Objective The purpose of this study was to evaluate the diagnostic value of gamma-glutamyl transpeptidase to cholinesterase ratio (GCR) in predicting hepatic fibrosis in patients with chronic hepatitis B (CHB). Methods 1335 HBeAg-positive and 1026 HBeAg-negative patients were enrolled in this study. The liver histological assessment by Scheuer scoring system was done, and the fibrotic staging ≥S2 and =S4 were defined as significant fibrosis and cirrhosis, respectively. Results Out of serum HBeAg positive patients, 886 cases were found to have significant fibrosis and 286 cases were having liver cirrhosis, and out of serum HBeAg negative patients, 556 cases having significant fibrosis and 202 having cirrhosis; in HBeAg-positive patients, the area under ROC curve (AUC) by GCR in predicting significant fibrosis was 0.770 (95%CI :0.747-0.793), significantly greater than [0.757 (95%CI:0.733-0.780) by gamma-glutamyltranspeptidase to platelet ratio (GPR, P<0.05), and in predicting cirrhosis was 0.816 (95%CI:0.794-0.837), which was close to that by GPR ; in HBeAg-negative patients, the AUC by GCR in predicting significant fibrosis was 0.761 (95%CI:0.733-0.787), which was close to that by GPR [0.758 (95%CI:0.731-0.784), and in predicting cirrhosis was 0.838 (95%CI:0.814-0.860), which was also close to that by GPR ; we set the GCR>0.100 and GPR>0.500 as the cut-off-value, the specificities in predicting significant fibrosis in HBeAg-positive patients were 81.5% and 80.6%, and in HBeAg-negative patients were 81.5% and 79.4%, respectively; the sensitivities in predicting cirrhosis in HBeAg-positive patients were 84.3% and 81.5%, and in HBeAg-negative patients were 79.2% and 82.7%, respectively. Conclusion The diagnostc performance of GCR in predicting significant fibrosis and cirrhosis in patients with CHB is higher than or close to that by GPR, which needs further investigation.

Objective The purpose of this study was to investigate the clinical value of transient elastography (TE) and two-dimensional shear wave elastography (SWE) in the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). Methods 164 patients with CHB B were enrolled in our hospital between March 2016 and December 2018, and all patients underwent HE and SWE. The liver biopsy was also performed. The area under ROC curve (AUC) was applied to analyze the diagnostic performance. Results The liver histopathological examination showed liver fibrosis S₁ in 50, S₂ in 42, S₃ in 39 and S₄ in 33 in our series; the liver stiffness measurement (LSM) of patients with S₁, S₂,S₃ and S₄ by TE were (6.5±1.1)kPa, (8.6±1.4)kPa, (11.7±1.8)kPa and (16.3±1.8)kPa, and by SWE were (5.9±0.8) kPa, (8.1±1.2)kPa, (10.9±1.5)kPa and (16.7±1.9) kPa(P >0.05); the AUC of SWE in diagnosing S₂, S₃ and S₄ were 0.971, 0.979 and 0.973, much higher than 0.902, 0.906 and 0.904(P <0.05) by TE, and the sensitivities were 90.3%, 90.6% and 100.0%, and the specificities were 95.8%, 90.6% and 84.5%, while they were 78. 5%, 81.3% and 73.1%, and 93.3%, 87.9% and 91.0%, respectively, by TE. Conclusion The application of TE and SWE in the diagnosis of liver fibrosis in patients with CHB might possess a efficient performance in clinical practice.

Objective The aim of this study was to investigate the efficacy of entecavir and matrine combination therapy in patients with chronic hepatitis B (CHB). Methods 180 patients with CHB were enrolled in our hospital, and were randomly divided into control (n=90) and observation (n=90) group. All patients received entecavir, and those in the observation group received matrine and entecavir combination. Serum matrix metalloproteinase-9 (MMP-9), transforming growth factor-β1 (TGF- β1) and angiotensin-II (Ang-II) were detected. The percentages of peripheral blood T lymphocytes as well as CD80 and CD86 positive cells were determined by FCM. Results At the end of six-month observation, serum rates of ALT normalization, serum HBeAg negativity and HBV DNA loss in the observation group were 34.4%, 91.1% and 86.7%, significantly higher than 18.9%, 78.9% and 63. 3%(P<0.05) in the control; serum MMP-9, TGF-β1 and Ang-II levels were (30.5±3.6)ng/ml , (19.5±2.2) ng/ml and (33.7±4.1)ng/dL, significantly different as compared to [(22.4±2.7)ng/ml , (22.6±2.8) ng/ml and (46.3±4.9)ng/dL, P<0.05] in the control; the percentages of Th2 and Th1 cells as well as CD80 and CD86 positive cells were (6.6±1.5)%, (9.8±2.3)%, (2.5±0.7)% and (1.6±0.5)%, significantly different as compared to 【(9.0±2.7)%, (7.9±1.4)%, (1.9±0.3)% and (1.1±0.2)%,P<0.05】 in the control group. Conclusion The combination therapy of matrine and entecavir improve the short-term efficacy in patients with CHB, which might be related to the regulation of imbalanced immune response and inhibition of liver fibrosis.

Objective This study was aimed to explore the clinical efficacy of sequential telbivudine treatment in serum HBeAg-positive chronic hepatitis B patients with partial response to standardized pegylated interferon alpha-2a therapy. Methods 63 patients with HBeAg-positive chronic hepatitis B were recruited in this study between January 2016 and February 2017 who had been treated with pegylated interferon alpha-2a for 48 weeks, and got partial response to the regimen. Out of them, 31 received tibivudine for further 48 week treatment, and 32 discontinued any treatment. All the patients were followed-up for 24 weeks. Results At week 24, week 48 of treatment and 24 week follow-up, the serum HBeAg negative rates in sequential treatment group were 22.5%, 25.8% and 35.4%, significantly higher than 0.0%, 3.2% and 3.2%(P<0.05) in patients who discontinued any treatment, at treatment or observation week 48 and follow-up week 24, serum HBV DNA negative rates in sequential treatment patients were 90.3% and 87.0%, significantly higher than 34.3% and 18.7%(P<0.05) in the control, and serum alanine aminotransaminase normalization rates in patients with sequential treatment were 96.7% and 90.3%, significantly higher than 75.0% and 25.0%(P<0.05) in the latter; at treatment or observation week 48 and follow-up week 24, serum HBV DNA level in patients with sequential treatment were (2.6±0.3)lg IU/mL and (1.9±0.1)lg IU/mL, siginificantly lower than 【(4.5±0.7)lgI U/mL and (5.5±0.2)lgIU/mL, P<0.05】, serum ALT level were (56.3±2.4)IU/L and (43.3±3.1)IU/L, significantly lower than 【(60.1±7.2)IU/L and (71.3±2.8)IU/L,respectively, P<0.05】 in the control, and at follow-up week 24, serum HBsAg level in patients receiving telbivudine was (2.0±0.2)lg IU/mL, significantly lower than 【(2.6±0.3)lg IU/mL, P<0.05】 in the control; 9 patients(29.0%)had transient serum CK elevation and got back to normal during telbivudine treatment. Conclusion The sequential administration of telbivudine for further treatment might effectively improve the negative serum conversion rate of HBeAg and HBV DNA in patients with HBeAg-positive chronic hepatitis B after failed pegylated interferon alpha-2a treatment.

Objective We conducts a real-world study to investigate the efficacy of combination of sofebuvir (SOF) and daclatasvir (DCV) in the treatment of patients with chronic hepatitis C (CHC). Methods A total of 43 patients with CHC were recruited in this study between September 2015 and September 2017, and all patients were treated with combination of SOF and DCV for 12 weeks. The patients were followed-up for 12 to 48 weeks. Results All the 43 patients completed the 12 week regimen and 12 week followed-up. 23 out of the 43 patients completed 24 week and 18 of them completed 48 week treatment-free followed-up. Serum HCV RNA loss at week 2, 4 and 12 were 77.0% (33/43), 93.0% (40/43), and 100.0% (43/43), respectively, and the SVR12 was 100%; serum HCV RNA kept negative in 23 patients 24 weeks, and in 18 patients 48 weeks after discontinuation of the treatment; serum ALT were (28.3±14.4)U /L, (25.4±12.9)U /L,(22.5±9.4)U /L and (21.8±8.6) U /L at the end of week 2, 4, 12 treatment and at the end of 12 week followed-up, respectively, all significantly lower than(66.0±46.1)U /L at presentation (P <0.01) and serum AST levels were(25.4±10.4)U /L, (24.7±9.6)U /L,(22.8±7.7)U /L and (22.3±6.5)U /L, respectively, also all significantly lower than (51.1±31.7)U /L before treatment (P <0.01); at baseline, estimated glomerular filtration rate (eGFR) was less than 90 ml·min^-1·1.73 m² in 8 patients, a certain declines to 60.76 ml·min^-1·1.73 m² were observed during the anti-viral treatment and all returned to pre-treatment levels after withdrawal of the treatment; there was no dose adjustment during the regimen; the common side effects were insomnia (n=3), nausea(n=2),fatigue(n=1), headache(n=1) and alopecia(n=1), and all the phenomena occurred in the early stage of the treatment and relieved without special treatment. Conclusion The application of combination SOF and DCV in the treatment of patients with CHC might get a short-term satisfactory efficacy, which needs long-term observation.

Objective The aim of this study was to investigate the clinical and pathological characteristics of immunoglobulin G4-associated autoimmune hepatitis (IgG4-AIH) in children. Methods 38 children with AIH were enrolled in our hospital between June 2014 and June 2019, and the diagnostic criteria was based on the simplified diagnostic scoring system reported by the International Autoimmune Hepatitis Group (IAIHG) in 2008 or the AIH diagnostic scoring system established by IAIHG in 1999. According to Umemura et al and other scholars’s reports, IgG4-AIH was diagnosed by hepatic IgG4 positive plasma cell infiltration≥10/ high power field of vision (HPF) and serum IgG4≥135 mg/dl. Serum IgG and IgG4 levels were detected by ELISA, and liver biopsies were performed routinely. The hepatic IgG4 positive plasma cell infiltration was evaluated by immunohistochemical staining. Results Out of the 38 patients with AIH included, four were diagnosed as IgG4-AIH and thirty-four were classical AIH; serum IgG and IgG4 levels in patients with IgG4-AIH were 22.6(13.2, 29.8)mg/dL and 226.5(105.8, 424.6)mg/dL, not significantly different as compared to 18.9(10.4, 25.3)mg/dL and 209.4(96.1, 401.6)mg/dL in patients with AIH (P>0.05); the hepatic IgG4 positive plasma cell infiltration in patients with IgG4-AIH were 40.2(25.4, 55.7)/HPF, significantly higher than in patients with AIH; the hepatic IgG4 positive plasma cell infiltration in patients with IgG4-AIH were positively correlated to histological activity index (r=0.48)and liver fibrosis staging(r=0.37, P<0.05); the returning to normal time for serum ALT in patients with IgG4-AIH was (3.5±0.8)w, significantly shorter than in patients with AIH, the returning to normal time for serum AST level was (3.6±0.6)w, much shorter than , for ALP was (4.0±1.1)w, much shorter than , for GGT was(4.2±1.5)w, significantly shorter than , and for serum IgG back to normal was (7.6±2.8)w, also much shorter than in patients with AIH. Conclusions Children with IgG4-AIH have the same as serum IgG4 levels in kits with AIH, while the infiltration of IgG4 positive plasma cells in liver tissues is significantly higher than that in children with AIH. In addition, the children with IgG4-AIH have a good therapeutic response to hormone therapy, and the recovery times of serological indexes are much quick. Our findings should be validated by multi-central studies because of too little cases with IgG4-AIH in our study.

Objective The purpose of this study was to explore the clinical value of fasting C-peptide in assessing the progression of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods 456 patients with NAFLD and T2DM were recruited in this study, and all of them underwent liver stiffness measurement (LSM), which showed that 41 patients had progressive hepatic fibrosis (PHF, LSM >7.9 kPa) and 415 hadn’t (Nphf, LSM ＜7.9 kPa). The Logistic regression analysis was applied to explore the risk factors of liver fibrosis progression, and the receiver operating characteristic curve(ROC) was used to evaluate the diagnostic value of fasting C-peptide for progressive liver fibrosis in this setting. Results The blood HDL-C, PLT counts, serum AST, fasting C-peptide and HbA1c levels in patients with PHF were (1.5±0.2)mmol/L, (259.3±50.3)×10⁹/L, (39.3±5.1)U/L, (2.7±0.8)ng/ml and (10.7±1.0)%, significantly different as compared to 【(1.4±0.3)mmol/L, (267.1±48.2)×10⁹/L, (26.1±4.1)U/L,(2.1±0.7)ng/ml and (8.1±1.1)%, respectively, P<0.05】 in patients with nPHF; non-conditional univariate analysis and multivariate analysis showed that the age , gender (OR=1.250, 95% CI:1.005-1.554, P=0.045), BMI (OR=1.117, 95% CI:1.011-1.235, P=0.030), HbA1c level (OR=1.117, 95% CI:1.011-1.235, P=0.030) and fasting C-peptide (OR=1.206, 95% CI:1.068-1.361, P=0.003) were the risk factors, and the ROC analysis demonstrated that the area under ROC (AUC) for fasting C peptide was 0.7 (95% CI:0.7-0.81, P<0.05), e.g. when serum fasting C-peptide level equal to 2.36 ng/mL as the cut-off-value, the sensitivity was 73.2% and the specificity was 67.0%. Conclusion The application of fasting C-peptide in the diagnosis of PHF in patients with NAFLD and T2DM is valuable, which warrants further investigation.

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 This study aimed tosystematically evaluate the efficacy and safety of polyene phosphatidylcholine combined with metformin in the treatment of patients with non-alcoholic fatty liver disease (NAFLD). Methods We searched CNKI, WanFang Data, VIP, EMbase and PubMed for retrieving randomized controlled trials (RCT) on application of metformin and polyene phosphatidylcholine combination in treatment of patients with NAFLD before August 2018. The Meta analysis was carried out by using RevMan 5.3 software. Results Eighteen RCTs having 1596 patients with NAFLD were finally included, and 803 in observation received combination and 793 in the control received medicines without anyone of the two combined agents. The results showed that the efficacy in combination group was superior to that in the control as respect to the reduction of the homeostasis model assessment for insulin resistance (HOMA-IR) levels, fasting plasma glucose (FPG) levels, AST levels, ALT levels, GGT levels, LDL-C levels, TC levels, TG levels, increasing HDL-C levels, improving ultrasonic parameters, and liver/spleen CT value ratio (P＜0.05); there were no significantly differences in fasting insulin (FINS) levels and incidences of adverse effects between the two groups (P＞0.05). Conclusion The efficacy of polyene phosphatidylcholine combined with metformin in the treatment of patients with NAFLD is good without obvious adverse reactions. It is safe and reliable, and needs multi-centre verification as the low-level quality of all the studies included.

Objective The aim of this study was to investigate the effects of fenofibrate on blood lipids, vascular endothelial functions and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods 112 patients with NAFLD and T2MD were enrolled in our hospital between January 2017 and May 2018, and were randomly divided into two two groups, with 56 in each group. The patients in control group was treated with insulin at base of excised and diet modulation, and those in the observation were treated with fenofibrate at the basis of routine treatment in control. Results At the end of three month observation, blood TG levels were (1.9 ± 0.4) mmol/L vs. (3.5 ± 0.5) mmol/L, the TC levels were (4.9 ± 0.7) mmol/L vs. (6.4 ± 0.8), the HDLC levelswere (1.4±0.3) mmol/L vs. (1.2±0.4) mmol/L, and the LDLC levels were (2.4±0.3) mmol/L vs. (2.6±0.4) mmol/L, respectively, in the observation group and in the control group, with a significant difference (P<0.05); serum endothelin levels were (49.5±3.7) pg/mL vs. (52.4±6.8) pg/mL,the thromboxane levels were (184.5±92.6) pg/mL vs. (272.7±94.8) pg/mL, the epoprostenol were (32.1±18.4) pg/mL vs. (23.5±11.3) pg/mL, and the nitric oxide levels were (64.8±13.6) μmol/L vs. (53.2±12.4) μmol/L, respectively, with the difference being significant (P<0.05); serum laminin levels were (170.3 ± 65.3) μg/L vs. (208.7 ± 77.4)μg/L, the hyaluronic acid levels were (178.6 ± 83.4)μg/L vs. (233.6 ± 81.6)μg/L, the collage typeⅣ levels were (6.6±1.4)μg/L vs. (7.4±1.3)μg/L, and the procollagen type III levels were (118.4±22.9) μg/L vs. (132.5±31.7)μg/L, respectively, in the two groups, with the difference being significant (P<0.05). Conclusion Fenofibrate could effectively reduce the blood lipid levels, improve vascular endothelial functions and reduce the index of serum liver fibrosis in patients with NAFLD and type 2 diabetes mellitus, which is worthy of clinical application.

Objective The aim of this study was to explore the efficacy of tiopronin and metoprolol combination in treatment of patients with alcoholic liver disease (ALD). Methods 76 patients with ALD were recruited in our hospital, and were randomly divided into control (n=38) and observation group (n=38). The patients in both groups were treated with tiopronin orally, and those in the observation group were additionally treated with metoprolol. The treatment lasted for three months. Serum levels of liver fibrosis index, liver function index, portal vein diameter(PVD), spleen vein diameter(SVD) and spleen thickness as well as fatty liver were compared between the two groups. Results At the end of the treatment, serum type IV collagen, hyaluronic acid and laminin levels in the observation group were (84.3±24.7) μg/L, (142.6±46.8) μg/L and (134.4±35.2) μg/L, significantly lower than in the control; serum alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase and alkaline phosphatase levels were [(42.6±12.3) U/L, (41.3±11.8) U/L, (119.3±55.6) U/L and (91.3±37.8) U/L, significantly lower than in the control; the PVD, SVD and spleen thickness in the observation group were (11.8±1.1) mm, (6.3±1.2) mm and (54.3±10.7) mm, significantly lower than in the control; the percentages of mild, moderate and severe fatty liver in the observation group were 7.9%, 15.8% and 7.9%, significantly lower than 18.4%, 31.6% and 13.2% in the control (P<0.05). Conclusion The combination of tiopronin and metoprolol in the treatment of patients with ALD is efficacious with reduced serum level of liver enzymes and liver fibrosis index, and the possible mechanism by which the regimen work might be related to the inhibition of liver fibrosis.

Objective The aim of this study was to summarize the clinical characteristics and analyze the risk factors of drug-induced liver injury(DILI) caused by antituberculosis therapy. Methods 558 patients receiving antituberculosis therapy in our hospital were retrospectively analyzed in this study, and 69 patients had DILI. The incidences and laboratory indexes of patients with different antituberculosis regimen were compared and the risk factors affecting the incidence of DILI were determined by Logistic analysis. Results During the anti-tuberculosis process, 69 (12.4%) out of 558 patients with tuberculosis developed DILI; out of 442 nave patients, the incidence of DILI was 5.4%, much lower than 35.9% in 103 relapse patients or 61.5% (P<0.05) in 13 patients with multi-drug resistance (MDR); serum alanine aminotransferase, aspartate aminotransferase, total bilirubin, glutamyltranspeptidase and alkaline phosphatase peak levels in the 69 patients with DILI were 152.1±9.6 U/L, 174.8±15.4 U/L, 94.8±8.6μmol/L, 131.3±10.2 U/L and 152.0±14.3 U/L; the incidences of DILI in patients with different age, liver disease history, alcohol abuse and anti-tuberculosis regimen were significantly different and liver disease history, relapse and patients with MDR were the independent risk factors for DILI occurrence (P<0.05). Conclusion The incidence rate of DILI is different in patients with different anti-tuberculosis treatment, and the clinicians must take the risk factors into consideration in order to avoid the harmful elements and protect the patients to finish the anti-tuberculosis regimen.

Objective The aim of this study was to investigate the evaluation of fetal cardiac functions by velocity vector imaging (VVI) in pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods 100 ICP pregnant women (mild in 50 and severe in 50) and 98 healthy pregnant women and their fetuses were enrolled in our hospital between May 2016 and May 2018. All the fetuses were examined by echocardiography and the parameters were analyzed by velocity vector imaging (VVI), which included diastolic peak velocity (Vd), systolic peak velocity(Vs), peak systolic strain (S), diastolic peak strain rate (SRd) and peak systolic strain rate (SRs). Results The overall S of the left ventricle in fetuses from severe ICP group was (-11.2±1.1) %, significantly lower than in from mild ICP group or in from healthy control, the SRd was (1.5±0.2)/S, significantly lower than in fetuses from mild ICP group or in healthy group, and the SRs was (-1.7±0.1)/S, significantly lower than in from ICP mild group or in from healthy control; there was no significant difference in left ventricular Vd and Vs among the three groups (P>0.05); the overall Vd of right ventricle in fetuses from severe ICP group was (1.3±0.3) cm/s, significantly lower than or , the S was (17.6±2.5) %, significantly lower than or , the SRd was (1.6±0.6) /s, significantly lower than or , and the SRs was (-2.1±0.2) /s, significantly lower than or in from mild ICP group or healthy control group; there was no significant difference in the overall Vs of right ventricle among the three groups (P>0.05). Conclusion The early evaluation of fetal cardiac functions by VVI parameters might be beneficial in clinical practice.

Objective To assess the safety and efficacy of citrate to heparin as a catheter locking solution in patients with liver failure undergoing artificial liver support system (ALSS) therapy. Methods 41 patients with acute-on-chronic liver failure were recruited in our hospital, and all the patients received double plasma molecular absorption system (DPMAS)and sequential plasma exchange (PE). The citrate or heparin was used as locking catheter solution in 22 patients with 80 times and in 19 patients with 79 times, respectively. Blood activated partial thromboplastin time (APTT) were monitored. Results Two hours after locking, the blood APTT in citrate-locking was (65.6±12.2)s, significantly shorter than【(89.8±43.1)s,P<0.01】 in heparin-locking; the incidences of catheter-related infection in the two groups was 0.0%(0/22) and 5.3%(1/19), respectively, without significant difference (P=0.46); there were no significant differences as respect to the 3-month survival (52.3% vs. 54.5%), hospital stay, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatic-renal syndrome and gastrointestinal bleeding in the two groups (P>0.05). Conclusions The application of citrate for catheter locking has a good approach in patients with liver failure undergoing ALSS therapy, without obvious alteration of coagulation index, which might be safer.

Objective The purpose of this study was to investigate the application of subjective comprehensive assessment (SGA), simple nutritional assessment (MNA) and nutritional risk screening 2002 (NRS2002) in nutritional assessment of patients with decompensated cirrhosis. Methods 98 patients with decompensated liver cirrhosis were admitted to our hospital between January 2017 and January 2018, and the nutritional risk were screened by SGA, MNA and NRS2002 in all the patients. The consistency of the three methods was compared byKappa value. Results The incidence of mild to moderatemalnutrition by MNA was 36.7% and that of severe malnutrition was 30.6%, the incidence of mild to moderate malnutrition by SGA was 30.6% and that of severe malnutrition 2.0%, and the incidence of mild to moderate malnutrition by NRS2002 was 25.5% and that of severe malnutrition was 15.3%; the Kappa value was 0.344(P＜0.05) as regard to the consistence of SGA and MNA, the Kappa valve was 0.476 (P＜0.05) as regard to the consistence of SGA and NRS2002, and the Kappa value was 0.463(P＜0.05) as the consistence of evaluation by MNA and NRS2002 were compared. Conclusion The differences of malnutrition status assessed by different methods in our series might be great, which hints further investigation needed in the future for Objective evaluation in this setting.

Objective The purpose of this study was to investigate urine retinol binding protein (RBP) levels in patients with hepatitis B-induced decompensated liver cirrhosis (LC) as the index for acute kidney injury (AKI). Methods 112 patients with decompensated hepatitis B liver cirrhosis and 35 healthy individuals were recruited in our hospital between May 2015 and May 2018,and urine RBP levels were detected by ELISA. The diagnostic efficacy of urine RBP for AKI was evaluated by area under the ROC (AUC). Results Urine RBP level in patients with decompensated cirrhosis was (2.2±1.0) mg/L, significantly higher than in healthy persons; urinary RBP, urinary microalbumin (mAlb) and estimated glomerular filtration rate (eGFR) in 28 patients with severe ascites were (3.2±0.6) mg/L, (24.9±7.7) mg/L and (58.3±13.9) mL/min/1.73 m², among them, the urinary RBP and urinary mAlb levels were significantly higher than those in the 31 mild ascites or 53 moderate ascites, and the eGFR level was significantly lowerthan that in patients with mild ascites or moderate ascites, with thedifferences were statistically significant (P<0.05); there was no significant difference as respect to sCr level between patients with severe ascites and moderate ascites , but they were much higher than that in mild ascites ; univariate analysis showed that there were no significant differences in platelet counts and upper gastrointestinal bleeding between 43 patients with secondary AKI and 69 without (P>0.05); there were significant differences in mAlb, eGFR, RBP, blood sodium, serum bilirubin, white blood cell counts, prothrombin time activity, NH3⁺, hepatic encephalopathy and spontaneous bacterial peritonitis between the two groups (P<0.05); the AUC of urine RBP in the diagnosis of AKI was 0.856 (95% CI: 0.777-0.915), with the cut-off-value of 2.6 mg/L, sensitivity of 81.4% and specificity of 84.1%. Conclusion Urine RBP level might be used to diagnose AKI as it reflect the severity of ascites in patients with decompensated liver cirrhosis.

Objective The purpose of this study was to explore the clinical feature of and risk factors for nosocomial infections in patients with hospitalized decompensated hepatitis B liver cirrhosis. Methods 100 patients with decompensated hepatitis B liver cirrhosis were recruited in our hospital between February 2016 and December 2018. The clinical characteristics of patients with nosocomial infection were retrospectively analyzed, and the risk factors for infection were evaluated by Logistic regression analysis. Results Among the 100 patients with decompensated hepatitis B cirrhosis, 25 (25.0%) had nosocomial infection, and among them, 10 (40.0%) were respiratory tract infection, 7 (28.0%) were spontaneous bacteria peritonitis, 4(16.0%) were gut infection; the infected bacteria strains were Escherichia Coli in 5 (29.4%), Staphylococcus Aureus in 4(23.5%), Klebsiella Pneumonia in 2(11.8%), Pseudomonas Aeruginosa in 2(11.8%) and Streptococcus Pneumonia in 2(11.8%); univariate analysis showed that there were no significant differences between male and female patients, or patients with or without hepatic encephalopathy or prophylactic antibiotics(P>0.05), while there were significant differences between young and elderly patients, patients with short or long hospital stay, with different Child-Pugh scores, with or without invasive check-up, with lower serum albumin and bilirubin levels, with or without ascites and with or without anti-viral therapy and multivariate Logistic analysis showed that older than 60 years (OR=4.176, P=0.023), hospital stay longer than one month (OR=44.116,P=0.021), poor Child-Pugh score(OR=5.160,P=0.009), invasive check-up (OR=5.265, P=0.003) and ascites (OR=2.921, P=0.033) were the independent risk factors for nosocomial infections. Conclusion Patients with decompensated hepatitis B liver cirrhosis are prone to nosocomial infection, and clinicians should take risk factors into consideration in this settings to decrease the occurrence of nosocomial infection.

Objective The aim of this study was to investigate the value of early anticoagulant intervention in cirrhotic patients with portal hypertension after transjugular intrahepatic portosystemic stent shunt (TIPS) combined withpartial splenic embolism (PSE). Methods 86 patients with cirrhosis and portal hypertension were recruited in our hospital between September 2016 and September 2018, and were randomly divided into two groups. All patients underwent TIPS and PSE, and after operation, the patients were divided into two groups. The patients in control received heparin and aspirin, and those in the observation received low molecular weight heparin combined with warfarin for anticoagulant intervention. All patients were followed-up for three months. Results The platelet count in the observation group was (274.3±30.2)×10⁹/L on the 7th day after operation, which was significantly higher than before operation, and PLT count in the control group was (257.6±29.7)×10⁹/L, which was also significantly higher than before operation; there were no significant differences as respect to PLT counts, prothrombin time (PT)and activated partial thrombin activity time(APTT ) between the two groups (P>0.05); On the 7th day after surgery, there were no significant differences as respect to the diameter of portal vein, the average blood velocity of portal vein and the portal vein flow between the two groups (P<0.05); there was no significant difference in the incidence of ascites, hemorrhage, hepatic encephalopathy, skin ecchymosis and fever between the two groups (P>0.05), while the incidence of portal thrombosis in the observation group was 2.5%, significantly lower than 16.7% in the control (P<0.05). Conclusion Early intervention with low molecular weight heparin combined with warfarin might effectively prevent portal vein thrombosis after TIPS combined with PSE in patients with cirrhosis, which warrants further investigation.

Objective The aim of this study was to investigate the correlation of polymorphisms of cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and patatin-like phospholipase domain containing 3(PNPLA3) genes to the pathogenesis of alcoholic liver cirrhosis (ALC). Methods 110 patients with ALC and 100 healthy persons were recruited in our hospital between January 2017 and January 2019. The blood polymorphisms of CTLA-4 gene rs4675369 and PNPLA3 gene rs738409 were detected by polymerase chain reaction-restriction fragment length polymorphism. Results The percentages of CTLA-4 gene rs4675369 locus type AA, type AG and type GG in patients with ALC were 26.4%, 49.1% and 24.6%, not significantly different compared to 26.0%, 50.0% and 24.0% in healthy persons (P>0.05), and the percentages of A allele and G allele of CTLA-4 gene were 50.9% and 49.1%, without significant differences compared to 51.0% and 49.0% in healthy persons (P>0.05); the percentages of PNPLA3 gene rs738409 locus genotype GG and allele G in patients with ALC were 17.2% and 38.2%, significantly higher than 4.0% and 24.0%, respectively, in healthy persons (P<0.05); serum ALT, AST, GGT and ALP levels in ALC patients with CTLA-4 gene rs4675369 locus genotype AA,AG and GG or PNPLA3 gene rs738409 locus genotype CC, CG ad GG were not significantly different (P>0.05). Conclusions Ourstudy shows CTLA-4 gene polymorphism has nothing to do with the pathogenesis of alcoholic liver cirrhosis, and what roles of PNPLA3 gene play needs future further investigations.

Objective The aim of this study was to investigate the efficacy ofultramicro-angiography (SMI), color Doppler flow imaging (CDFI) and enhanced computed tomography (CT) in detecting tumor blood supply in patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE). Methods 135 patients with PLC were admitted to our hospital between April 2016 and April 2019, and all patients underwent TACE and received SMI,CDFI and enhanced CT scan 30 days after operation. Results The detection rates of tumor blood supply by SMI and CDFI were 54.2% and 25.0%, respectively, both significantly lower than 84.5% by enhanced CT (P < 0.05); for lesions with diameter < 2.0 cm, the tumor blood supply detection rate by SMI and CDFI were28.1% and 0.0%, respectively, both significantly lower than 73.7% by enhanced CT (P< 0.05), and for lesions with diameter ≥2.0 cm, the detection rate of tumor blood supply by SMI and CDFI were 67.6% and 37.8%, respectively, both significantly lower than 90.1% by enhanced CT(P＜0.05). Conclusion The application of enhanced CT scan in evaluating tumor blood supply after TACE in patients with PLC might be useful in clinical practice, and SMI and CDFI are simple, convenient and economical.

Objective The purpose of this study was to investigate the application of contrast-enhanced ultrasound (CEUS) in differential diagnosis of hepatocellular carcinoma (HCC) and liver metastases (LM). Methods 77 patients with HCC (79 foci) and 40 patients with LM (41 foci) were recruited in our hospital, and routine sonography and CEUS were conducted. Results The enhancement type I, type II and type III in patients with HCC were 2.5%, 26.6% and 70.9%, significantly different as compared to 36.6%, 9.8% and 53.7%, respectively, in patients with LM (P＜0.05); the peak time of enhancement and the time of washing out in HCC foci were (29.16±7.87)s and (51.89±22.80)s, significantly different as compared to 【(25.98±5.30) and (37.49±10.68)s, respectively, P＜0.05 】 in LM foci. Conclusion The performance of CEUS in differentiating HCC and LM foci is efficacious, which might be helpful in clinical practice.

Objective To explore the liver imaging report and data management system (LI-RADS) in CT and MR imaging in diagnosis of patients with hepatocellular carcinoma (HCC). Methods 200 patients with high risk for HCC, such as chronic hepatitis B, cirrhosis, alcohol abuse and elevated serum alpha-fetoprotien levels were recruited and all patients underwent CT and MRI plain and enhancement scan. The imaging was evaluated according to the LI-RADS v2017 grading criteria. The evaluation was performed by two radiologists, and the consistency of one doctor was evaluated one month later. In LI-RADS grading, LR-1 and LR-2 were considered benign lesions, while LR-4, LR-5, and LR-5TIV were malignant lesions. The results of pathology were acted as gold standard of diagnosis. Finally, the sensitivity, specificity, and accuracy of LI-RADS diagnosis were calculated. Results We enrolled 200 patients, and all finished CT and MRI; the histopathological examination showed that there were 125 patients with HCCs, 27 with intrahepatic cholangiocarcinomas, 9 with metastasis, and 39 with benign lesions; by LI-RADS classification, 17 cases were diagnosed as benign, and 151 cases as malignant by CT scan, while 17 cases were diagnosed as benign, and 169 cases as malignant by MRI; in CT diagnosis, the Kappa value was 0.912 (P<0.001), while the data of MR diagnosis showed the Kappa value was 1.000 (P<0.001), indicating that the diagnostic accuracy by using LI-RADS grading in MR examination was superior to that of CT scan; by LI-RADS grading standard, the sensitivity, specificity and accuracy of CT scan were 95.4%, 81.2% and 90.2%, while those of MRI were 100%, 85.4% and 92.4%. Conclusion The LI-RADS based on CT and MRI has a very good repeatability and high accuracy in the evaluation of HCC, the possibility for HCC is quite greater in CT-evaluated LR-3 lesions, thus, Gd-DTPA enhancement of MRI is firmly recommended for such patients. We suggest that the patients with LR-3 lesions by MRI scan should be regularly followed-up.

Objective The aim of this study was to investigate the influence of crystal and colloidal liquid infusion base on goal-directed fluid therapy (GDFT) during anesthesia on clinical efficacy and safety in patients with hepatocellular carcinoma (HCC) undergoing partial hepatectomy. Methods 90 patients with HCC were enrolled in our hospital between October 2017 and October 2018, and all patients underwent partial hepatectomy. The patients were randomly divided into 3 groups including control (n=30) with conventional liquid management, colloidal group (n=30) with fast filling of colloid liquids and crystal group (n=30) with fast filling of crystal liquids during anesthesia. The central venous oxygen saturation (ScvO₂), as well as blood lactate (Lac) and glucose (Glu) levels were monitored. Results The time of first exhaust, time of early ambulation, and hospitalization stay after operation in colloidal group were (55.8±8.3)h, (3.4±0.5)d and(7.8±1.5)d, in crystal liquid group were (54.7±8.0)h, (3.6±0.7)d and (8.1±1.7)d, all significantly shorter than (62.3±10.1)h, (4.6±0.9)d and (10.2±2.6)d(P <0.05) in the control; at T3 and T4, the ScvO₂ in colloidal group was (83.7±7.1)% and (84.2±7.5)%, in crystal liquid group was (82.1±7.8)% and (82.5±8.0)%, all superior to (76.4±6.7)% and (74.9±5.4)%(P <0.05), respectively, in the control, at T2, T3 and T4, blood Lac levels in the colloidal group were (1.3±0.3)mmol/L, (1.7±0.4)mmol/L and (1.8±0.4)mmol/L, in crystal liquid group were (1.4±0.2)mmol/L,(1.8±0.4)mmol/L and (1.9±0.5)mmol/L, all much lower than (1.7±0.3)mmol/L,(2.2±0.5)mmol/L and (2.6±0.7)mmol/L(P <0.05), respectively, in the control, and blood Glu levels in the colloidal fluid group were (5.5±0.8)mmol/L, (7.0±1.3)mmol/L and (6.8±1.1)mmol/L, in crystal fluid group were (5.6±0.7)mmol/L, (7.1±1.0)mmol/L and (7.2±1.2)mmol/L, all superior to (6.3±1.1)mmol/L,(8.4±1.7)mmol/L and (8.2±1.4)mmol/L(P <0.05), respectively, in the control; on day five of post-operation, serum ALT levels in colloidal and crystal liquid groups were (65.3±7.6)U/L and (68.3±7.4)U/L, both significantly lower than (123.4±15.3)U/L(P <0.05) in the control; the incidence of nausea and vomiting after operation in colloidal group was6.7%, significantly lower than 33.3% and 26.7%(P<0.05) in other two groups. Conclusion Compared with conventional liquid management, the application of crystal and colloidal liquid infusion under the guidance of goal-directed fluid therapy in patients with HCC undergoing partial hepatectomy could efficiently accelerate the recovery of health after operation, which might be related to the increase of tissue perfusion and liver function protection. Fast filling of colloidal liquids might reduce the risk incidence of nausea and vomiting after operation.

Objective To explore the clinical value of CT perfusion imaging combined with color Doppler sonography in the diagnosis of hepatic nodular lesions. Methods 50 patients with liver nodular lesions were admitted to our hospital between January 2016 and December 2018, and underwent CT and sonography. The hepatic artery perfusion (HAP),portal vein perfusion (HPP), total hepatic perfusion (TLP) and hepatic arterial perfusion index (HAPI) were measured, and the contrast enhancement time, peak time, and initial regression time of different lesions were recorded. Results The HAP of hepatic hemangioma was (0.7±0.2) mL·min^-1·mL^-1, much greater than (0.4±0.2)mL·min^-1·mL^-1 of hepatocellular carcinoma and (0.3±0.2)mL·min^-1·mL^-1 of hepatic metastases (P<0.05), the HPP was (0.6±0.2)mL·min^-1·mL^-1 , much greater than (0.2±0.1) mL·min^-1·mL^-1 of carcinoma and (0.4±0.1) mL·min^-1·mL^-1 of hepatic metastasis (P<0.05), the TLP was (1.4±0.4) mL·min^-1·mL^-1, greater than (0.7±0.3) mL·min^-1·mL^-1 of carcinoma and (0.8±0.4) mL·min^-1·mL^-1 of hepatic metastases, while the HAPI of hepatocellular carcinoma is (0.7±0.2) mL·min^-1·mL^-1, significantly higher than (0.4±0.1) mL·min^-1·mL^-1 of hepatic metastases and (0.5±0.2) mL·min^-1·mL^-1 of hepatic hemangioma (P<0.05); the hepatocellular carcinoma showed ring-shaped hyperechoic enhancement, and hypoechoic in delayed phase, and the contrast mode was “fast-forward and fast-out”, liver metastasis showed were uniformly enhanced, diffusely enhanced in the portal phase, and mostly hypoechoic in the delayed phase, and the hepatic hemangioma was mostly enhanced in the circumferential ring, isechoic in the delayed phase, and the contrast mode was “slow-in and slow-return”; the onset of enhancement in hepatocellular carcinoma was (13.2±4.0) s, much faster than (15.6±2.4) s and (18.7±3.2) s in liver metastases and hepatic hemangioma (P<0.05), the peak time was (19.2±3.4) s, much faster than (28.3±5.9) s and (67.3±24.2) s, while the fading time in hepatic hemangioma was (307.4±75.6)s, significantly slower than (39.1±4.2) s and (35.4±6.8)s in hepatocellular carcinoma and hepatic metastases (P<0.05). Conclusion The application of CT perfusion imaging combined with color Doppler sonography might help distinguish hepatic malignancy from benign ones.

Objective The aim of this study was to investigate the evaluation of intrahepatic lesion activity by ¹⁸F-FDG PET/CT scan in patients with hepatic alveolar echinococcosis (HAE). Methods 109 patients with HAE admitted to our hospital between June 2016 and June 2018, and all patients received albendazoletreatment for six months. All patients underwent ¹⁸F-FDG PET/CT scan before and after treatment. Results PET/CT examination in 109 patients with HAEbefore treatment showed that most HAE lesions were with mixeddensity and irregular shape, with calcification,liquefaction necrosis, unclear boundary and aggressive growth. The radioactive distribution was found in the edge of the lesions, which was higher than that of the liver; PET/CT scan at six month after the treatment showed that the radiation activity around the lesions disappeared or significantly decreased in 75 cases, and the radiation distribution was slightly reduced in 34 cases; the maximum standardized uptake value of the radiation distribution in the proliferative infiltration zone in the 109 patients after the albendazole treatment was(3.6±1.4), significantly lower than 【(4.9±1.9), P＜0.05】 before treatment. Conclusion The use of ¹⁸F-FDG PET/CT scan might help evaluate the lesion activity,which could guide the albendazole treatment.

Objective The aim of this study was to investigate the imaging feature of patients with microvesicular polycystic liver diseases (PLD). Methods A total of 60 patients with PLD were enrolled in this study, and all patients were undergone computer tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (US) examination. Results Out of the 60 patients selected, 19 had hepatomegaly, 25 had obvious gastrointestinal symptoms, and 6 had abdominal mass, while most patients had normal serum liver function tests; the main CT findings in this 60 patients with PLD were as follows: a circular low-density images of different sizes scattered in the liver parenchyma, numerous numbers, no enhancement, and accompanied or not accompanied with liver enlargement; the MRI showed scattered long T1 and long T2 signals in the liver parenchyma, with different sizes of numerous numbers, without enhancement, and some patients had liver enlargement; the ultrasonography showed that the echoes of liver parenchyma increased unevenly, showing patchy, stripy and multiple hypoechoic areas in different sizes, and some of them were especially small in diameter. Conclusion Although CT and MRI have obvious advantages in the diagnosis of patients with PLD, the ultrasonography might easily demonstrate the manifestations and features of patients with microvesicular polysystic liver disease.

Objective The aim of this study was to explore the efficacy and safety of laparoscopic surgery in treatment of adult patients with congenital choledochal cyst (CCC). Methods The clinical data of 25 patients with CCC in our hospital between February 2012 and May 2018 were analyzed retrospectively. 17 patients received traditional open operation, and 8 received total laparoscopic surgery. Results The first feeding time, postoperative anal exhaust time, postoperative defecation time, hospital stay and intraoperative bleeding in patients with open surgery were (5.0±1.7) d, (3.8±1.5) d,(4.7±1.8) d, (9.4±2.3) d and (241.6±15.3)mL, significantly longer or greater than 【(3.0±1.1) d, (2.6±0.8) d, (3.1±1.3) d, (6.6±1.2) d and (94.0±9.7)mL, respectively, P<0.05】 in patients with laparoscopic surgery, while the operation time was (278.3±60.5)min, much longer than 【(231.7±41.2)min, P<0.05】 in patients with open surgery; 3 days after operation, serum C reactive protein level in patients with open surgery was (77.4±6.4)mg/L, significantly higher than 【(30.8±3.5)mg/L, P<0.05】 in patients with laparoscopic surgery; the total incidences of complications after operation were 37.5% and 58.8% in the two groups, no significant difference (P>0.05). Conclusion As compared with traditional open operation, the laparoscopic surgery is efficacious in dealing with patients with adult CCC, which might reduce the inflammatory response and intraoperative bleeding, and promote postoperative recovery.

Objective The aim of this study was to explore the efficacy and safety of laparoscopic surgery in treatment of adult patients with congenital choledochal cyst (CCC). Methods The clinical data of 25 patients with CCC in our hospital between February 2012 and May 2018 were analyzed retrospectively. 17 patients received traditional open operation, and 8 received total laparoscopic surgery. Results The first feeding time, postoperative anal exhaust time, postoperative defecation time, hospital stay and intraoperative bleeding in patients with open surgery were (5.0±1.7) d, (3.8±1.5) d,(4.7±1.8) d, (9.4±2.3) d and (241.6±15.3)mL, significantly longer or greater than 【(3.0±1.1) d, (2.6±0.8) d, (3.1±1.3) d, (6.6±1.2) d and (94.0±9.7)mL, respectively, P<0.05】 in patients with laparoscopic surgery, while the operation time was (278.3±60.5)min, much longer than 【(231.7±41.2)min, P<0.05】 in patients with open surgery; 3 days after operation, serum C reactive protein level in patients with open surgery was (77.4±6.4)mg/L, significantly higher than 【(30.8±3.5)mg/L, P<0.05】 in patients with laparoscopic surgery; the total incidences of complications after operation were 37.5% and 58.8% in the two groups, no significant difference (P>0.05). Conclusion As compared with traditional open operation, the laparoscopic surgery is efficacious in dealing with patients with adult CCC, which might reduce the inflammatory response and intraoperative bleeding, and promote postoperative recovery.

Objective The purpose of this study was to investigate the traditional Chinese medicine (TCM) syndrome of post-cholecystectomy syndrome (PCS) based on factor-cluster analysis. Methods The clinical data mainly including TCM syndrome in 50 patients with PCS were collected in our hospital between March 2014 and March 2018. The PCS symptom were analyzed by factor-cluster analysis. Results The main TCM syndromes in our series were as follows, e.g. nausea and vomiting accounted for 68.0%, hypochondriac and running pain for 66.0%, costal channeling pain for 48.0%, chest swelling for 32.0%, mental burnout for 48.0%, fatigue for 44.0% , poor appetite for 40.0% and loose stool for 26.0%; the KMO test showed that the KMO was 0.8, and the Bartlett test showed that the approximate chi-square value was 13454.5 (P < 0.05); the factor analysis showed that there were 12 common factors, and the patients with PCS were classified into six syndrome types based on disease location and syndrome elements; the six syndromes were stagnation of Liver-qi in 42.0%, the dampness-heat of liver and gallbladder in 20.0%, the spleen-deficiency and stomach-weakness in 18.0%,the cold-congealing and yang-failure in 10.0%,the disturbance of heart and mind in 6.0%, and the blood stasis-qi stagnation in 4.0%. Conclusion The results of factor-cluster analysis showed that the TCM symptoms of patients with PCS were well dispersed and the syndromes were clear. The main symptoms were stagnation of liver-qi, dampness-heat of liver-gallbladder and weakness of spleen and stomach, which might help clinicians to manage the patients with PCS.

Objective The aim of this study was to investigate the clinical value of diameters of gallbladder polyp in forecasting carcinogenesis. Methods 420 patients with gallbladder polyps were recruited in our hospital between January 2010 and March 2019, and all patients underwent open or laparoscopic cholecystectomy. Multivariate Logistic regression analysis was applied to determine the risk factors of gallbladder carcinogenesis. The area under ROC curve (AUC) was drawn for sensitivity and specificity in predicting the malignant transformation of polyps with different diameters of gallbladder polyps. Results 388 patients had benign and 32 had malignant gallbladder polyps proven by post-operational histopathological examination; the age of patients with benign gallbladder polyps was (46.6 ±8.7) years, significantly younger than in patients with malignant gallbladder polyps; the diameter of benign gallbladder polyps was 6 (2, 27) mm, significantly less than in patients with malignant gallbladder polyps; there were no significant differences as respect to gender, number of gallbladder polyps, gallstone, serum carcinoembryonic antigen and CA19-9 levels and fasting blood glucose between patients with benign and malignant polyps; the multivariate analysis showed that the diameter of gallbladder polyps was an independent risk factor affecting the nature of gallbladder polyps (P < 0.05, OR =1.52, 95% CI:1.36-1.69); the ROC curve analysis demonstrated that the AUC was 0.89 (0.85 to 0.93), e.g. when the diameter of polyps was equal to 13 mm, the diagnostic sensitivity and specificity were 91.0% and 71.8%, respectively. Conclusions The diameter of gallbladder polyps is of high value in predicting gallbladder carcinoma. When the diameter is greater than 13 mm, the possibility of malignant transformation of gallbladder polyps is higher, and we recommend that the gallbladder polyps should be excised as soon as possible.

Objective The aim of this study was to investigate the effects of fecal bacteria transplantation (FBT) on microflora in rats with high-fat-induced liver steatosis. Methods 32 rats were randomly divided into group A, B, C and D. The non-alcoholic fatty liver disease (NAFLD) model was established by high-fat feeding, and fecal bacteria transplantation from patients with NAFLD and healthy persons were performed. The 16 sDNA flora of intestinal mucosal tissue were analyzed. Results The content of Rodentibacter in the model group was increased as compared to that in the control, but it increased more greatly in the rats with FBT from NAFLD, and it decreased greatly in rats with FBT from healthy persons. Conclusion The bacteria flora of patients with NAFLD might be a risk factor for hepatic steatosis, and FBT by using healthy person’s feces might alleviate the liver steatosis.

Objective To explore the mechanism of traditional Chinese medicine in the prevention and treatment of non-alcoholic fatty liver disease (NAFLD) by detecting serum tumor necrosis factor (TNF)-α and leptin in SD rat models with NAFLD. Methods 60 rats were randomly divided into normal (n=8) and high-fat-feeding group (n=48). Three rats were selected for tissue biopsies in the two groups after 10 weeks experiments. The model rats were further divided into model, three doses of herbal medicine and silybinbin-intervened group for eight weeks. Serum TNF-α and leptin levels were detected by ELISA. Results The body weights in low-, middle- and high dose of herbal medicine were were(566±19.4)g, (577±24.3)g and (585±18.5)g, significantly less than in the model group; serum TNF-α levels in three herbal medicine-intervend groups were (30.7±3.5)pg/mL, (34.1±4.2)pg/mL and (37.0±2.3)pg/mL, respectively, much lower than in the model; serum leptin levels in large- and middle-dose-intervined groups were (2.8±0.2)ng/mL and (2.8±0.1)ng//mL, significantly lower than in the model; serum AST, ALT, TG, TC and festing blood glucose levels in three herbal medicine-intervened groups decreased obviously as compared to those in the model (P<0.01). Conclusion The Chinese herbal medicine might ameliorate liver steatosis by down-regulation of TNF-α and leptin in rats with NAFLD, which warrants further investigation.

Objective Macrophages play a crucial role in maintaining homeostasis and repairing tissue damage. Macrophages in the liver can be further divided into Kupffer cells with self-renewal capacity, as well as monocyte-derived macrophages. On the one hand, macrophages can resist the damage of viruses, drugs and other unfavorable factors, and promote the recovery of liver tissue injuries; On the other hand, it also promote the recovery of hepatitis and cirrhosis. In this review, we focus on recent research advances in the classification and functions of liver macrophages and their roles in different liver diseases.

Fitz-Hugh-Curtis syndrome (FHCS) has been reported for almost 100 years since 1919, but the definition and etiology of it became a topic of debate among scholars and clinicians since the first discovery of a male patient in 1970 .In this paper, based on documented literatures, we puts forward that FHCS might be defined in a narrow or broad way, and reviews the progress of generalized FHCS in etiology , pathogenesis, clinical features, complications, diagnosis and therapy.

Based on the progression of clinical and basic research in hepatitis B virus (HBV), we updated the previous HBV guidelines from 2015. The guidelines included the prevention, diagnosis, and antiviral therapy of chronic hepatitis B, which accelerates ro achieve the goal of "the elimination of viral hepatitis as a public health threat by 2030" proposed by the World Health Organization.

Objective In order to standardize and update the prevention, diagnosis and antiviral therapy of hepatitis C and to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030; Chinese Medical Association, the Chinese Society of Hepatology, and the Society of Infectious Diseases organized relevant native experts in 2019 to revise the guideline for the prevention and treatment of hepatitis C (2019 edition) based on the basic and clinical research progress of hepatitis C infection at home and abroad, combined with the present actual situation of our country, so as to provide an important basis for the prevention, diagnosis and treatment of hepatitis C.