Objective To evaluate the value of PRETEXT staging system and CT imaging features in evaluating treatment response of pediatric hepatoblastoma （HB）. Methods The multi-detector CT imaging features in 47 children with pathologically confirmed HB were retrospectively reviewed between January 2013 and August 2016. The consistency between PRETEXT stage and post-surgical pathological grade was assessed. The CT imaging findings, including tumor margin,morphology,intra-tumor hemorrhage,calcification and intra-tumor cystic necrosis, and pathological grades was evaluated. Results Out of 47 children with HB,30（63.8%） were pathological-proven epithelial,and 17（36.2%） with epithelial-mesenchymal type;eight children with HB,including 6 with PRETEXT stage II and 2 with PRETEXT stage III, received surgery without chemotherapy,and their PRETEXT stages was completely consistent with pathological-proven grade, and the accuracy rate between POSTTEXT stages and pathological grades reached 79.5% （31/39） in 39 children receiving surgery after chemotherapy;the overall accuracy of PRETEXT stage was 83.0% as compared with post-surgical pathological grade;out of ten children with tumor calcification,eight was with epithelial-mesenchymal type tumor, much higher than in with epithelial type （x²=8.313,P=0.004）. Conclusion The PRETEXT stage is well consistent with post-surgical grade, and it might predict the pathological grade in consideration of specific image findings,which is helpful in determining management strategy of children with HB.

Objective To investigate the application of superb micro-vascular imaging （SMI） in the evaluation of blood suply in intrahepaitc lesions in patients with primary liver cancer（PLC） underwent transcatheter arterial chemoembolization （TACE）. Methods 45 patients with PLC were recruited in our hospital between January 2014 and December 2015. All patients received TACE, and 1 month later,they received computer tomography （CT）,SMI and color doppler flowimaging（CDFI）. The blood supply of lesions was compared with the contrast of enhanced CT scan. Results A total of 56 focci was found in the 45 patients with PLC,including 35 with single and 10 with multiple （21 foci）. The ability of enhanced CT scan in assessing lesion blood supply was better than CDFI （x²=38.205,P<0.001） or SMI （x²=12.010,P=0.001）;SMI assessment of blood supply was better than CDFI （x²=9.583,P=0.002）; furthermore,the diagnostic efficacy in assessing the blood supply by the area under the ROC curve with the CT scan as the golden criteria showed that the SMI was better than CDFI （P=0.031）,the sensitivity,accuracy and negative predictive value by SMI were 62.4%,58.9% and 31.5%,much better than by CDFI （30.4%,28.4% and 21.1%,x²=20.612,P<0.001, x²=10.251,P=0.001,x²=2.956,P=0.041）;SMI clearly showed the blood suply in lesions with diameters less than 2.0cm, while CDFI showed no blood flow signal in the same lesions（x²=5.758,P=0.016）,and SMI and CDFI both showed the blood flow in lesions greater than 2 cm,still the SMI assessment was better than CDFI（x²=6.560,P=0.010）. Conclusion SMI technology is a new approach of blood flow imaging, which can be used to detect the blood supply of tumor foci, which might provide a new method for the clinical evaluation of the curative effect of liver cancer after TACE.

Objective To investigate the imaging manifestations of hepatocellular carcinoma （HCC） by multiple row spiral CT and MRI enhanced scan. Methods Thirty six patients with HCC proved by histopathological examination were included in this study between December 2014 and December 2016. CT and MRI multiphase dynamic enhanced scan was carried out in all patients. The features of foci was observed and the diagnostic accuracy of CT and MRI was compared. Results Among the 36 patients with HCC,48 lesions were found,and 14 cases with 16 foci of less than 3 cm small liver cancer,and 9 cases with 32 lesions of larger than 3 cm massive liver cancer were detected;43 lesions（89.6%） were showed off by hepatic arterial phase of CT,39 lesions （81.3%） were detected by portal phase,and 40 lesions（83.3%） were detected by delay phase,while 46 lesions（95.8%） were detected by hepatic arterial phase of MRI,and the detection rate of MRI portal phase was 52.1%,and the detection rate of the delay period was 85.4%,significantly different between CT and MRI detection （x²=14.376,P<0.05）;41 foci （85.4%） were detected by CT,and 44 （91.7%） were found out by MRI without significant difference between the two detection（x²=0.924,P>0.05）. Conclusion CT and MRI multi-phase dynamic contrast-enhanced scan can show enhanced features of liver cancer lesions,and there is no significant difference between CT and MRI scan.

Objective To investigate the effect of paravertebral block anesthesia on circulating tumor cells and T lymphocyte subsets in patients with primary liver cancer（PLC） undergoing hepatectomy. Methods 110 patients with PLC undergoing resection of liver cancer were recruited in our hospital between March 2014 and March 2017,and they were divided into the paravertebral block and the epidural block group,with 55 cases in each group when anesthesia.All patients underwent radical hepatectomy in our hospital. Cardiovascular parameters were monitored before block （T0）,at 20min after block （T1）,at 60min after block（T2） and at the end of operation（T3）. The T lymphocyte subsets and circulating tumor cells in peripheral blood were detected. Postoperative pain was evaluated by VAS. Results The heart rates and mean arterial pressure in the paravertebral block group at T1,T2 and T3 were significantly quicker or higher than those in the epidural block group（P<0.05）;the percentage of CD4⁺ cells andratio of CD4⁺/CD8⁺ cells in the paravertebral block group 48h after operation were （39.57±7.12）% and （1.24±0.22）,much higher than [（36.83±6.63）% and （1.09±0.19）,P<0.05],while CD8⁺ cells and circulating tumor cells were （32.29±5.81）% and （18.61±3.35）×10^-5,significantly lower than[（34.61±6.23）% and（20.59±3.70）×10^-5,P<0.05] in the epidural block group;the dosage of remifentanil,recovery time and the times of pressing analgesia pump in the paravertebral block group were significantly less or shorter than those in the epidural block group（P<0.05）. Conclusion Paravertebral block can ensure hemodynamic stability,promote the recovery of postoperative immune functions,reduce peripheral circulating tumor cells and might reduce the risk of tumor invasion and metastasis in patients undergoing resection of liver cancer.

Objective To investigate the prognosis of patients with primary liver cancer （PLC） after radical tumor resection and analyze the the factors affecting the survival of patients with PLC after radical tumor resection. Method The clinical and pathological data of 301 patients with PLC（194 with tumor diameter >5 cm and 107 with tumor diameter≤5 cm） were retrospectively analyzed in our hospital between January 2008 and January 2012. All the patients underwent radical tumor resection, and followed-up for four years. The COX regression analysis was applied to determine the factors that might affect the survival of the patients. Result There were no significant differences as respect to the clinical parameters,except the tumor diameters,between the two groups（P>0.05）;one month after tumor resection, serum AFP level in patients with tumor diameter >5cm was significantly higher than in those with tumor diameter≤5cm（P<0.05）,while the liver function index in the two group were not significantly different （P>0.05）;the overall survival （OS） in patients with tumor diameter >5cm was （19.2±3.8） m,much shorter than（29.4±4.2）m in patients with tumor diameter ≤5cm,and the disease-free survival （DFS） in patients with tumor diameter >5cm was（12.3±2.7） m,also significantly shorter than （20.9±5.1） m （P<0.05） in patients with tumor diameter ≤5cm;univariate analysis showed than the OS and DFX in patients older than 50 yr,having operation time longer than 240 min,bleeding greater than 500 ml,with underlying liver cirrhosis,with high serum AFP levels, Child-Pugh class B,low serum albumin levels,vascular invasion and tumor diameters decreased obviously（P<005）,and further multivariate analysis demonstrated that tumor diameter,vascular invasion,Child-Pugh class,bleeding and underlying liver cirrhosis were the independent risk factors affecting the patients' OS and DFS （all P<0.05）. Conclusion The radical tumor resection might be the first choice in patients with PLC,and the underlying liver cirrhosis and/or the Child-Pugh class,vascular invasion and tumor diameters might affect the post-operational survival,which the surgeons should take into consideration in making choice of interventional approaches in dealing with patients with PLC.

Objective To analyze plasma levels of serine protease inhibitor Kazal 1（SPINK1） in patients with hepatocellular carcinoma（HCC） and its relationship with prognosis. Methods 80 patients with HCC,40 patients with liver cirrhosis and 30 normal persons in our hospital between May 2014 and September 2015 were retrospectively analyzed. The plasma SPINK1 and alpha-fetoprotein （AFP） levels were measured by enzyme-linked immunosorbent assay （ELISA） before hepatectomy. The ROC was drawn to evaluate the efficacy of plasma SPINK1 and AFP to diagnose HCC,and the relationship between the SPINK1 levels and the prognosis of patients with HCC was analyzed. Results The plasma SPINK1 level was （2.4±0.3） μg/L in the HCC patients,much higher than （2.0±0.2） μg/L in the liver cirrhosis patients or（1.3±0.1） μg/L in normal control（P<0.05）;plasma AFP levels was （125.7±14.5） μg/L in the HCC patients,significantly higher than （35.4±4.2） μg/L in patients with liver cirrhosis or in normal persons【（3.6±0.5）μg/L,P<0.05】;the ROC analysis showed that the sensitivity and the specificity of plasma SPINK1 were 77.2% and 67.6%,respectively,in diagnosing HCC as the cut-off-value was 1.70 μg/L,while the sensitivity and the specificity of plasma AFP were 63.4% and 62.5% as the cut-off-value was 124.8 μg/;the postoperative OS and DFS were（12.2±1.3） m and（11.2±1.2） m in 42 HCC patients with preoperative serum SPINK1 levels >1.70 μg/L,much shorter than（20.5±2.1） m and（15.7±1.9） m in 38 HCC patients with preoperative SPINK1 levels less than 1.70 μg/L,and the recurrence rates after operation were significantly different between the two groups（38.1% vs. 18.4%,x²=5.18,P<0.05）. Conclusions Plasma level of SPINK1 is high in HCC patients,which might be act as a new marker for diagnosis of patients with HCC, and increased plasma SPINK1 might be closely related to the poor prognosis of HCC patients after hepatectomy.

Objective To investigate the safety and efficacy of laparoscopic radical cholecystectomy (LRC) in treatment of patients with gallbladder cancer. Methods 40 patients with gallbladder cancer were recruited in our hospital between January 2013 and December 2015,and were randomly divided into two groups. 19 received LRC,and 21 received open radical cholecystectomy. All patients were followed-up for two years,and the overall survival was estimated by Kaplan-Meier analysis. Results The operation time,the numbers of lymph nodes cleared and bleeding in the LRC group were（238.4±31.2）min,（7.5±1.2） and（210.5±21.1）ml,while they were [（316.5±11.5）min（P<0.01),（7.8±0.9） and（301.2±22.8）ml（P<0.01),in the open redical cholecystectomy, respectively];the ambulation time,stoping drainage time,eating time,postoperative exhaust time and hospitalization time were（2.1±0.5）d,（3.5±2.1）d,（2.5±0.9）d,（1.1±0.1）d and （5.4±2.1）d,much shorter than in the open redical cholecystectomy [（7.1±1.2）d,（14.5±6.6）d,（3.8±1.8）d,（1.9±0.5）d and （8.2±5.8）d,respectively,P<0.01】;infection and bile leak occurred in one and two patients （15.8 %） in LRC group,much lower than four and five（42.9%,x²=4.286,P=0.038） in the open redical cholecystectomy;the 1 year survival rates in LRC and in open redical cholecystectomy group were 94.7% and 95.2%,and 2 year survival rates were 78.9 % and 71.4 %,respectively in the two groups（x²=0.655,P=0.418）;abdominal lymph node metastasis occurred in two patients in LRC group and in three in patients underwent open redical cholecystectomy. Conclusion LRC is safe and feasible for the treatment of patients with gallbladder cancer, and the efficacy is similar to that,but hospitalization time is shorter than that with open radical cholecystectomy.

Objective To investigate the influencing factors of prognosis in patients with hilar cholangiocarcinoma（HCCA） after surgical treatment. Methods 120 patients with HCCA were recruited in our hospital between January 2010 and January 2014,and 67 patients received surgical resection,including 30 with radical resection and 37 with R1 or R2 palliative resection,and 53 received bile duct drainage. Results The 1-year,2-year and 3-year survival rates in the 120 patients with HCCA were 67.5% （81/120）,45.8% （55/120） and 25%（30/120）,respectively,after treatment,and the 1-year,2-year and 3-year survival rates in patients undergoing radical resection were 93.33%,73.33%,60.00%,and the survival time was（30.26±5.26） months,much higher than 67.57%,48.65%,32.43% or longer than（22.14±4.78） m in patients with palliative resection or 52.83%,28.30%,0.0% and （15.21±3.74） m in patients with bile duct drainage （P<0.05）;Cox multivariate analysis showed that the surgical method [Exp（β）=5.214],resection margin [Exp（β）=2.703],differentiation degree [Exp（β）=4.781],TNM stage [Exp（β）=6.987],lymph node metastasis [Exp（β）=2.751] and portal vein invasion [Exp（β）=3.254] were the independent risk factors for the prognosis of patients with HCCA after treatment（P<0.05）. Conclusion Precise surgery should be given in patients with HCCA with detailed analysis of influencing factors of prognosis, which might be evaluated before any approaches is taken.

Objective To investigate the efficacy and prognosis of retrograde cholangiopancreatography （ERCP）-guided radiofrequency ablation combined with chemotherapy in treatment of patients with cholangiocarcinoma. Methods The clinical and follow-up data of 96 patients with cholangiocarcinoma admitted to our hospital between January 2009 and December 2014 were retrospectively analyzed. The patients were divided into control group and observation group with 48 cases in each group. The patients in the control group were treated with ERCP-guided radiofrequency ablation and the patients in the observation group were given chemotherapy on the basis of ERCP-guided radiofrequency ablation. The recent clinical outcomes were compared between the two groups. The prognosis of all patients was statistically analyzed and the survival was compared. Cox regression analysis was performed to explore the factors affecting the patients' survival. Results The levels of serum bilirubin was （72.6±22.2） μmol/L vs. （102.6±32.4） μmol/L,GGT was （262.2±64.6） U/L vs. （382.4±102.4） U/L and ALP was （206.4±62.6） U/L vs. （284.4±86.4） U/L,and serum albumin levels was （42.4±10.8） g/L vs.（36.2±10.6） g/L,all significantly different between the two groups（P<0.05）;the clinical effective rate in the observation group was remarkably higher than in the control group（91.6% vs. 75.0%,x²=4.800,P=0.028）;the 3 year overall survival rates in the observation group and the control group were 58.3% vs. 29.1%,respectively,and difference was statistically significant （x²=8.296,P=0.004）;the 3 year recurrence-free survival rate in the two groups were 54.2% and 25.0%,respectively,and the difference was statistically significant between the two groups（x²=8.537,P=0.003）;univariate Cox regression analysis showed that age,tumor location,number,differentiation,clinical stage,CEA level and treatment were all likely to affect the prognosis of patients with cholangiocarcinoma（P <0.05）;multivariate Cox regression analysis showed that the poor tumor differentiation（HR=1.84,95%CI:1.05-3.23）, stage III and IV（HR=1.76,95%CI:1.03-3.02）,metastasis （HR=1.81 95%CI:,1.05-3.12） and without chemotherapy after surgery （HR=1.84,95%CI: 1.03-3.27） were all independent factors influencing the prognosis of patients with cholangiocarcinoma（P<0.05）. Conclusions ERCP-guided radiofrequency ablation combined with chemotherapy could significantly improve the clinical efficacy of patients with cholangiocarcinoma,prolong the survival and ameliorate the prognosis. Taking the influencing factors into consideration and managing them in time might further improve the efficacy.

Objective To investigate the relative levels of S100A6 mRNA and its protein expression in tumorous tissues of patients with cholangiocarcinoma. Methods The tumorous tissues in 40 patients with cholangiocarcinoma in our hospital between 2008 and 2014 were collected,and liver tissues in another 40 patients with benign biliary diseases during the same period were also collected as control. S100A6 mRNA and its protein in liver tissues were detected. Serum S100A6 was assayed by ELISA. Univariate and multivariate unconditional Logistic regression analysis was made for the risk factors of high serum S100A6 levels in patients with cholangiocarcinoma. Results The expression of S100A6 protein in tumor adjacent tissues and liver tissues were positive in 8 （20%） and in 12（30%）,respectively,significantly lower than in 26（65%） in timorous tissues （P<0.05）;the relative levels of S100A6 mRNA in adjacent tissues and liver tissues were （0.92±0.33） and （1.12±0.46）,significantly lower than（1.93±0.57） in cholangiocarcinoma tissues （P<0.05）;the relative expression of S100A6 protein in tumor adjacent tissues and liver tissues was （0.56±0.16） and （0.85±0.46）,significantly lower than[（1.63±0.51）,P<0.05] in timorous tissues;serum S100A6 level in patients with cholangiocarcinoma was （2456.85±128.31） pg/ml,significantly higher than（2234.26±116.35） pg/ml in control group （P<0.05）;serum S100A6 level in patients with cholangiocarcinoma was positively correlated with CEA,CRP,invasion depth,lymph node metastasis,TNM stage and tumor differentiation （P<0.05）;multivariate Logistic regression analysis showed that tumor invasion depth,lymph node metastasis,poor TNM stage and differentiation were the risk factors for high serum S100A6 levels in patients with cholangiocarcinoma （P<0.05）. Concluson The implication of high serum S100A6 levels in patients with cholangiocarcinoma needs further investigation.

Objective To study the protective effect of neferine on acute liver injury induced by D- GalN / LPS in mice. Methods 80 mice were randomly divided into four groups, 20 in each and the mice in normal control and model group, saline was given by gavage, and the mice in the other two experiment groups was given intragasticly neferine at low （100 mg.kg^-1）and large （300 mg.kg^-1） dose. At the end of the last administration, 10 mice in each group were sacrificed to obtain blood for serum ALT, AST, SOD, MDA, GSH, TNF-α, IL-6 and IL-10 detection, and another ten mice in each group were followed-up for survival observation. The hepatic pathological examination were also performed. Results Serum ALT and AST levels in the model group were（272.4±42.8） U/L and（497.2±62.1） U/L,respectively, while they significantly decreased in neferine-intervened groups （P<0.05）,especially in mice with large neferine intervention;serum SOD and GSH levels in the model were （37.5±6.2） U/ml and （11.8±2.7） μmol/L,serum MDA level was （9.2±1.4）mol/L, while serum SOD and GSH levels in neferine-intervened groups significantly increased and serum MDA level significantly decreased （P<0.05）;serum TNF-α,IL-6 and IL-10 levels in the model were （587.6±48.9）pg/ml, （153.4±18.0） pg/ml and （96.4±9.7）pg/ml,respectively,while serum TNF-α and IL-6 levels in neferine-intervened groups significantly decreased, and serum IL-10 level significantly increased（P<0.05）,without significant differences between the two neferine-intervend groups（P>0.05）; the 12 h and 24 h survival rates in the model were 60.0% and 10.0%,while they were 80.0% and 50.0% in low-dose neferine-intervened group, and 90.0% and 70.0% in large-dose neferine-intervened group （P<0.05）. Conclusion Neferine can alleviate acute liver injury induced by D- GalN / LPS administration in mice, and the mechanism might be related to the inhibition of oxidative stress.

Objective To investigate the dynamic changes of expression and activity of prolyl endopeptidase （PREP） in the liver tissues of mice with non-alcoholic fatty liver disease （NAFLD）. Methods 40 male C57BL/6J mice were randomly divided into standard diet-fed and high fat diet-fed group. The animals were scarified at the end of 4 weeks and 16 weeks. The levels of serum biochemical index were measured by biochemical analyzer. Hematoxylin-easin staining,real-time polymerase chain reaction,western blot or Suc-Gly-Pro-AMC substrate method were applied to determinate the liver histological alterations,mRNA levels,protein expressions and activity of PREP,respectively. Results At the end of 4 weeks,the body weight,liver weight,alanine aminotransferase （ALT）,triglyceride （TG）,total cholesterol（TC） and fasting blood glucose （FBG） in mice in model group were similar with those in the control group; the liver tissues in model group showed mild steatosis with increased NAFLD activity score （NAS） of （3.43±0.79） as compared with that in the control group; relative levels of PREP mRNA,protein and activity had no statistical significance as compared with those in the control group;at the end of 16 weeks,the body weight,liver weight,ALT,TG,TC and FBG in model group were（32.93±2.72） g,（4.64±0.46） %,（53.64±22.01） IU/L,（1.18±0.17） mmol/L,（4.34±0.44） mmol/L and （5.67±0.87） mmol/L, respectively,significantly higher than those in the control group [（28.19±1.23） g,（4.02±0.11） %,（28.60±4.01） IU/L,（0.99±0.15） mmol/L,（2.94±0.18） mmol/L and （4.26±0.65） mmol/L,respectively,P<0.05];the NAS score in the model group was（5.60±1.43）,significantly higher than that in the control group [（0.40±0.70）,P<0.01];although the hepatic PREP protein expression was not statistically elevated both at 4 and 16 weeks, the relative levels of PREP mRNA and activity of the enzyme in the liver tissues of model group were increased to （1.81±0.34）-and （1.36±1.78）- fold of those in the control group at 4 and 16 weeks, respectively. Conclusion The dynamic changes of PREP activity in the mouse liver might participate in the progression from non-alcoholic fatty liver to non-alcoholic steatohepatitis.

Objective To observe the protective effect of Fufangbiejia, a herbal medicine, on diethylnitrosamine (DEN)-induced primary liver cancer (PLC) in rats and its impact on proliferating cell nuclear antigen (PCNA) and α-SMA expression. Methods 40 SD rats were randomly divided into control, model, high and low dose of herbal medicine-intervened groups, with 10 in each. The DEN was used to induce hepatic neoplasmas in rats, and the herbal medicine at dose of 0.625 g·kg^-1 and 1.25 g·kg^-1 or saline for gavage were given for 20 weeks. The PCNA and α-SMA were stained immunohistochemically. Results The liver weights, surface carcinoma nodule numbers, canceralization rates and liver index were （17.34±1.78） g, 10.0%, （3.10±0.72） and （3.16±0.45） in high dose group, significantly lower than in the model group 【（25.59±2.38） g, 100.0%,（4.95±0.58） and （14.14±2.37）,P<0.05】; the liver weights, surface carcinoma nodule numbers, canceralization rates and liver index were （19.89±1.80）g, 30.0%, （3.89±0.81） and （7.38±1.01） in low dose group, also significantly lower than in the model group and(P<0.05);the expression scores of PCNA and α-SMA were （5.98±1.12） and （7.96±1.37） in high dose group,and （9.23±1.34） and （12.34±2.88） in low dose group, both significantly lower than in the model group 【（19.59±2.67） and （25.12±3.19）,P<0.05】. Conclusions Fufangbiejia has a protective effect on DEN-induced primary liver cancer in rats, which might be related to the regulation of hepatic PCNA and α-SMA expression.

Objective To investigate the impact of maternal serum anti-hepatitis B surface antibody （anti-HBs） on their newborn response to hepatitis B vaccination. Method 60 pregnant women （31 with serum anti-HBs positive and 29 negative） and their single newborns were recruited between June 2012 and June 2013 in this study,and the fetuses were vaccinated with hepatitis B vaccine instance,1 month and 6 months after birth. All the fetuses were followed-up for three years. Results At the end of one year followed-up,the nonresponse, lower response,normal response and strong response rates in children with their mother's serum anti-HBs positive were 12.9%,22.6%,29.0% and 35.5%,without significant differences as compared to 10.3%,20.7%,37.9% and 31.0%（P>0.05） in children with their mother's serum anti-HBs negative;at the end of 3 year followed-up,serum anti-HBs positive in children with their mother's serum anti-HBs positive were 87.1%,no significant difference as compared to 89.7% （P>0.05） in children with their mother's serum anti-HBs negative;serum anti-HBs levels represented by geometric average concentration （GMC） in children with their mother's serum anti-HBs positive and negative were 74.3（6.3~854.0） mIU/ml and 73.6 mIU/ml（3.4~950.6） mIU/ml,respectively,no significant difference（P>0.05）,while they both decreased as compared to serum levels of their own at the end of one year [1162.1（164.5~3202.3） mIU/ml and 1104.2 mIU/ml（153.0~2584.7） mIU/ml,respectively,P<0.05];serum HBsAg and anti-HBc were all negative in the 60 children,and boosting vaccination were completed in seven children with serum anti-HBs negative,and six responded. Conclusion Inoculation of hepatitis B vaccine in newborn infants in accordance with the current national vaccination plan can definitely protect them from hepatitis B viral infectoin. Maternal serum anti-HBs might not obstacle the immune response of their newborns to hepatitis B vaccination.

Objective To explore the correlation between blood IL-28B genotype and allele frequencies and clinical phototypes of hepatitis B viral（HBV） infection. Methods A total of 145 healthy persons and 453 patients with HBV infection including 45 with asymptotic HBV carriers（ASC）,181 with chronic hepatitis B（CHB）,69 with HBV-induced liver cirrhosis（LC）,79 with hepatocellular carcinoma（HCC） and 79 with hepatitis B-induced liver failure（LF） in Jiangsu Province were recruited in this study. All the patients and controls were of Han nationality. Peripheral blood IL-28B gene polymorphisms（rs8099917 and rs12979860） were genotyped by PCR and directed sequencing of DNA samples. The IL-28B genotypes and allele frequencies were compared between patients with hepatitis B and healthy controls. Results The genotypes of IL-28B rs12979860 gene showed CC,CT and TT,and LF patients with CC genotype and C allele frequencies were 96.2% and 98.1%,significantly higher than 87.6% and 93.1%,respectively （OR=0.257, 95%CI=0.068~0.973,P=0.045;OR=0.255,95%CI=0.070~0.928,P=0.038） in the healthy controls; the genotypes of IL-28B rs8099917 demonstrated TT,TG and GG,and LC patients with TT genotype and T allele frequencies were 92.8% and 96.4%,significantly higher than 86.2% and 92.4%,respectively （OR=0.288,95%CI=0.087~0.948,P=0.041;OR=0.299,95%CI= 0.096~0.926,P=0.036） in the healthy controls. Conclusion IL-28B gene polymorphisms might be associated with progression of HBV infection in Han populations in Jiangsu Province. C allele of IL-28B rs12979860 gene and T allele of rs8099917 might be the factors that trigger HBV infection disease deterioration.

Objective To investigate the prediction of response in patients with low serum HBsAg level chronic hepatitis B （CHB） receiving peginterferon-α-2a （Peg-IFNα-2a） after nucleos（t）ide analogues （NAs） treatment. Methods 80 patients with CHB with low HBsAg level admitted to our hospital between April 2014 and April 2016, and they were randomly divided into the observation group and the control group with 40 cases in each by the randomized number table. All patients had been given NAs for a long time and had gained virologic response before enrollment. Patients in the control group was given entecavir,and those in the observation group was additionally given peg-IFNα-2a besides entecavir for 48 weeks. The multivariate analysis was performed, and the baseline serum HBsAg level was estimated for the virologic response at the end of treatment by the area under the curve（AUC） of receiver operating characteristic（ROC）. Results At the end of 48 weeks of treatment,serum HBsAg level and HBV DNA load were （1.5±0.3） lg U/ml and （0.1±0.1） lg U/ml,respectively,in the observation group,significantly lower than （2.0±0.2） lg U/ml and（1.3±0.3） lg U/ml in the control（P<0.05）,and serum HBsAg clearance rate and HBV DNA negative rate were 32.5% and 92.5%,respectively,in the observation group,significantly higher than 6.3% and 55.0% in the control （P<0.05）;the baseline serum HBsAg level was an independent factor for HBsAg clearance （OR: 0.337,95% CI: 0.026-0.652,P<0.05）;According to AUC analysis,the sensitivity,specificity,positive predictive value, negative predictive value and the accuracy rate were 0.85,0.68,67.2% and 85.3% and 72.5% when baseline HBsAg level being 2.0 lg U/ml as the cut-off value. Conclusions The peg-IFN-α-2a treatment can improve the clinical efficacy in CHB patients with low serum HBsAg level after NAs therapy,and the baseline HBsAg level has some predictive values for end of treatment response.

Objective To investigate the changes of emotion,attitude and quality of life in patients with chronic hepatitis B（CHB）. Methods 75 patients with CHB and 70 healthy persons were recruited in our hospital between June 2015 and December 2016. The self rating anxiety scale（SAS）,self rating depression scale （SDS） and trait coping style questionnaire（TCSQ） and quality of life scale by WHO（WHOQOL-BREF） were obtained in the two groups. Logistic analysis was applied to evaluate the impact of them on the quality of life in patients with CHB. Results The SAS score,SDS score and the negative score of TCSQ in patients with CHB were （66.8±9.5）,（64.5±10.2） and （38.3±9.6）,respectively,much higher than [（37.9±8.4）,（41.3±9.1） and （23.1±6.4）,P<0.05] in the control;the positive score of TCSQ in patients with CHB was （26.4±8.1）,and HOQOL-BREF score was （65.7±14.3）,much lower than [（23.1±6.4） and （78.4±8.2）,P<0.05] in the control; the physical and psychological score of WHOQOL-BREF in patients with CHB were positively correlated to positive score and negative score of SAS,SDS and TCSQ（P<0.05 or P<0.01）,and Logistic analysis showed than the SDS,PC and NC score were the factors influencing the quality of life in patients with CHB（P<0.01）. Conclusions The quality of life in patients with CHB is relatively decreased, especially in physiological and psychological fields, which warrants social and clinical concerns.

Objective To investigate the efficacy of bacillus subtilis duplex and polyene phosphatidylcholine combination in the treatment of patients with nonalcoholic fatty liver diseases （NAFLD） and its effects on serum people end limb homologous protein 2（Pygo2）,high mobility group protein B1（HMGB1） and hypoxia inducible factor-1α （HIF-1α） levels. Methods 78 patients with NAFLD admitted to our hospital between June 2015 and June 2016 were divided randomly into observation（n=39） and control group （n=39）,and received bacillus subtilis duplex and polyene phosphatidylcholine combination or the latter alone for three months. Serum Pygo2,HMGB1 and HIF-1α were detected by using ELISA. Results At the end of three month treatment,serum levels of TG, TC,LDL-C and HDL-C in the observation group were（1.2±0.2） mmol/L,（4.1±0.2） mmol/L,（3.1±0.1） mmol/L and （3.9±0.3） mmol/L,significantly different compared to[（1.6±0.3） mmol/L,（5.1±0.3） mmol/L,（3.5±0.2） mmol/L and （3.2±0.2） mmol/L in the control,P<0.05];serum levels of MDA and SOD were （4.4±0.7） μmol/L and （168.9±15.7） U/L,significantly different compared to[（5.4±0.8） μmol/L and（154.4±15.3） U/L in the control,P<0.05]; serum levels of Pygo2,HMGB1 and HIF-1 alpha were（41.5±3.4）μg/L,（15.7±4.6） μg/L and（24.5±4.6）μg/L, respectively, significantly lower than [（48.2±3.7） μg/L,（26.4±5.1） μg/L and（32.6±4.7） μg/L in the control,P<0.05]; the percentages of normal liver, and mild, moderate and severe fatty liver were 56.4%,and 35.9%,5.1% and 2.6%,respectively,significantly better than（10.3%, and 30.8%,41.0% and 17.9%,P<0.05） in the control. Conclusion The application of bacillus subtilis duplex and polyene phosphatidylcholine combination in the treatment of patients with NAFLD is clinically efficient,which might effectively improve blood lipid imbalance,inhibit oxidative stress,and reduce serum Pygo2,HMGB1 and HIF-1α levels.

Objective To investigate the efficacy of serum neutrophil gelatinase associated apolipoprotein (NGAL) and cystatin C （Cys C） in early diagnosis of hepatorenal syndrome（HRS） in patients with acute on chronic liver failure （ACLF）. Methods The clinical data of 204 patients with acute on chronic liver failure in our hospital between January 2010 and January 2017 were retrospectively analyzed,and we found 58 patients having HRS. Serum NGAL,Cys-C, creatinine（Cr）,β2-microglobulin（β2-MG） and urea nitrogen（BUN） were assayed. The diagnostic value of serum parameters in ACLF patients were investigated by the area under the receiver operator characteristic curve （AUROC）. Results The gender,body mass index,course of disease, diabetes,platelet count,blood K⁺,mean arterial pressure were not significantly different between patients with HRS and those without （P>0.05）,while there were obvious differences as respect to the age,hypertension,coronary heart disease,white blood cell count,albumin,proteinuria,blood urea nitrogen, blood Na⁺ and Child-Pugh score between the two groups （P<0.05）;serum NGAL,Cys-C,sCr,β2-MG and BUN levels in patients with HRS were（64.1±18.4） ng/mL,（3.1±1.1） mg/L,（165.8±25.7） μmol/L,（6.3±2.1） mg/L and （12.6±4.3） mmol/L,significantly higher than （11.5±.3） ng/mL,（1.2±0.4） mg/L,（62.6±11.4） μmol/L,（2.7±1.2） mg/L and（4.1±1.5） mmol/L in patients without HRS（P<0.05）;serum parameters of liver functions such as serum bilirubin,and coagulation index in patients with HRS were more severe than those in patients without HRS （P<0.05）;the sensitivity and accuracyof NGAL and Cys-C in diagnosing HRS were 89.6% and 92.1%,and 85.9% and 95.4%,respectively, significantly higher than those by serum Cr,β2-MG or BUN,and the sensitivity and accuracy of combination of NGAL and Cys-C were 92.1% and 96.7%,respectively,also significantly higher than those by NGAL or Cys-C alone. Conclusion The probability of hepatorenal syndrome occurrence in ACLF patients with old age is increasing,and the application of serum NGAL and Cys C in the early diagnosis and prediction of HRS in patients with ACLF is promising, which warrants further clinically observation.

Objective To investigate serum levels of Toll like receptor 4（TLR4）,transforming growth factor beta 1（TGF-β1） and interleukin-17 （IL-17） in patients with chronic hepatitis B （CHB） and hepatitis B-induced liver cirrhosis. Methods 112 patients with CHB,52 patients with hepatitis B liver cirrhosis and 33 healthy persons in our hospital between June 2015 and April 2017 were enrolled in this study. Serum IL-17, TLR4 and TGF-β1 levels were detected by enzyme linked immunosorbent assay （ELISA） and liver biopsy was performed routinely. Results Serum levels of IL-17 in patients with chronic hepatitis B,liver cirrhosis and healthy persons were（264.42±32.53） pg/ml,（271.54±33.71） pg/ml and （64.18±5.52） ng/ml,respectively,serum levels of TLR4 were （5.81±0.83） pg/ml,（37.41±6.05） pg/ml and （1.07±0.13） ng/ml respectively, and serum levels of TGF-β1 were （3.67±0.42） pg/ml,（7.82±1.07） pg/ml and （1.61±0.07） ng/ml, respectively （P<0.05）;serum IL-17,TLR4 and TGF-β1 levels in 19 patients with Child-Pugh class B were（231.38±28.67） pg/ml,（18.61±2.87）pg/ml and （5.76±0.52） ng/ml,in 16 patients with class C were（301.72±32.72） pg/ml,（39.47±6.82） pg/ml and （9.42±1.27） ng/ml,both were significantly higher than in 17 patients with Child-Pugh class A【（204.53±26.57） pg/ml,（4.72±0.71） pg/ml and（3.18±0.34）ng/ml,respectively,P<0.05】;the liver biopsies showed than liver fibrosis staging So in 8,S1 in 42,S2 in 43,S3 in 19 and S4 in 52. Serum IL-17,TLR4 and TGF-β1 levels in each group of liver fibrosis were significantly different（P<0.05）,and they increased as the pathological fibrosis stages got worse. Conclusion Serum levels of TLR4,TGF-β1 and IL-17 increase in patients with CHB and hepatitis B-induced liver cirrhosis,which might hint the diagnosis and the severity of liver cirrhosis.

Objective To investigate the relationship between serum insulin-like growth factor I（IGF-I） levels and intestinal barrier damage in patients with hepatitis B liver cirrhosis. Methods 107 patients with hepatitis B liver cirrhosis （35 were of Child-Pugh class A,42 of Child-Pugh class B and 30 of Child-Pugh class C） were recruited in our hospital between January 2015 and January 2017,and 40 healthy volunteers were included at the same period serving as control. Serum IGF-I,diamine oxidase（DAO）,D-lactic acid and endotoxin, as well as excretion ratio of urine lactulose/mannitol（L/M） were detected. Results Serum IGF-I level in the healthy control was （217.1±40.2） ng/ml, significantly higher than [（180.3±33.4）ng/ml in patients with Child-Pugh class A,（152.4±26.5）ng/ml in Child-Pugh class B or（126.9±21.8）ng/ml in Child-Pugh class C,all P<0.05）;serum DAO,D-lactic acid and endotoxin levels,and L/M ratio in the healthy control were （2.5±0.5） U/ml,（7.1±1.3） μg/ml and （0.4±0.1） EU/ml,and （6.3±1.1）%,significantly lower than [（3.3±0.7）U/ml,（9.0±1.6）μg/ml and （0.6±0.1）EU/ml,and （9.2±1.7）% in patients with Child-Pugh class A,or （4.6±0.9）U/ml,（11.2±1.9）μg/ml and （0.8±0.1）EU/ml,and （12.6±2.3）% in Child-Pugh class B or （5.8±1.0）U/ml,（13.4±2.4）μg/ml and（1.1±0.2）EU/ml, and（15.7±2.8）% in Child-Pugh class C, all P<0.05];serum IGF-I level in patients with liver cirrhosis was negatively correlated with serum DAO,D-lactic acid,endotoxin and urine L/M ratio（r=-0.845,r=-0.808,r=-0.867,r=-0.839, P<0.01）. Conclusion Patients with hepatitis B liver cirrhosis have damaged intestinal barrier, and serum IGF-I level might reflect it in this setting.

Objective To explorethe diagnostic efficacy of serum cystatin C on acute kidney injury （AKI） in patients with liver cirrhosis. Methods 114 patients with liver cirrhosis were recruited between January 2015 and February 2017 in our hospital,and 62 of them had AKI and 52 without. The AKI included acute tubular necrosis （ATN） in 8,hepatorenal syndrome （HRS） in 16 and prerenal azotemia （PRA） in 38. Serum albumin,total bilirubin,creatinine,urea nitrogen and cystatin C were detected,and the sensitivity,specificity and accuracy were calculated. Results 19 had coronary heart disease,17 had diabetes,and 16 had hypertension in patients with AKI,significantly higher than 12,10 and 11 in patients without（P<0.05）;serum cystatin C in patients with AKI was （2.4±0.2） mg/L,much higher than （0.9±0.1） mg/L,and serum albumin was（28.3±4.8） g/L,much lower than （34.1±7.3） g/L（P<0.05） in patients without;urea nitrogen was（15.3±5.4） mmol/L,platelet counts was （73.1±11.3）×10⁹/L,total bilirubin was（43.8±9.5） μmol/L,creatinine was（127.6±23.5） μmol/L,significantly different as compared to （6.4±3.3） mmol/L,（90.6±12.7）×10⁹/L,（23.6±6.4） μmol/L,（73.4±15.2） μmol/L in patients without AKI （P<0.05）;in the ATN group,serum cystatin C level was （3.6±1.6） mg/L,platelet counts was （102.6±21.7）× 10⁹/L, total bilirubin was （73.2±16.8）μmol/L,serum creatinine was（346.8±30.7） μmol/L,much higher than those in HRS group and in PRA group（P<0.05）;the accuracy was 92.1% and the specificity was 95.7% when serum cystatin C was used to diagnose the patients with AKI,significantly higher than those by serum creatinine or urea nitrogen（P<0.05）. Conclusion The application of serum cystatin C level in the diagnosis of liver cirrhosis patients with AKI is helpful in clinical practice,which needs further investigation.

Objective To investigate the preventive effect of meropenem on nosocomial infections in cirrhotic patients complicated by upper gastrointestinal bleeding（UGB）. Methods 86 patients liver cirrhosis （LC） complicated by UGB were recruited in our hospital between January 2015 and January 2016,and were divided into two groups by the random computer-generated numbers,with 43 cases in each group. All patients received conventional hemostatic and hepatoprotective therapy,and meropenem or ceftriaxone sodium intravenously for seven to ten days. Serum procalcitonin （PCT）,endotoxin （ETX）,tumor necrosis factor-α （TNF-α）,interleukin-6 （IL-6）, IL-8 and interferon-γ（IFN-γ） were detected. Results At the end of two weeks,the rates of infections and rebleeding in meropenem group were 9.3% and 14.0%,much lower than 25.6% and 32.6%（P<0.05） in ceftriaxone group and the 4-week mortality rates were 18.6% and 20.9%,respectively（P>0.05）;at the end of seven days,serum levels of PCT,ETX,TNF-α,IL-8 and IFN-γ in meropenem group were（0.32±0.05）ng/mL,（10.3±2.5）pg/ml,（20.5±3.6）ng/ml,（12.3±1.9）ng/ml and （19.1±3.6）ng/ml,all but IFN-γ,much lower than （0.40±0.05）ng/ml,（13.1±3.1）pg/ml,（24.2±3.9）ng/ml,（14.8±2.0）ng/ml and（16.3±3.5）ng/ml（P<0.05） in ceftriaxone group. Conclusions Meropenem could be effectively used to reduce the infection and rebleeding rates in cirrhotic patients at the urgent circumstance of UGB,which warrants further investigation.

Objective To investigate the hospitalization costs in patients with hepatitis B liver cirrhosis from 2013 to 2015. Methods The hospitalization costs of 406 patients with hepatitis B liver cirrhosis in our hospital between 2013 and 2015 was investigated and the factors influencing the hospitalization cost was analyzed. Results The total costs of medical care in 114 patients with hepatitis B cirrhosis was （14008.32±465.65） yuan in 2013,（13292.68±362.05） yuan in 132 patients in 2014,and（10915.32±256.49） yuan in 130 patients in 2015,respectively;the proportion of medicine expenses in hospitalization costs from 2013 to 2015 was the highest,accounting for 45.7%,46.3% and 47.0%,respectively,followed by the test fee, accounting for 26.4%,26.4% and 27.0%,respectively;there were significant differences as respect to the total costs of hospitalization between patients with different ages,Child classes,peroid of hospital stay,type of anti-viral therapy and whether or not for second hospital admission and surgery（P<0.05）;in addition,there were statistically significant differences in the total hospitalization expenses among patients with gastrointestinal bleeding,ascites,hepatic encephalopathy and cancer （P<0.05）;multiple linear regression analysis showed that hepatitis B liver cirrhosis patients with Child class C,longer hospital stay,second admission,surgical treatment,combination anti-viral therapy and complications（such as gastrointestinal bleeding, ascites,hepatic encephalopathy and cancer） increased the medical costs（P<0.05）. Conclusion Reasonably shortening the hospital stay,strengthening the prevention and treatment of complications and less hospital admission might be the key to reduce the economic burden of patients with hepatitis B liver cirrhosis.

Objective To analyze the outcomes of laparoscopic esophagogastric devascularization and splenectomy or preserving spleens in patients with cirrhotic portal hypertension. Methods 60 patients with cirrhotic portal hypertension were divided into the splenectomy group （n=30） and spleen preservation group （n=30） according to the operation carried out. Results At the end of two weeks after operation,the diameter of portal veins and blood flow volumes in the splenectomy group were（1.1±0.2） cm and（820.1±101.1） ml/min, significantly narrower or smaller than those in the spleen preservation group [（1.3±0.2） cm and （941.0±188.1） ml/min, P<0.05],while the average blood flow velocity [（19.2±3.1） cm/s] was significantly higher than that in the spleen preservation group [（16.2±2.5） cm/s,P< 0.05];serum levels of laminin in the splenectomy group 3 month after operation was （100.9±29.1） ng/L,significantly lower than that in the spleen preservation group [（126.7±30.1） ng/L,P<0.05];the incidence rates of portal venous thrombosis,gastrointestinal bleeding and ascites in the splenectomy group during follow-up were 3.3%,0.0%,10.0%,much lower than those in the spleen preservation group （16.7%,26.7%,33.3%,P<0.05）;during the follow-up period,2（6.7%） patients in the spleen preserving group died. Conclusion The spleen preservation must be carefully taken in laparoscopic devascularization in patients with liver cirrhosis and portal hypertension,which might lead to severe outcomes in this setting.

Objective To investigate the application of paravertebral block anesthesia combined with general anesthesia in patients with hepatic hemangioma resection. Methods 123 patients with hepatic hemangioma were admitted to our hospital between June 2014 and December 2016,and were divided into observation group （n=62） and control group（n=61） by digital parity method, receiving general and paravertebral block anesthesia,or general anesthesia alone when resection of hepatic hemangioma underwent. The degree of pain was determined by visual analogue pain score （VAS）,and serum levels of tumor necrosis factor alpha （TNF-α） and soluble triggering receptor expressed on myeloid cell-1（sTREM-1） were measured by enzyme-linked immunosorbent assay. Results At 3 h,24 h and 48 h post-operation,the VAS scores in the observation group were（3.6±1.1）,（3.1 ± 0.9） and （2.9±0.7）,respectively,significantly lower than [（4.5±1.5）,（3.8±1.2） and （3.5±3.5）,P<0.05] in the control group; at 24 h and 72 h postoperation,serum TNF-α levels in the observation group were（135.1±21.8）pg/ml and （99.3±18.2） pg/ml,much lower than【（230.5±32.1） pg/ml and （183.7±22.7）pg/ml,P<0.05】 in the control,and serum sTREM-1 levels were（215.9±29.6）pg/ml and （168.5±25.3） pg/ml,also much lower than 【（295.4±41.6）pg/ml and（241.8±27.4）pg/ml,P<0.05】 in the control group;the extubation time after surgery in the observation group was （5.3±1.9） h,significantly shorter than [（6.3±2.1） h,P<0.05],the duration of ICU stay was （25.5±8.6） h,significantly shorter than [（31.6±9.8） h,P<0.05],the hospitalization stay was （9.4±2.1） d,much shorter than [（10.6±2.4） d,P<0.05],and the dosage of sufentanil administration was（1.5±0.3） mg,significantly lower than [（2.5±0.4） mg,P<0.05] in the control;the total incidence of pain related adverse events in the observation group was 16.2,significantly lower than 34.4% in the control（P<0.05）. Conclusion The paraspinal block anesthesia at the basis of general anesthesia might reduce the postoperative pain, get down blood inflammatory factor levels,and decrease pain related adverse events in patients with hepatic hemangioma resection.

Objective To analyze the efficacy of stone removal under endoscopic retrograde cholangiopancreatography （ERCP） and open common bile duct exploration （CBDE） in the treatment of patients with common bile duct residual stones after laparoscopic cholecystectomy （LC）. Methods 84 patients with common bile duct residual stones after LC in our hospital between February 2015 and December 2016 were selected in this study, and 38 cases of them were given CBDE（group A） and 46 cases were treated with stone removal under ERCP （group B）. Results The average intraoperative bleeding volume in the group B was significantly lesser than that in the group A [（3.4±1.3） ml vs. （124.2± 65.8） ml],the operative time [（34.8±4.2） min vs. （123.3±15.8） min],the exhaust time [（1.0±0.7） h vs. （42.6±9.1） h] and the hospital stay [（4.9±3.5） d vs. （9.3±4.3） d] in group B were all significantly shorter than those in group A （all P<0.05）;at the end of one week,serum levels of GGT [（63.7±7.5） IU/L vs. （70.2±7.9） IU/L] and ALP[（105.6± 11.5） IU/L vs. （115.4±12.8） IU/L] in group B were not significantly different as compared to those in group A （P>0.05）;there were no significant differences as respect to the stone removal success（100.0% vs. 97.8%）,incidence of complications （23.7% vs. 15.2%） and stone recurrence （5.3% vs. 6.5%） between the two groups（P>0.05）. Conclusions Stone removal under ERCP for patients with common bile duct residual stones after LC can reduce the intraoperative bleeding, with shorten operative time and hospital stay, which can be repeatedly conducted for the recurrence or residual stones in common bile duct.

Objective To investigate the efficacy of rigid choledochoscopy and three-dimensional visualization-guided surgery in the treatment of patients with complex intrahepatic cholelithiasis. Methods 58 patients with complex intrahepatic cholelithiasis were recruited in our hospital between March 2014 and March 2016. The CT scan was reconstructed by three-dimensional visualization,and partial hepatectomy or common bile duct incision exploration was performed based on the simulation surgery. Results The real surgery was in 100% conformity with the preoperational three-dimensional visualization reconstruction;31 patients received partial hepatectomy with the incised volume of （241.6±26.2） mm³ in accordance with the reconstruction,and 27 patients received common bile duct incision exploration;36 patients underwent bile duct dilatation and bile duct stent for bile duct patency;bile duct stones were removed under rigid choledochoscopy in one-stage surgery,except 3 cases were removed in second stage surgery because of pyogenic cholecystitis or elderly age with multiple stones; there was no stone recurrence during 9 to 31 months of follow-up. Conclusion Three-dimensional visualization-guided individualized surgery and application of rigid choledochoscopy is safe and effective in the treatment of patients with complex intrahepatic cholelithiasis. The regimen can improve the rate of stone removal and reduce the long-term recurrence.

Objective To investigate the application of whole abdomen thin slice coronal single shot fast spin echo sequence of MRI in the diagnosis of children with intrahepaitc and extrahepatic bile duct diseases. Method 26 children with biliary system diseases（biliary atresia in 8,biliary dilatation in 14,gall bladder stone in 2 and biliary stone in 2） were recruited in our hospital between October 2014 and September 2016. The full abdomen thin-layer coronal single excitation scanning fast spin echo sequence was performed,and MRI enhancement scanning was done in 9 cases after 15~20 minutes. The bile duct and its branches of livers inside and outside were observed. Result The intrahepatic bile duct was displayed properly in children with biliary atresia,and the shape of gallbladder was fine and did not show extrahepatic biliary duct in 2 cases,did not show bile duct and gallbladder in 6 cases. 4 cases appeared with hepatosplenomegaly,2 cases demonstrated the long triangle T₂ signal in the hepatic portal area;11 children with biliary dilatation showed common bile duct fusiformis dilatation,1 cases presented with Caroli disease,2 cases appeared hepatic cystic mass,and 4 cases appeared with enlarged gallbladder and intrahepatic biliary dilatation;children with biliary calculi had common bile duct lumen local uniformed signal, and short T₂ signal filling defect. The gallbladder neck short T₂ signal filling defect was observed in 1 child with gallbladder stones;as compared to the scanned images at the same level,the delayed enhancement of MRI scan showed the reduced liver and pancreatic parenchyma signal,and increased intraductal long T₂ signal and the biliary system was more clear. Conclusion As compared with the conventional MRI scan,the whole abdomen thin coronal single shot fast spin echo sequences can provide more detailed observation in the biliary system in patients,especially in children,and give us a more comprehensive understanding of the whole lesions in clinical practice.

Diabetic hepatopathy (DH) is a complications of diabetes, most commonly arised from non-alcoholic fatty liver disease and glycogenic hepatopathy. DH has a high morbidity and always leads to serious clinical consequences. However, the disease has been neglected to date. In this review, we summarized the findings regarding the clinical and pathological features, mechanisms and therapeutic strategies of the disease.