Objective The aim of this experiment was to investigate the changes of lipid metabolism related genes in liver tissues of mice with nonalcoholic fatty liver diseases (NAFLD). Methods A NAFLD model was established in ten mice by feeding high-fat diet. The histopathological changes of the liver tissues were observed. Blood total cholesterol (TCH) and triglycerides (TG) levels were detected, and sterol regulatory element-binding proteins (SREBPs), acetyl coenzyme carboxylase (ACC) and fatty acid synthase (FAS) mRNA were detected by reverse transcription-polymerase chain reaction. Results The steatosis of liver cells was found in mice in NAFLD model group; blood TG and TCH levels in NAFLD model group were (0.63±0.13) mmol/L and (7.23±0.7) mmol/L, significantly higher than [(0.28± 0.06) mmol/L and (2.78±0.6) mmol/L, P<0.001] in ten mice in the control; at the end of 24 w experiment, hepatic FAS and SREBP-1 mRNA in NAFLD mice were (3.9±1.1) and (1.8±0.7), significantly higher than 【(1.0±0.3) and (1.0±0.4), FAS: t = 6.231, P<0.001; SREBP-1: t = 2.431, P =0.035】, while the ACC mRNA was (1.2±0.5), not significantly different as compared to 【(1.0±0.4), t = 0.765, P =0.462】 in the control. Conclusion The lipid metabolism related genes in liver tissue of mice with NAFLD are significantly up-regulated, which might play a pivotal role in the pathogenesis of NAFLD.

Objective The purpose of this study was to investigate the expression of visceral adipose tissue-derived serine protease inhibitor (Vaspin) in HepG2 cells and in liver tissues of rats with nonalcoholic fatty liver diseases (NAFD). Methods 12 Sprague-Dawley rats were randomly divided into model (n=6) and control group (n=6) by computer-generated numbers. The rats in the two groups were fed with high-fat diet (Lieber-DeCarli liquid high fat diet) and standard diet for 7 weeks respectively. The Vaspin expression was stained by immunohistochemical method. The HepG2 cells were induced by oleic acid to establish hepatocyte steatosis in vitro, and the expression of Vaspin protein in hepatocytes was detected by Western blot. Results The liver cells swollen in model group and many fat droplets were seen in cytoplasm of the cells, suggesting the cell model was successfully built up; the immunohistochemical staining showed that intensified expression of Vaspin in liver tissues of rats in the model,and the expression was mainly around the lipid droplet; the Western blot demonstrated that the Vaspin/GAPDH expression in steatotic hepatocytes and in control cells were (0.49±0.70) and (0.68±0.40), respectively (P<0.05). Conclusion Vaspin expression intensifies in steatotic hepatocytes and in liver tissues of rats with NAFLD, which might be involved in the pathogenesis of NAFLD, especially in lipid droplet formation.

Objective To explore the protective effect of liver injuries by lentivirus-transfected miR-203 overexpression in rats with alcohol-induced liver disease (ALD). Methods 60 male SD rats were randomly divided into ALD (group A), NC-miRNA plus ALD (group B) and miR-203 plus ALD (group C). Lenti-NC or Lenti-miR-203 were administered to rats by tail vein injection using a 30 gauge ultra-fine insulin syringe before ALD model establishment. Real-time PCR was used to detect miR-203 levelss in liver tissues, and HE staining was used to evaluate the injury of liver tissues. The changes of superoxide dismutase (SOD), catalase (CAT) and malonaldehyde (MDA) in liver tissue homogenates in each group were detected by ELISA and hepatic IL-1β and NF-κB protein expression were detected by Western Blot. Results At the end of eight week model establishment, the miR-203 level in group C rat liver tissue was (2.8±0.1), significantly higher than 【(1.3±0.5), P＜0.05】 in group B; serum AST, ALT and bilirubin levels in group C were (89.5±7.9)U/L, (38.5±10.1)U/L and (27.8±5.1)μmol/L, significantly lower than 【(162.8±16.5)U/L, (69.6±7.5)U/L and (54.9±7.8)μmol/L, P＜0.05】, respectively,in group B; hepatic homogenate SOD and CAT in group C were (57.6±11.4)U/mg and(54.6±9.9)U/mg, significantly higher than [(41.6±7.6)U/mg and (45.7±6.0)U/mg, P＜0.05】, respectively, in group B, while hepatic homogenate MDA level was (2.8±0.1)nmol/g, much lower than 【(5.0±0.2)nmol/g, P＜0.05】 in group B; the results by Western bloting showed thant hepatic IL-1β and NF-κB expression in group C were (0.7±0.2) and (0.3±0.1), significantly lower than 【(1.2±0.3) and (1.0±0.2), respectively, P＜0.05】 in group B. Conclusion Our findings suggest that the overexpression of miR-203 has a protective effect on liver injury in ALD rats, which might be attributed to the intensified antioxidant and anti-inflammatory effects.

Objective The aim of this study was to investigate the expression of lectin-like receptor G1 (KLRG1) in natural killer cells of patients with chronic hepatitis B (CHB). Methods 120 patients with CHB and 120 healthy persons were included in this study, and the percentage of NK cells, KLRG1⁺ NK cells and interferon-γ secreting NK cells from peripheral blood mononuclear cells (PBMCs) were detected by flow cytometry, and the cytotoxicity of NK cells to LX-2 cells was also assayed. Results The percentage of NK cells in peripheral blood of patients with CHB was (17.2±7.7)%, significantly higher than [(11.3±6.9)%, t=9.85, P=0.01], the percentage of KLRG1⁺NK cells was (52.2±20.3)%, much higher than [ (30.3 ±16.9)%, t=6.57, P=0.01] and the percentage of interferon-γ secreting NK cells was(14.6±3.8)%, significantly lower than 【(42.5±9.5)%, t=11.24,P=0.01】 in the control; the expression of CD38, CD69, HLA-DR and TRAIL in NK cells in patients with CHB intensified greatly as compared to those in control (P=0.012, P=0.015, P=0.025, P=0.019);the early apoptosis rate of LX-2 cells in patients with CHB was 11.5% (6.6%-13.7%), and the late apoptosis rate was 7.2% (5.1%-8.5%), decreased greatly as compared to 15.4% (11.5%-24.3%) or 13.5% (8.1%-20.4%) in the control (U=6.50, P=0.025; U=2.02,P=0.002) . Conclusion The expression of KLRG1 in NK cells in patients with CHB intensifies, and the reduced secretion of INF-gamma might decrease the immune functions and lead to chronic infections.

Objective The aim of this study was to observe the efficacy of telbivudine on viral load loss and mother-to-child transmission in pregnant women with chronic hepatitis B viral carrier. Methods 60 pregnant women with HBV carrier were randomly divided into two groups in our hospital between February 2016 and February 2018, and 30 cases in the observation at six month of pregnancy were, while another 30 in the control were not given telbivudine until the end of delivery. All newborns were routinely injected with recombinant hepatitis B vaccine and hepatitis B immunoglobulin after birth. Serum HBV DNA, HBsAg, interleukin-2 (IL-2), IL-4 and IL-6 levels were assayed. Results Before anti-viral treatment, serum HBV DNA loads in the two groups were not significantly different (P>0.05), while serum HBV DNA level after delivery in the observation group was (3.7±0.7)lg copies/mL, significantly lower than 【(7.8±1.0)lg copies/mL, P<0.05】 in the control; after delivery, serum IL-2 level in the anti-viral group was (20.6±2.7)pg/mL, significantly higher than 【(15.7±1.3)pg/mL, P<0.05】, serum IL-4 level was (19.7±1.5)pg/mL, significantly lower than 【(30.6±2.8)pg/mL, P<0.05】, and serum IL-6 level was (21.5±4.2)pg/mL, much lower than 【(29.7±5.1)pg/mL, P<0.05】 in the control; the gestational age, height, body mass and Apgar’s scores of newborns in the two groups were not significantly different (P>0.05); at 6 month and one year follow-up, there was one infant having HBV infection in the control, while there was no infant infected in the observation. Conclusion We recommend oral telbivudine administration at second trimester of pregnancy for blocking mother-to-child HBV transmission in women carrying HBV, which might safe and efficacious.

Objective To investigate the changes of serum hepcidin and iron metabolism index in patients with hepatitis B and in pC1.3 plasmid containing HBV genome-transfected Huh7 cells in vitro. Method 71 patients with CHB and 24 healthy subjects were recruited in this study, and serum hepcidin, serum iron (SI), ferritin (Ferr), and transferrin (Tf) as well as IL-6 levels were detected. The HBV-infected Huh7 cells were constructed, and the expression of Hepc were detected by RT-PCR and Western blot, respectively. Result Serum SI, Ferr, IL-6, alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), and serum total bilirubin (TBIL) levels were significantly elevated and serum Hepc, Tf, soluble transferrin receptor (sTfR), and albumin (ALB) levels were significantly decreased (P<0.05) in patients with CHB as compared to those in healthy persons (P<0.05); the relative levels of Hepc mRNA in HBV-transfected Huh7 cells at 24 h after transinfection was (5.21±0.43) , significantly higher than (0.73±0.14) in vacant plasmid-infected Huh7 cells (P<0.05), and at 48 h, it was (8.45±0.61), also significantly higher than (1.16±0.17) in the control (P<0.05); the relative expression of Hepc protein in HBV-transfected Huh7 cells at 48 h of plasmid transfection was (0.78±0.08), significantly higher than (0.41±0.02) in the vacant (P<0.05). Conclusion Detection of hepcidin and iron metabolism-related indicators might help to assess the progress of chronic hepatitis B, and an appropriate administration of hepcidin or its corresponding endogenous activators needs clinical trials.

Objective The aim of this study was to explore the application of mind map-guided health education on the self-management ability and medication compliance in patients with chronic hepatitis B (CHB). Methods 80 patients with CHB were admitted to our Department of Infectious Diseases, First Affiliate Hospital, Anhui Medicai University from January 2017through May 2019, and were divided into observation and control group according to the order number of admission, with 50 cases in each group. The patients in the control group received conventional health education, and those in the observation received standardized health education data established by the authors with a mind map multimedia presentation software. The self-management ability and treatment compliance of patients in the two groups were evaluated by self-care ability measurement scale (ESCA) and Chinese version of Morisky medication adherence scale -8 (MMAS-8) questionnaire. Results At presentation, there was no significant difference in self-management ability between the two groups (P>0.05) ; After the intervention, the self-management ability score, self-management skill score, self-management responsibility score, self-management concept score and health knowledge level in observation group were (106.3±5.3), (21.8±3.8) , (22.0±2.2), (27.5±1.5) and (35.0±1.5), significantly higher than [(93.5±3.5), (20.9±2.1), (21.0±1.8), (24.5±1.7)and (27.2±2.1), respectively, P<0.05) in the control group; at the end of 12 weeks after discharge, the treatment compliance rate in the observation group was 90.0%, significantly higher than 57.5% in the control group(P< 0.05). Conclusion The mind map health education plan for patients with CHB might improve the patients' self-management ability and treatment compliance effectively, which worth further investigation.

Objective The aim of this study was to investigate the short-term efficacy and tolerance of sofosbuvir/velpatasvir and ribavirin combination in the treatment of hepatitis C patients with genotype 2 or 3 infection. Methods 58 patients with chronic hepatitis C (CHC) and genotype 2 or 3 infection were enrolled in our hospitals from June 2018 through April 2019, and were randomly divided into two groups, 29 in each group. The patients in control group were treated with ribavirin combined with interferonα-2b, and those in the observation group were treated withsofosbuvir/velpatasvir and ribavirin combination. The regimen in the two groups lasted for three months. Serum HCV RNA was detected by RT-PCR, and the viral genotypes was determined by genetic chip sequencing. Results The rapid viralogical response and early viralogical response rates in the observation group were 72.4% and 89.7%, significantly higher than 44.8% and 65.5%(P＜0.05) in the control; at the end of four week treatment, the white blood cell counts in the observation was(5.8±2.1)×10⁹/L, significantly higher than 【(3.7±1.9)×10⁹/L, P＜0.05】 in the control group; at the end of 12 week treatment, the white blood cell count andplatelet count were(3.4±0.4)×10⁹/L and (99.60±24.2)×10⁹/L, both significantly higher than【(2.9±0.9)×10⁹/L and (82.01±14.8)×10⁹/L, respectively, P＜0.05】 in the control group; there was no significantly differences as compared to the side effects in the two groups, and no discontinuation because of severe untoward reactions happened in the two groups. Conclusion The application of sofosbuvir/velpatasvir and bibavirin combination therapyin the treatment of CHC patients with genotype 2 or 3 infection has a good short-term efficacy, which warrants further investigation.

Objective The aim of this study was to investigate the implication of HFE, a genetic hemochromatosis candidate gene, polymorphism in individuals with hepatitis C viral infection. Methods 257 individuals with hepatitis C infection (131 with hepatitis C infection and 126 with chronic hepatitis C, CHC) were enrolled in our hospital between November 2016 and November 2018, and serum ferritin was assayed. The distribution of two polymorphic loci, e.g. rs2071303 and rs9366637, were detected. Results Serum ferritin level in individuals with hepatitis C infection were (97.5±4.1)μg/L, significantly lower than 【(202.1±24.5)μg/L,P＜0.05】 in patients with CHC, serum ALT level was (34.0±4.5)U/L, significantly lower than 【(88.4±5.6)U/L, P＜0.05】, AST level was (37.5±4.2)U/L, much lower than 【(70.0±5.4)U/L, P＜0.05】 in patients with CHC; the frequency of non-Ⅰb in individuals with HCV infection was 29.8%, much highpolymorphism; Ferritin; Active disease than 13.5%(P＜0.05), and of mixed was 9.1%, significantly lower than 21.4%(P＜0.05) in patients with CHC; serum SF level in infected persons with GG genotype at rs2071303 locus was (97.6±4.2) μg/L, significantly lower than [(199.5±45.4) μg/L, P<0.05], in with GA genotype was (97.6±4.1) μg/L, significantly lower than [(207.5±34.7) μg/L, P<0.05], in with AA genotype was (96.7±3.7) μg/L, significantly lower than [(198.0±44.8) μg/L, P<0.05] in patients with CHC, and SF level in infected persons with TT genotype at rs9366637 locus was (97.4±4.0) μg/L, significantly lower than [(206.4 ±35.6) μg/L, P<0.05], in with TC genotype was (97.2±4.0) μg/L, significantly lower than [(208.5±34.0) μg/L, P<0.05], in with CC genotype was (99.1±4.5) μg/L, significantly lower than [(178.5±58.6) μg/L, P<0.05] in patients with CHC; the frequency of AA genotype of rs2071303 in infected persons was 13.7%, significantly lower than 21.4% in patients with CHC (P<0.05), and the frequency of haplotype AC was 3.1%, significantly lower than 8.3% in patients with CHC (P<0.05). Conclusion HFE gene polymorphism is closely related to the active disease in individuals with chronic hepatitis C viral infection, which warrants further investigation.

Objective The aim of this study was to explore the predictive value of serum glycosylated hemoglobin (HbA1c) and interleukin-6 (IL-6) levels on the risk of nonalcoholic fatty liver disease (NAFLD). Methods A total of 658 individuals were recruited in this study, and all of them underwent a comprehensive physical examination in our hospital between March 2014 and September 2015. Blood HbA1c and serum IL-6 levels were assayed, and Logistic analysis was applied to show the independent risk factors for NAFLD. Results Out the 658 individuals for physical check-up, 86 cases(13.1%) were found having NAFLD during the three-year follow-up by sonography; the BMI in patients with NAFLD was (26.4±2.5)kg/m², significantly higher than [(21.3±2.6) kg/m², P＜0.05] in 572 healthy persons; serum ALT, AST and GGT levels in patients with NAFLD were (55.1±7.2)U/L, (63.1±9.3)U/L and (73.6±6.2)U/L, significantly higher than [(23.5±6.3)U/L, (21.7±4.4)U/L and(25.1±6.4)U/L, respectively, P＜0.05] in the healthy persons; blood TG, LDL-C,FPG and2hPG levels in patients with NAFLD were (2.5±1.1)mmol/L,(1.1±0.2)mmol/L,(5.8±1.0)mmol/L and (7.6±2.3)mmol/L, significantly different as compared to [(1.2±0.3)mmol/L, (1.4±0.3)mmol/L,(5.0±0.8)mmol/L and (6.6±2.1)mmol/L, respectively, P＜0.05] in healthy persons; blood HbA1c in patients with NAFLD was (6.0±0.9)%, significantly higher than [(5.0±0.6)%, P＜0.05] and serum IL-6 level was (13.3±4.2)ng/L, significantly higher than [(3.1±0.8)ng/L, P＜0.05] in the healthy persons; Logistic analysis showed than elevated blood HbA1c(OR=1.355, 95%CI:1.121-2.315) and serum IL-6 levels(OR=1.368, 95%CI:1.056-2.685) were the risk factors for the occurrence of NAFLD. Conclusion Abnormal elevation of serum glycosylated hemoglobin and IL-6 levels might hint to a certain degree the happening of nonalcoholic fatty liver disease in the future, which must be concerned in clinical practice.

Objective Objective The aim of this study was to investigate the efficacy of liraglutide in treatment of patients with nonalcoholic fatty liver disease (NAFLD) complicated by type 2 diabetes mellitus (T2DM). Methods 90 patients with NAFLD and T2DM were recruited in our hospital between January 2014 and December 2018,and were randomly divided into control (n=45) and observation group (n=45). They were treated with metformin or metformin and liraglutide combination for 12 weeks. Fasting blood glucose (FPG) , postprandial 2 h blood glucose (2hPPG) and glycosylated hemoglobin (HbA1c), blood lipid index and serum hyaluronic acid (HA), laminin (LN), type IV collagen (CIV), and type III procollagen (PIIIP) were assayed. The parameters of brachial artery, such as T1 and T2, endothelium-dependent relaxation (EDR) and endothelium-non-dependent relaxation (END) were recorded by high-resolution ultrasound. Results At the end of three-month treatment, the FPGs in the observation and control group were (7.3±1.9) mmol/L vs. (8.6±1.8) mmol/L, and the 2 hPPG were (9.8±2.3) mmol/L vs. (11.4±2.2) mmol, and HbA1c were (7.2±1.0)% vs. (8.3±1.2)%, respectively, all significantly different (P<0.05); serum TC levels were (4.8±0.9) mmol/L vs. (5.6±1.2) mmol/L, TG were (1.5±0.4) mmol/L vs. (2.0±0.6) mmol/L, LDL-C were (2.0±0.6) mmol/L vs. (2.9±0.7) mmol/L, and HDL-C was (1.6±0.3)mmol/L vs. (1.3±0.2)mmol/L, all significantly different (P<0.05); T1 were (56.1±6.5)s vs. (62.9±5.8)s, EDR were (7.8±1.0)% vs. (5.2±0.8)%, and END were (21.3±2.9)% vs. (17.2±2.5)%, all significantly different (P<0.05); serum HA were (70.3±9.2) ng/ml vs. (85.9±10.3) ng/ml, CIV were (50.2±0.7) ng/ml vs. (67.3±0.9) ng/ml, and PIIINP were (6.2±). 0.6) ng/ml vs. (8.3±0.5) ng/ml, all significantly different (P<0.05) in the two groups. Conclusion Liraglutide is efficacious in treatment of patients with NAFLD and mellitus, which could effectively decrease blood sugar levels, improve vascular endothelial functions and correct lipid metabolism disorder.

Objective The aim of this study was to investigate the changes of blood glycosylated hemoglobin(HbA1C) and thyroid hormone levels in patients with nonalcoholic fatty liver disease (NAFLD) complicated by type 2 diabetes mellitus (T2DM). Methods 50 patients with T2DM and 55 patients with NAFLD complicated byT2DM were recruited in the Department of Endocrinology in our hospital between April 2017 and March 2019, and all patients underwent somatology, serum liver and kidney function tests, blood lipids, HbA1C, fasting insulin (FINS), free triiodothyronine (FT3), free tetraiodothyronine(FT4) and thyroid stimulating hormone (TSH) were assayed. Results The body mass index (BMI) in patients with NAFLD complicated byT2DM was (28. 4±2.7) kg/m², significantly higher than [(24. 0±2.4) kg/m², P<0.05] in patients with T2DM, the waist circumference in patients with NAFLD and T2DM was (94.5±8.5) cm, significantly higher than(84.0_7.6) cm, P < 0.05)in patients with T2DM, and the hip circumference in patients with NAFLD complicated by T2DM was (97.1±8.0) cm, significantly higher than (89.7±7.2) cm, P<0.05) in T2DM patients;serum level of alanine aminotransferasein patients with NAFLD complicated by T2DM was (79.5±7.6) u/L, significantly higher than [(42.3±4.3) μ/L, P<0.05] in patients with T2DM, serum aspartate aminotransferase level in patients with NAFLD complicated by T2DM was (59.7±6.1) u/L, significantly higher than[(41.2±3.9) u/L, P<0.05] in patients with T2DM, and serum level of glutamyltranspeptidasein patients with NAFLD complicated byT2DM was (105.8±9.4) u/L, significantly higher than [(60.9±6.5) u/L, P<0.05] in patients with T2DM; blood triglyceride levelin patients with NAFLD complicated by T2DM was (4.2±1.7) mmol/L, significantly higher than [(2.4±0.9) mmol/L, P<0.05] in patients with T2DM, and blood level of fasting insulinin patients with NAFLD complicated by T2DM was (12.0±2.5) mU/L, significantly higher than [(9.1±1.8) mU/L, P<0.05] in patients with T2DM;serum level of thyroid stimulating hormone level in patients with NAFLD complicated byT2DM was (3.4±1.2) mU/L, significantly higher than [(1.9±0.8) mU/L, P<0.05] in patients with T2DM, while serum FT3 and FT4 levels in the two groups were not significantly different (P>0.05). Conclusion The BMI, serum liver function index, TG, FINS and TSH in patients with NAFLD complicated by T2DMchange greatly, significantly different as compared to in patients with T2DM,and clinicians should take these differences into consideration in clinical practice for early diagnosis and management.

Objective The purpose of this study was to explore the diagnostic value of serological indexes and fatty liver index (FLI) in patients with nonalcoholic fatty liver diseases (NAFLD). Methods 86 patients with NAFLD and 86 healthy persons were recruited in our Department between March 2016 to March 2019, and serum pancreatic lipase (P-LIP), procalcitonin (PCT), C-reactive protein (CRP) were assayed, and fatty liver index (FLI) was calculated. Results Serum PCT and CRP levels as well as FLI in patients were (0.10±0.05) μg/L,(5.6±1.0)μg/L and (37.4±3.6), significantly higher than 【(0.04±0.02)μg/L,(2.8±0.7)μg/L and (18.2±1.3), respectively, P<0.05】, while serum P-LIP level was (27.1±2.4)U/L, much lower than 【(35.8±3.2)U/L, P<0.05】 in healthy individuals; serum PCT, CRP, P-LIP and FLI in 18 patients with non-alcoholic steatohepatitis (NASH)-related cirrhosis were (0.18±0.07)μg/L, (7.4±1.2)μg/L, (22.9±1.7)U/L and 39.41±4.0, significantly different as compared to 【(0.11±0.04)μg/L, (4.8±0.5)μg/L, (27.7±2.2)U/L and (38.0±3.7), respectively, in 33 patients with NASH or 【(0.07±0.02)μg/L, (3.0±0.3)μg/L, (34.2±2.6)U/L and (35.8±3.4), respectively, in 35 patients with single non-alcoholic fatty liver(P<0.05); the sensitivity (Se) and specificity (Sp) of FLI in diagnosing NAFLD were 76.7% and 73.3%, while they were 66.3% and 86.1% when combination of FLI with serumCRP, PCT and P-LIP. Conclusion The application of FLI is a simple way to diagnose patients with NAFLD , and the combination of serum index might improve the diagnostic efficiency.

Objective The purpose of this study was to investigate the efficacy pitavastatin and atorvastatin in treatment of patients with non-alcoholic fatty liver disease (NAFLD). Methods 98 patients with NAFLD were randomly divided into observation and control group, with 49 patients in each. The patients in the control group received atorvastatin, and those in the observation group received pivastatin for 6 months. Serum insulin, C-peptide (C-P) and tumor necrosis factor-α(TNF-α) levels were assayed and homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Results At the end of treatment, serum total cholesterol, triglyceride and low density lipoprotein cholesterin levels in the observation group were (3.8±1.2) mmol/L, (2.3±0.6) mmol/L and (2.1±0.5) mmol/L,significantly lower than [(4.7±1.3) mmol/L, (2.9±0.7) mmol/L and (2.6±0.4) mmol/L, respectively, P<0.05], while serum high density lipoprotein cholesterin level was (1.4±0.2) mmol/L, significantly higher than [(1.2±0.3) mmol/L, P<0.05] in the control; serum alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase levels were (47.4±14.1)U/L,(42.3±8.6)U/L and (52.1±7.5)U/L, significantly lower than 【(61.2±19.2)U/L,(56.9±9.2)U/L and(69.6±6.4)U/L, respectively, P<0.05】 in the control; serum TNF-α and C-P levels were (3.3±1.2)ng/L and (3.2±0.9)ng/L, significantly lower than 【(4.1±1.1)ng/L and (4.5±0.6)ng/L, P<0.05】 in the control, while there was no significantly difference of HOMA-IR in the two groups (P>0.05). Conclusion The pivastatin administration has a good role of reducing lipids, anti-inflammatory reaction and improving IR in patients with NAFLD, which needs further investigation.

Objective Non-alcoholic fatty liver diseases (NAFLD) is the most common type of chronic liver disease all over the world, which is related to metabolic abnormalities and oxidative stress. The purpose of this study was to assess the effects of calorie restriction diet on insulin resistance, lipid profile and oxidative stress index in patients with NAFLD. Methods 124 patients with NAFLD were recruited in our hospital From January 2018 through January 2019, and were randomly divided into group A and group B, with 62 in each. The daily calorie intake in groupA was controlled at 1200～1500 kcal.d^-1 on the premise of ensuring protein, basic vitamin and trace element intake, the patients in group B designed their own diets forthemselves. The study lasted for 12 weeks. Results At presentation, there was no significant differences in fasting blood glucose (FPG), insulin, insulin resistance index (HOMA-IR), islet B cell function (HOMA-B) and insulin sensitivity detection index (QUICKI) between the two groups (P>0.05), while at the end of 12 weeks of observation, the HOMA-IR in group A was (3.5±2.0) , significantly lower than [(4.7±2.2), P < 0.05) in group B, and the QUICKI was (0.3±0.1) , significantly higher than [(0.2±0.2), P<0.05] in group B, and there were no significant differences (P>0.05) as respect to FPG, insulin and HOMA-B in the two groups; before treatment, there was no significant difference in blood lipid profile, such as blood low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride (TG) and total cholesterol (TC) between the two groups (P>0.05), and at the end of 12 week observation, the blood LDL level in group A was (120.7±23.7) mg/dl, significantly lower than [(149.0±33.4) mg/dl, P<0.05] in group B, blood TC level was (197.6±40.7) mg/dl, significantly lower than [(230.5±42.8) mg/dl, P<0.05], and blood TG level was (176.2±75.0) mg/dl, significantly lower than [(186.4±63.7) mg/dl, P<0.05], while blood HDL level was (43.5±7.4) mg/dl, significantly higher than [(40.9±8.2) mg/dl, P< 0.05) in group B; there was no significant difference in serum malondialdehyde (MDA) between the two groups [(60.6±35.2) μ mol/l vs. (60.7±36.2) μmol/l, P > 0.05], while at the end of 12 week observation, serum MDA level in group A was [(55.5±35.8) μmol/l, significantly lower than [(60.3±34.3) μmol/l, P<0.05] in group B. Conclusion The application of calorie restriction diets might effectively improve insulin resistance, blood lipid profile and oxidative stress in patients with NAFLD, which is worth further study in multi-central clinical practice.

Objective The aim of this study was to study the application of acoustic radiation force impulse imaging (ARFI) in quantitative assessment of nonalcoholic fatty liver (NAFL) in children. Methods 92 children with NAFL and 120 health children were enrolled in our hospital between April 2015 and January 2019, and all were checked-up by acoustic radiation force impulse imaging technology for the shear wave velocity (SWV). The diagnosticefficacy was analyzed by the area under ROC (AUC). Results The SWV in children with NAFL was (1.3±0.2)m/s, significantly higher than [(0.8±0.2)m/s, P＜0.01] in healthy children; the SWV in 36 children with mild NAFL was(1.1±0.1)m/s, significantly lower than [(1.2±0.1)m/s, P＜0.01] in 31 children with moderate NAFL or [(1.4±0.3)m/s, P＜0.01] in 25 children with severe NAFL(P＜0.01); the AUC analysis showed that the optimal cut-off-value for diagnosis of NAFL by SWV was 1.09 m/s, with the AUC of being 0.836, sensitivity of 0.826, and specificity of 0.850. Conclusion The application of ARFI could accurately and quantitatively evaluate NAFL in children, and it plays an important role in the early screening of ARFI.

Objective The aim of this study was to investigate the efficacy of cetylcysteine combined with magnesium isoglycyrrhizinate in treatment of patients with drug-induced liver injuries (DILI). Methods 100 patients with DILI were randomly divided into observation (n=50) and control group (n=50) in this study. The patients in the control group were treated with magnesium isoglycyrrhizinate, and those in the observation group received acetylcysteine and magnesium isoglycyrrhizinate combination for 4 weeks. Serum malonaldehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), interleukin-6 (IL-6) and procalcitonin (PCT) levels were assayed in all the patients. Results At the end on the observation, serum bilirubin, aspartate aminotransferase, alanine aminotransferase and glutamic transpeptidase levels in the combination group were(14.2±4.6)μmol/L,(62.9±6.8)U/L,(67.5±6.9) and (54.9±8.9)U/L, significantly lower than 【(21.4±7.3)μmol/L, (90.3±8.4)U/L, (86.4±7.5)U/L and (63.6±6.4), respectively, P<0.05】 in the control; serum MDA level was (4.8±0.7)μmol/L, much lower than 【(6.2±1.1)μmol/L, P<0.05】, serum SOD and GSH-Px levels were (81.5±7.9)U/L and (124.7±9.9)U/L, significantly higher than 【(75.5±8.3)U/L and (92.6±8.7)U/L, respectively, P<0.05】, serum IL-6 and PCT levels were (4.2±0.7)pg/L and (0.3±0.1)ng/L, significantly lower than 【(6.6±1.2)pg/L and (0.5±0.1)ng/L, respectively, P<0.05】 in the control. Conclusion The combination of magnesium isoglycyrrhizinate and acetylcysteine in treatment of patients with DILI is efficacious for short-term observation, which might be related to the inhibition of inflammatory reaction and oxidative stress.

Objective The aim of this study was to evaluate the diagnostic efficacy of spot quantitative elastography (ElastPQ) by sonography for hepatic fibrosis in patients with autoimmune liver disease (AILD). Methods 58 patients with autoimmune hepatitis (AIH) and 46 patients with primary biliary cirrhosis (PBC) were admitted to our hospital, and all of them received sonography for ElastPQ detection. Serum parameters were obtained for aspartate aminotransferase to platelet ratio index (APRI) and fibrosis factors-four (FIB-4) calculation. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) were calculated for diagnostic sensitivity (Se), specificity (Sp) and accuracy (Ac). Results There were significantly differences in serum ALT, AST, ALP and GGT levels between patients with AIH and PBC(P<0.05); the ElastPQ in patients with AIH was (5.8±0.9)kPa, significantly lower than 【(7.1±1.2)kPa, P<0.05】, while there were no significantly differences with respect to APRI【1.6(1.1,2.3)vs. 1.7(1.4,2.0)】 and FIB-4【2.8(1.8, 3.5) vs. 2.6(1.9, 3.2), P>0.05】 between the two groups; we set the ElastPQ equal to or greater than 6.09 kPa as the cut-off-value, the Se, Sp and Ac in predicting liver fibrosis ≥F3 in patients with PBC were 99.7%, 80.9% and 91.8%, while the diagnostic efficacy was relatively low in patients with AIH. Conclusions The application of ElastPQ is helpful in diagnosis of hepatic fibrosis in patients with PBC, which warrants further investigation.

Objective The aim of this study was to investigate the clinical efficacy of double plasma adsorption and plasma exchange (PE) in treatment of patients with acute-on-chronic hepatitis B liver failure (ACLF). Methods 60 patients with ACLF were recruited in this study between September 2016 and October 2017, and were randomly divided into control group (n=30) and observation group (n=30). The patients in the observation group were treated with double plasma adsorption combined with PE, and those in the control group were treated with PE alone. All patients were followed-up for 3 months. Results At the end of 12 weeks, prothrombin time activity, serum albumin and bilirubin levels in the observation group were (75.3±2.8)%, (37.0±3.0)g/L and (180.2±93.0)μmol/L, significantly different as compared to 【(60.2±2.1)%, (33.6±2.5)g/L and (232.0±98.3)μmol/L, respectively, P＜0.05] in the control; blood hemoglobin and platelet counts were (103.2±22.1)g/L and (80.2±5.9)×10⁹/L, blood potassium, sodium and chlorine levels were (3.7±0.8)mmol/L, (137.1±5.0)mmol/L and (99.0±7.2)mmol/L, and serum creatinine level was (73.2±14.8)μmol/L, not significantly different as compared to those in the control 【(102.6±15.3)g/L,(75.5±6.0)×10⁹/L,(3.7±0.5)mmol/L,(137.5±8.0)mmol/L, (99.1±5.7)mmol/L and (73.5±15.5)μmol/L, respectively, P＜0.05】; the fatality rate in the observation was 16.7%, much lower than 33.3% in the control(P＜0.05). Conclusion The application of double plasma adsorption and PE in the treatment of patients with ACLF caused by hepatitis B infection might reduce the short-term mortality, which warrants further investigation.

Objective The aim of this study was to investigate the efficacy of ursodeoxycholic acid (UDCA) combined with calcitriol in treatment of patients with primary biliary cirrhosis (PBC). Methods m 100 patients with PBC were randomly divided into observation and control group with 50 cases in each group. The patients in the control group was treated with UDCA, while those in the observation group was treated with UDCA combined with calcitriol capsules for one year. Result At the end of one year treatment, the response rate in the observation was 72.0%, much higher than 52.0% (P<0.05) in the control; serum ALP level was (132.6±37.9)U/L, significantly lower than 【(151.6±47.1)U/L, P＜0.05】, serum GGT level was (162.8±17.8) U/L, much lower than 【(189.7±18.0) U/L, P＜0.05】, serum TBA level was (12.0±1.7)μmol/L, significantly lower than 【(16.2±2.1)μmol/L, P＜0.05 】 in the control; serum 25-hydroxyvitamin D3 level was (19.0±4.5)ng/mL, significantly higher than 【(11.2±3.8)ng/mL, P＜0.05】, the percentage of peripheral blood CD4⁺ cells was (3.4±1.1)%, significantly higher than 【(3.0±0.8)%, P＜0.05】, that of Th17 cells was (1.5±0.8)%, much lower than 【(1.9±1.0)%, P＜0.05】 in the control; there were significant differences as respect to serum diamine oxidase [(3.3±1.1) U/mL vs. (4.0±1.7)U/mL], lactic acid [(2.1±1.6)mmol/L vs. (2.5±2.0)mmol/L] and endotoxin [(0.4±0.1)EU/mL vs. (0.6±0.2)EU/mL] levels in the two groups(all P＜0.05). Conclusion The application of UDCA and calcitriol combination might greatly improve liver functions in PBC patients.

Objective The aim of this study was to investigate the clinical efficacy of ultrafiltration, concentration and reinfusion of ascites (UCRA) and alprostadil and terlipressin combination in treatment of patients with cirrhosis complicated by refractory ascites (RA). Methods 104 patients with cirrhosis complicated with RA were recruited in the Department of Infectious Diseases in our hospital between March 2017 and June 2018, and were randomly divided into two groups, with 52 in each, receiving UCRA and synthetical treatment, e.g. combination of UCRA and intravenous administration of alprostadil and terlipressin. All patients were followed-up for six months. Results At the end of one week treatment, the velocity of main portal vein and velocity of splenic vein in synthetical treatment group were (25.6±1.5)cm/s and (27.3±2.7)cm/s, significantly rapider than 【(21.4±1.3)cm/s and (25.4±2.1)cm/s, respectively, P<0.05】 in patients receiving UCRA treatment alone; serum nitric oxide (NO), endothelin-1 (ET-1) and endotoxin were (13.4±2.1)μmol/L, (53.2±10.3)pg/mL and (31.4±13.2)pg/mL,significantly different as compared to 【(16.2±2.3)μmol/L, (68.3±12.6)pg/mL and (49.5±14.1)pg/mL, respectively, P<0.05】 in UCRA-treated groups; the abdominal circumference, ascites depth and urine volume/24 h were (98.6±7.2)cm,(35.2±9.3)mm and (1531.4±234.2)mL, significantly different as compared to [(102.7±6.4)cm, (48.3±11.5)mm and (1249.5±215.1)mL,respectively, P<0.05】 in thesubsided rate in the latter; at the end of six month observation, the ascites synthetical treatment group was 67.3%, significantly higher than 26.9% in the UCRA-treated group (P<0.05). Conclusion The application of alprostadil and terlipressin might assist ultrafiltration, concentration and reinfusion of ascites in treatment of patients with liver cirrhosis and RA, and the long-term efficacy should be observed.

Objective The aim of this study was to investigate the efficacy of laparoscopic portal-azygos vein devascularization and splenectomy in treatment of patients withcirrhotic portal hypertension. Methods 86 patients with cirrhotic portal hypertension complicated with megaspleen were enrolled in our hospital between December 2016 and December 2018, and 43 patients underwent open and other 43 underwentlaparoscopic portal-azygos vein devascularization and splenectomy. Results The bleeding volume and hospital stay in patients with laparoscopic surgery were(180.8±23.1)ml and (6.0±1.3)d, significantly less or shorter than 【(286.4±35.7)ml and (8.6±1.5)d,P<0.05】 in patients with open surgery; seven days after operation, the white blood cell andplatelet counts in patients with laparoscopic surgery were (8.9±1.4)×10⁹/L and (132.0±28.9)×10⁹/L, and those in patients with open operation were (7.2±1.8)×10⁹/L and (125.6±30.3)×10⁹/L, respectively, all significantly increased as compared to these before operation (P<0.05); the portal vain diameters and blood volume in patients with laparoscopic operationwere(1.2±0.1)cm and (911.7±261.7)ml/min, and those in patients with opensurgery were (1.2±0.2)cm and (888.5±191.5)ml/min, respectively, all significantly narrowed or decreased as compared to these beforeoperation (P<0.05); the post-operational complications in patients with laparoscopic surgery was 9.3%, much lower than 37.2%(P＜0.05) in patients with open operation. Conclusion The application of laparoscopic portal-azygos vein devascularization and splenectomy is efficacious in the treatment of patients with cirrhotic portal hypertension and megaspleen. It might have less trauma, low incidence of complications and quick recovery.

Objective The aim of this study was to investigate the clinical value of echocardiography in evaluating cardiac structure and function in patients with liver cirrhosis (LC). Methods A total of 124 patients with liver cirrhosis and 60 healthy persons were recruited in this study between April, 2018 and April, 2019, and all underwent echocardiography. The model for end-stage liver disease (MELD) were calculated in patients with LC, and 41 were found to be mild with MELD score of ≤9, 35 moderate with 10≤MELD score ≤19, and 22 severe with MELD score ≥20. The cardiac parameters measured by echocardiography included left-atrial end-systolic diameter (LAs), left-ventricular end-diastolic diameter (LVd), right-atrial end-systolic diameter (RAs), right-ventricular end-diastolic diameter (RVd), left-ventricular ejection fraction (LVEF), and Ea/Aa ratio of mitral annulus by tissue Doppler imaging (TDI) mode, and the pulmonary artery systolic pressure (PASP) in cirrhotic patients was estimated. Results The LAs in the control group and in the cirrhosis group were (36.3±3.1) and (37.8±4.3), respectively, LVd were (47.8±2.8) and (49.4±4.6), respectively, and the Ea/Aa ratio were (1.1±0.3) and (1.0 ±0.2), respectively, all significantly different (P <0.05); In the mild, moderate, and severe groups of patients with liver cirrhosis, LAs were (36.1±4.2), (38.2±4.1), and (40.1±3.7), respectively, LVd were (47.4±4.5), (50.3±4.4) and (51.4±3.8), respectively, and PASP were (31.2±4.6), (33.4±4.5) and (35.1±5.4), respectively, all significantly different (P <0.05); out of the 124 patients with liver cirrhosis, 9 cases (7.3%) had PASP>40mmHg, diagnosed as having pulmonary hypertension (PAH) . Conclusion With the progression of end-stage liver disease, the function of the hearts in patients with liver cirrhosis gradually decrease, and echocardiography has the clinical application value with high sensitivity and repeatability in evaluating cardiac function and estimating pulmonary artery pressure in cirrhotic patients.

Objective The aim of this study was to analyze the distribution of intestinal flora in patients with hepatitis B liver cirrhosis. Methods A total of 103 patients with hepatitis B liver cirrhosis (compensated cirrhosis in 41 and decompensated cirrhosis in 62) and 20 healthy persons were enrolled in our hospital between July 2018 and April 2019, and the sequences of intestinal bacteria were carried out by Illumina Miseq. Results At the genius level, the proportion of Megamonas, Bacteroides and Faecalibacterium in the healthy persons were 14.8%, 11.4% and 9.8%, the proportion of Bacteroides, Faecalibacterium and Megamonas in patients with compensated cirrhosis were 15.2%, 11.5% and 11.2%, while the proportion of Bacteroides, Faecalibacterium and Veillonella in patients with decompensated liver cirrhosis were 16.9%, 9.6% and 9.2%, respectively; we used Chao, Shannon and Simpson index to analyze the flora abundance and diversity, and the Chao index in healthy persons was (1250.5 ±283.7), significantly higher than (1111.5±277.1,P＜0.05) in patients with compensated or (910.2 ±369.6, P＜0.05) in decompensated liver cirrhosis, the Shannon index in healthy persons was (3.7±0.6), significantly higher than (3.5 ±0.1,P＜0.05) in patients with compensated or (3.3±0.4,P＜0.05) in decompensated liver cirrhosis, and the Simpson index in the healthy persons was (0.3 ± 0.1), significantly higher than (0.2±0.1, P＜0.05) in patients with compensated or (0.1±0.4, P＜0.05) in patients with decompensated liver cirrhosis. Conclusion The intestinal flora abundance and diversity in patients with hepatitis B liver cirrhosis decrease as the progress of the disease, which might have a significant implications in dealing with the patients in clinical practice.

Objective The aim of this study was to investigate the predicting value for survival by preoperative neutrophil-to-lymphocyte ratio (NLR) of patients with massive hepatocellular carcinoma (HCC) treated with TACE combined with microwave ablation (MWA). Methods 87 patients with massive HCC were recruited and treated with TACE combined with MWA in our hospital between January 2007 and October 2013, and they were divided into high (NLR≥2.37, n=47) and low NLR group (NLR<2.37, n=40 patients) pre-operationally. Results The males proportion was 78.7%, ≥55 years old was 29.8%, tumor diameter were (7.1±1.2) cm, Child-Pugh grade A proportion was 61.7%, the proportion of serum albumin ≥35 g/L was 34.0%, the proportion of serum ALT>40U/L was 76.7%, AST>40U/L was 53.2% and AFP ≥200 μg/L was 59.6% in patients with high NLR, not significantly different as compared to 80.0%, 27.5%,(6.9±1.1)cm, 62.5%, 30.0%, 75.0%, 57.5% and 57.5% in patients with low NLR(P>0.05); the survival rates at 1a , 2 a and 3 a in patients with low NLR after treatment were 92.5%(37/40),62.5%(25/40) and 20.0%(8/40), significantly higher than 55.3%(26/47),31.9%(15/47) and 8.5%(4/47) in patients with high NLR(P <0.05); the median survival time of patients with high and low NLR were 13(11-17)months and 28(23-33)months (P<0.05). Conclusion The NLR might predict the short-term and long-term survival in patients with massive hepatocellular carcinoma treated with TACE combined with MWA, and the higher blood neutrophil counts might impact the clinical prognosis.

Objective The aim of this study was to investigate the significance of blood miR-145 levels in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) treatment. Methods 72 patients with HCC and 60 healthy persons were recruited in our hospital between January 2013 and December 2015, and blood miR-145 levels were detected by qRT-PCR. The diagnostic performance of serum miR-145 and alpha-fetoprotein (AFP) in predicting prognosis were compared by ROC curve analysis. Results One month after TACE treatment, 16 patients (22.2%) got PR, 13 patients (18.1%) got SD, and 43 patients (59.7%) got PD results; the blood miR-145 level in patients with HCC was (0.59±0.25) , significantly lower than [(1.02±0.28), P < 0.05] in the control, and blood miR-145 level in the HCC group 1 month after TACE was (0.81±0.26) , significantly increased as compared to that before TACE (P< 0.05); the blood miR-145 levels in patients with HCC were related to TNM grades and preoperative serum AFP level (P<0.05); the miR-145 level in patients with PD response was (0.86±0.21) , significantly higher than [(0.62±0.19) or (0.75±0.19), respectively, P<0.05] in patients with PR or SD; at the end of 3 year follow-up, 28 patients (38.9%)died; the 3 annual overall survival rate in HCC patients with high level of miR-14 was 75.6%, significantly higher than 41.9% in patients with low miR-14 level (x²=8.765, P< 0.05); the areas under the ROC of blood miR-145, serum AFP and miR-145 plus AFP in predicting the poor prognosis of patients with HCC were 0.871, 0.851 and 0.942, respectively, with the sensitivity and accuracy of combined prediction being 91.67% and 90.15%, respectively. Conclusion The detection of blood miR-145 might predict the prognosis of patients with HCC after TACE, which needs further investigation.

Objective The purpose of this study was to observe the clinicalefficacy of ¹²⁵I seed implantation or 3-dimensional conformal radiation therapy (3DCRT) and transcatheter artery chemoembolization(TACE) combination intreatment of patients with advanced hepatocellular carcinoma (HCC). Methods 92 patients with advanced HCC were recruited and were randomly divided intoobservation and control group, with 46 cases in each group. The patients inobservation group were treated with¹²⁵I seed implantation and TACE combination,and those in the control group were treated with 3D CRT combined with TACE.The short-term efficacy was evaluated and adverse reactions were recorded.Serum alpha-fetoprotein (AFP), alpha-fetoprotein heterogenous L3(AFP-L3) andGolgi protein (GP73) were detected. Results The disease control rates at 4thweek after treatment in the observation and the control group were 62.5% and57.5%(P>0.05), and the 1-year survival rates in the two groups were 52.5%and 45.0% (P > 0.05); at presentation and one month after treatment, there werenosignificant differences as comparison of serum AFP, AFP-L3 and GP73 levels in thetwo groups (P>0.05); the incidences of leucopenia, anemia, thrombocytopenia,and gut reaction during the treatment in the two groups were notsignificantlydifferent (P>0.05), while the incidence of radiation-induced liver injury inthe observation group was much lower than that in the control (P<0.05). Conclusion The short-term efficacy of ¹²⁵I seed implantation combined with TACE in the treatment of patients with advanced HCC is similar to that of 3D CRT combined with TACE, while the former is safer a mild side effects occur.

Objective The aim of this study was to investigate the anesthetic efficacy of target-controlled infusion of (TCI) in accordance with propofol in partial hepatectomy. Methods Eighty-six patients with primary liver cancer (PLC) undergoing partial hepatectomy in our hospital between April 2017 and January 2019 were randomly divided into study group and control group with 43 in each. The patients in the control group were given routine anesthesia and those in the study group were anesthetized with remifentanil combined with propofol at the manner of TCI. The extubation time, eye opening time, spontaneous respiratory recovery time, stress response index and standard for coming out of the awakening room (Aldrete) were compared between the two groups. Modified vigilance sedation scale (OAA/S) score was obtained and the complications between the two groups were compared. Results The extubation time, the eye opening time and spontaneous respiratory recovery time in patients in the study group were significantly shorter than those in the control group [(12.7±3.3) min, (10.1±3.2)min and (9.4±2.1)min, vs. (18.4±5.2)min, (17.6±3.4)min and (16.4±5.4)min, respectively, P<0.05】; there was no significant difference in stress response index between the two groups at T0 (P > 0.05), while the level of stress response index in the study group was better thanthat in the control group (P < 0.05) during the operation; immediately after extubation and 15 minutes after extubation, the Aldrete scores in the study group were (9.4±0.7) and (9.4±0.8), and the OAA/S scores were (4.3±0.4) and (4.7±0.4), significantly higher than [(8.3±0.4) and (8.9±0.5), and (3.4±0.4) and (4.2±0.5), respectively, P<0.05】 in the control; the incidence of adverse reactions in the study group was 11.6%, significantly lower than 27.9% in the control (P < 0.05). Conclusion The application of the compound propofol TCI anesthesia is appropriately applied to the partial hepatectomy, and the stress reaction during the operation could be effectively reduced, which might improve the recovery of patients with PLC after operation.

Objective The aim of this study was to compare the clinical efficacy of transcatheter arterial embolization (TAE) and microwave ablation in the treatment of patients with cavernous hemangioma of liver (CHL). Methods 74 patients with CHL were recruited in the Department of General Intervention between January 2014 and April 2018, and 37 were treated by microwave ablation and another 37 were treated by TAE. All patients were followed-up for six months. Results There was no statistical difference as respect to the clinical efficacy between the two groups (86.5% vs. 75.7%, P>0.05); After treatment, serum levels of alanine aminotransferase and aspartate aminotransferase in microwave ablation group were (47.9±5.7) U/L and (35.5±4.3) U/L, significantly lower than [(93.5±11.2) U/L and (61.3±5.8)U/L,P<0.05】in the TAE group; at 12 h, 24 h and 48 h after operation, the visual analogue score in the microwave ablation group were (2.8±0.5), (1.7±0.2) and (1.1±0.1), significantly lower than [(4.7±0.9), (2.6±0.8) and (1.8±0.3), respectively, P<0.05] in the TAE group; After treatment, there was no significant difference in the incidence of adverse reactions between the microwave ablation and the TAE-treated group (P>0.05). Conclusion The application of TAE and microwave ablation in the treatment of patients is efficacious, which has little side effects and lower incidence of postoperative pain.

Objective The aim of this study was to investigate the survival of patients with severe traumatic hepatic rupture (STHR) after damage control surgery (DCS). Methods The clinical data of 66 patients with STHR were retrospectively analyzed in our hospital between April 17 and January 2019, and 32 patients received conventional surgery and 34 received DCS. The survival rates in short-term follow-up were compared between the two groups. Results The surgery time in the DCS group was (141.0±10.7) min, significantly shorter than that [(185.2±15.8) min, P<0.05] in the conventional surgery group, the intraoperative blood loss in the DCS group was (754.6±52.3) mL, significantly less than [(1185.7±104.6) mL, P<0.05] in the conventional surgery group, the injury severity score (ISS) in the DCS group was (39.9±4.4), significantly lower than [(46.8±5.0), P<0.05] in the conventional surgery group, and the shock correction time in the DCS group was (6.2±1.1) h, significantly shorter than [(9.1±3.4) h, P<0.05] in the conventional surgery group;the parameters monitored after operation, such aspH [(7.4±1.3) vs. (7.4±0.8)], prothrombin time [(12.9±2.3) s vs. (13.0±2.8) s] and APTT [(37.1±3.2) s vs. (40.3±7.5)s] were not significantly different (P>0.05) in the two groups; the incidences of post-operational complications, such as subdiaphragmatic abscess, biliary fistula, abdominal infection and stress peptic ulcer in DCS group was 20.6%, significantly lower than 62.5%(P<0.05) in the conventional operation group; the survival rate inDCS group was 88.2%, significantly higher than 71.9% in the conventional surgery group (P<0.05). Conclusion The application of DCS might significantly improve the perioperative indexes of patients with severe traumatic liver rupture, which is related to the less postoperative complications.

Objective The purpose of this study was to investigate the correlation of serumvascular endothelial growth factor-C (sVEGF-C) and carcinoembryonic antigen(CEA) levels to prognosis in patients with gallbladder cancer. Methods 93 patients with gallbladder cancer were included in this study between February 2011 and January 2018, and serum sVEGF-C levels were detected by double antibody-sandwich enzyme-linked immunosorbent assay, and serum CEA levels were detected by radioimmunoassay. The correlation of serum sVEGF-C and CEA levels to the prognosis of patients with gallbladder cancer was analyzed. Results Serum sVEGF-C and CEA levels were significantly different in gallbladder cancer patients with different tumor infiltration (Tstage), lymphatic metastasis (N stage), distant metastasis (M stage) and clinopathological stage (P<0.05); during 22 month follow-up period, 45 survived (48.4%) and 48 died (51.6%); serum sVEGF-C level in the dead group was (84.9±20.7) pg/mL, significantly higher than [(56.4±18.9) pg/mL,P<0.05], and serum CEA level was (138.7±49.6) μg/L, significantly higher than [(76.8±27.4) μg/L,P<0.05] in the survival group; multivariate Logistic regression analysis showed that clinopathological stage (OR=6.658, 95% CI=1.800-24.632), serum sVEGF-C (OR=4.005,95% CI=1.292-12.415) and CEA (OR=3.170, 95% CI=1.482-6.849) were the independent risk factors affecting the prognosis of patients with gallbladder cancer (P<0.05). Conclusion Serum sVEGF-C and CEA levels increase greatly in patients with gallbladder cancer, which might impact the poor prognosis and warrants further investigation.

Objective The aim of this study was to explore the clinical Efficacy of Rouviere sulcus guided posterior triangle approach and conventional laparoscopic cholecystectomy (LC) in the treatment of patients with benign gallbladder diseases. Methods A total of 104 patients with benign gallbladder diseases were recruited in our hospital between March 2018 and March 2019, and they were randomly divided into observation group (n=52) and control group (n=52) . The patients in the control group underwent LC, and those in the observation underwent LC by Rouviere groove-guided orientation and posterior triangle gallbladder approach. The visual analogue score (VAS) at different postoperative time and the complications during hospitalization in the two groups was recorded. Results One patient (1.9%)in the observation group, while six (11.5%) patients in the control converted to open surgery during LC, which led to the operation time, intraoperative bleeding volume, time for out-of-bed activity after operation and hospitalization stay in the control much longer or greater than those in the observation [(113.5±5.1)min,(34.5±5.4)mL, (3.4±0.9)d and (8.0±1.2)d vs. (75.1±5.2)min,(13.4±5.1)mL, (1.4±0.8)d and (3.8±1.0)d, respectively,P＞0.05]; at 12 h and 24 h after operation, the VAS score in the control group were (4.8±1.0) and (5.2±1.3), significantly greater than 【(2.8±1.0) and (3.1±1.2), respectively,P＞0.05】 in the observation; there were no significant differences as respect to the biochemical parameters between the two groups(P>0.05); after operation, the incidences of bile leakage, bile duct injuries, incision infection, peritonitis and abdominal distention in the observation group were 3.8%, 0.0%, 1.9%, 1.9% and 1.9%, significantly lower than 3.8%, 9.6%,3.8%, 3.8% and 3.8%(P<0.05) in the control. Conclusion The LC with Rouviere sulcus-guided posterior triangle approach for the treatment of patients with benign gallbladder diseases might boost the operation success and reduce the operation-related complications, which worth further investigation.

Objective The aim of this study was to observe the clinical efficacy and safety of laparoscopic cholecystectomy (LC) in treatment of patients with benign gall bladder diseases. Methods 136 patients with benign gallbladder diseases were recruited in our hospital between January 2016 and January 2018, and all of them underwent LC. During the operation, the lateral approach to remove the gallbladder were conducted in 68 patients in group A, and the antegrade or retrograde approached to remove gallbladder were conducted in another 68 patients in group B. The post-operational pain was evaluated by visual analogue scales, and serum C-reactive protein (CRP),interleukin-6 (IL-6),neutrophil elastase (NE) and tumor necrosis factor-α (TNF-α) levels were assayed. Results The successful rates of operation in group A and in group B were 97.1% and 95.6%, and the conversion to open operation was 2.9% and 4.4%, respectively (P>0.05); 6 hours after operation, the VAS score in group A was (3.1±0.6), much lower than 【(4.1±1.0),P＜0.05】, and 12 hours after operation, the VAS score was (1.5±0.5), significantly lower than 【(3.1±0.7), P＜0.05】 in group B; after operation, serum CRP, IL-6, NE and TNF-α levels in group A were (2.9±1.3)mg/L, (3.3±0.7)ng/L, (1.2±0.5)μg/L and (0.9±0.7)ng/L, significantly lower than 【(4.2±1.6)mg/L, (4.8±1.5)ng/L, (2.6±0.9)μg/L and (1.9±0.8)ng/L, respectively,P<0.05】 in group B; at the end of three-month follow-up, the incidence of post-operational complications, such as gallbladder rupture or gallbladder bed exudation, in group A was 7.4%, much lower than 23.5% (P<0.05) in group B. Conclusions Laparoscopic cholecystectomy by through lateral approach to remove gallbladder might achieve satisfactory clinical outcomes, which could reduce trauma and post-operational complications.

Objective The aim of this study was to investigate the incidences of inflammatory bowel disease (IBD) and gallbladder polyp (GP) in patients with primary sclerosing cholangitis (PSC). Methods The clinical data of 201 patients with PSC in Eastern Branch of the First Hospital affiliated to Sun Yat-sen University between January 2000 and December 2018 were retrospectively analyzed. The diagnosis of PSC was based on endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP), and the presence of GP and IBD were confirmed by abdominal CT , abdominal ultrasound or enteroscopy. Results A total of 23 patients (11.4%)with GP and 154(76.6%) with IBC were found out of this 201 cases with PSC; in 23 patients having GP, the incidences of IBD, ulcerative colitis (UC) and Crohn's disease (CD) were 87.0%, 73.9% and 8.7%, and in 178 patients without GP, they were 75.3%, 58.4% and 15.7%, not significant differences between the two groups (P>0.05); 15 patients with GP underwent cholecystectomy, and the histopathological examination post-operationally demonstrated that 5(33.3%) were adenocarcinoma, 3 (20.0%) were advanced atypical hyperplasia and another 7 belonged to benign polyp; the clinical data between patients with benign and malignant lesions were not significantly different (P>0.05). Conclusions GP and IBD are common lesions in patients with PSC, and the reason of these complications occurrence is not clear. The GP in patients with PSC, even a small polyp, has a risk of developing malignant tumors, which warrants early cholecystectomy as sooner as possible.

The PNPLA3 gene is expressed in both humans and mammals and is also expressed in liver cancer cells. PNPLA3 can cause accumulation of triglycerides in hepatocytes and fatty degeneration in hepatocytes after its mutation in humans and mice. Overexpression of mutant PNPLA3 in human and rat liver cancer cells also results in lipid accumulation in liver cancer cells compared to overexpression of its wild-type. In this paper, we summarize the effects of PNPLA3 gene on lipid metabolism in hepatocytes and hepatoma cells, and try to explain the effects of PNPLA3 on human hepatocytes and liver cancer cells, rat, mouse hepatocytes and liver cancer cells.