Conclusion The combination of high-frequency and color Doppler ultrasonography in diagnosing gallbladder polyps is efficacious, which could guide the clinicians to make an appropriate decisions.

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 analyze the differential diagnosis of enhanced multi-slice spiral CT scanning in patients with hepatic hemangioma (HH) and malignant liver metastasis. Methods A total of 133 patients with space occupying lesions inside livers were encountered in our hospital between January 2018 and January 2020, and the comprehensive diagnosis based on imaging and histopathological examination revealed HH in 102 cases and malignant liver metastasis in 31 cases. All patients underwent enhanced multi-slice spiral CT scanning. Results In patients with HH, the blood flow passing time was (14.3±1.7) s, the liver blood volume was (25.4±2.6) ml/100 g, and the capillary surface permeability was (33.1±4.6), significantly higher than [(9.4±1.0)s, (13.7±1.6)ml/100 g and (27.1±3.1), respectively, P＜0.05], while the proportion of hepatic artery perfusion was (0.3±0.1)%, and the hepatic blood flow was (151.3±15.9)ml/100g/min, significantly lower than [(0.5±0.2)% and (189.3±19.6)ml/100g/min, respectively, P＜0.05] in patients with malignant liver metastasis; the incidences of lesion fusion was 60.8%, the distribution under liver capsules was 74.5%, and the target ring sign was 33.3%, significantly higher than 3.2%, 0.0% and 0.0%, respectively (P＜0.05), while the quasi circular central low-density mass was 2.0%, and the bovine eye sign was 1.0%, significantly lower than 61.3% and 48.4%(P＜0.05)in patients with malignant liver metastasis; based on the golden criteria, the sensitivity, specificity and accuracy by CT scan in diagnosing HH were 89.2%, 77.4% and 86.5%, with the Kappa of 0.638 consistent with histopathological diagnosis. Conclusion The diagnostic performance of enhanced multi slice spiral CT scanning in patients with HH is efficacious, which might guide the clinicians to make suitable plans for the patients with HH.

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.