Objective The aim of this experiment was to explore the effect of alcohol on intestinal stem cell proliferation. Methods 18 C57BL/6 mice were randomly divided into control and alcohol group (9 in each). A mouse model with chronic alcohol injury was established by Gao-Binge method. Before sampling, the 5-bromo-2′-deoxyuridine (BrdU) was intraperitoneally injected. At 2 h, 24 h and 72 h after BrdU injection, the small intestine tissues were collected and immunohistochemical staining was conducted to detect BrdU positive cells. The number of BrdU positive cells in small intestinal tissue at 2 h was used as the detection index of intestinal epithelial cell proliferation, and the distances of BrdU positive cells from the distal end of small intestinal villi to the basal part of small intestinal crypt at 2 h, 24 h and 72 h were dynamically measured as the detection index of intestinal epithelial cell migration. The expression of intestinal stem cell specific marker, Lgr5 was detected by immunohistochemistry. Results The small intestinal villi in alcohol-intervened group were significantly shortened and atrophic compared with those in the control group; the expression of Lgr5 in alcohol-intervened group was significantly weaker than that in control group; the number of BrdU positive cells in each intestinal crypt in experimental group was (3.50±0.65), significantly less than that in control group ; the migration distance of BrdU positive cells in alcohol-intervened group at 2 h, 24 h and 72 h after BrdU injection were (66.67±1.60) μm, (219.40±12.11) μm and (313.90±9.76) μm, significantly shorter than those in the control . Conclusion Alcohol induces decreased proliferation and migration of intestinal epithelial cells by inhibiting intestinal stem cell proliferation, which might damage the renewal and repair ability of intestinal epithelium, leading to abnormal intestinal epithelial barrier functions.

Objective The aim of this study was to construct and select an HL-7702 cell line stably expressing HBx in vitro. Methods The HBx gene fragment was amplified by RT-PCR and ligated into pIRES vector. The sequence of pIRES-HBx recombinant plasmid was identified by restriction enzyme digestion and sequencing. The recombinant plasmid was further verified by real-time PCR and Western blot, and the HL-7702 cell stably expressing HBx was selected by G418. Results The correct HBx fragment was amplified by PCR, and the pIRES-HBx plasmid was successfully constructed. The recombinant plasmid overexpressed HBx protein in both HEK 293 cells and HL-7702 cells. The HL-7702 cell stably expressing HBx was further verified by immunofluorescence. Conclusions We Successfully construct a pIRES-HBx expression vector and a stably expressing HBx HL-7702 cells, which might provide us a basic experimental tools for further research.

Objective The aim of this experiment was to explore the effect and underlying mechanism of curcumin on oleic acid-induced steatosis of HepG2 cells in vitro. Methods HepG2 cells were treated with or without 1 mmol/L oleic acid (OA) to establish nonalcoholic fatty liver disease (NAFLD) cell model. The HepG2 cells were divided into four groups, e.g. control (con), steatosis model (OA) , curcumin control and curcumin-intervened groups. Bodipy493/503 staining was used to detect the distribution of lipid droplets in the HepG2 cells. The ultrastructure of mitochondria was examined by transmission electron microscopy. Reactive oxygen species (ROS) levels were detected by DCFH-DA. The TNF-α and IL-6 levels in the supernatants were measured by a commercial kit. The apoptosis was determined by Hoechst 33258 staining. Western blott was applied to determine the expression of Bcl-2, Bax, mCytc, NF-κB, and Caspase-3/9 proteins. Results Compared with in the control cells, the cells treated with OA showed significantly increased lipid droplets accumulation, while the cells treated with curcumin showed reduced lipid droplets accumulation; the mitochondrial damage including mitochondrial swelling and vesiculation in OA group was more obvious than that in control group, while the mitochondrial damage treated by curcumin was significantly improved; the TNF-α and IL-6 levels in OA group were much higher than that in the control group , while they decreased greatly in curcumin-inervened group ; the ROS levels was (52.24±5.11)% in OA group, significantly higher than (6.71±2.31)% in the control group, while it decreased to (37.44±7.21)% in curcumin-treated group (P<0.05); the apoptosis rate in OA group was (12.12±0.72)%, significantly higher than (2.04±0.57)% in the control group, while it decreased significantly in curcumin-treated group ; the expressions of Bax, NF-κB and cleaved-Caspase-3/9 intensified, and Bcl-2 and mCytc decreased greatly in OA group as compare to those in the control, while the expressions of Bax, NF-κB and Caspase-3/9 decreased, and Cytc and Bcl-2 increased (P<0.05) in curcumin-intervened group. Conclusion Curcumin effectively prevent oleic acid-induced steatosis in HepG2 cells, which might be related to the alleviation of inflammatory reaction, oxidative stress and inhibition of apoptosis.

Objective The aim of this study was to investigate the effect and possible mechanism involved of naringenin liposome on lipid metabolism in rats with non-alcoholic fatty liver disease (NAFLD) induced by high glucose and fat diet. Methods Fifty male SD rats were randomly divided into control, model, naringenin, naringenin liposome group I and naringenin liposome group II with 10 rats in each. Except the rats in the control, the rats in other four were fed with high-sugar and high-fat diets, receiving intraperitoneal injection of normal salt, 30 mg·kg^-1·d^-1 naringenin, 20 mg·kg^-1·d^-1 and 30 mg·kg^-1·d^-1 of naringenin liposomes, respectively, for 12 weeks. Serum superoxide dismutase (SOD), catalase (CAT) and malonaldehyde (MDA) levels were detected by ELISA, and Nrf2 mRNA and its protein were assayed by RT-PCR and Western blot, respectively. Results The body weight, liver mass, serum TC, TG, ALT, AST, SOD, CAT and MDA levels in the model group were (547.6±19.8) g, (12.9±0.3) g, (1.2±0.2) mmol/L, (2.6±0.2)mmol/L, (69.8±5.3) U/L, (229.6±18.2) U/L, (29.9±6.4) U/L, (26.5±2.4) U/mg and (11.7±1.1) nmol/mL, and they all, but SOD and CAT, decreased in naringin-intervened, naringin liposome group I and naringin liposome group II (P<0.05); Nrf2 protein and Nrf2 mRNA in the liver tissues in naringenin group, naringenin liposome group I and naringenin liposome group II increased as compared to those in the model group. Conclusion Naringenin liposome effectively reduce the blood lipid levels in rats with NAFLD, which might be related to the production of SOD and CAT and activation of Nrf2 gene.

Objective The aim of this study was to investigate the effects of captopril on hepatocellular steatosis in rats with nonalcoholic fatty liver disease (NAFLD).Methods 64 male Sprague-Dawley rats were randomly divided into four groups with 16 in each, and the rats in control were fed with normal diet or with high-fat diet for NAFLD model, in which were intragastricly administered with normal salt (model), captopril or rosiglitazone for six weeks.The hepatic cytochrome oxidase P4502E1 (CYP2E1) mRNA was detected, and serum malondialdehyde (MDA) and glutathione (GSH) levelswere assayed.Results The extensive steatosis and cell edema were found in themodel group, while in the captopril-intervened group, the hepatocytes were arranged normally, with a small amount of steatosis and decreased cells edema; serum aspertate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC) and total glycerin (TG) levels in the captopril-intervened group were (94.1±15.6)U/L,(27.3±6.2)U/L,(1.4±0.2)mmol/L and (1.0±0.2)mmol/L, significantly lower than 【(134.4±35.1)U/L,(35.2±7.1)U/L,(1.8±0.4)mmol/Land (1.4±0.2)mmol/L, respectively,P＜0.05】 in the model; the liver wet weight, liver index and hepatic CYP2E1 mRNA levels in captopril-intervened group were(11.7±2.1)g, (2.3±0.3)% and (1.8±0.2), significantly lower than 【(14.3±2.0)g,(2.6±0.2)% and (2.3±0.1), respectively, P＜0.05】 in the model; serum MDA level was (7.6±2.5)nmol/L, significantly lower than 【(12.1±2.6)nmol/L, P＜0.05】, while serum GSH level was (41.0±17.5)mg/L, significantly higher than 【(22.2±10.2)mg/L, P＜0.05】 in the model. Conclusion Captopril could effectively reduce the steatosis of hepatocytes in rats with nonalcoholic fatty liver disease, which might be related to the modulation of lipid metabolism disorder, the restoration of liver function and the enhancement of anti-oxidative stress

Objective The purpose of this study was to investigate the clinical efficacy of N-acetylcysteine (NAC) in the treatment of patients with chronic icteric hepatitis B. Methods A total of 62 patients with chronic hepatitis B (CHB) and hyperbilirubinemia were recruited in our hospital between January 2015 and December 2018, and they were randomly divided into observation (n=32) and control group (n=30). The patients in the control group were treated with comprehensive supporting treatment, such as liver protection, jaundice reduction, immune regulation and anti-viral therapy, and the patients in the observation group were treated with intravenous infusion of NAC at dose of 8.0 g daily on the basis of treatment in the control group for six weeks. Serum Ⅲ type collagen (PC-Ⅲ), type IV collagen (IV-C), hyaluronic acid (HA), laminin (LN)] levels were detected by radioimmunoassay, and serum interleukin-1 beta(IL-1β), IL-6, IL-8 and tumor necrosis factor alpha (TNF-α)] were assayed by ELISA. Results At the end of six week treatment, serum ALT and AST levels in the observation group were (45.4±2.9) U/L and (74.3±8.7) U/L, not significantly different as compared to , while total serum bilirubin level were (85.1±54.6)μmol/L, much lower than in the control; serum PC-Ⅲ, IV-C, HA and LN levels were (87.1±15.8)μg/L,(74.5±15.2)μg/L, (95.7±13.7)μg/L and (83.9±16.5)μg/L, significantly lower than in the control; serum IL-6, IL-8 and TNF-α levels were (15.1±2.8)μg/L, (5.2±2.9)μg/L and (13.7±0.9) μg/L, significantly lower than in the control; the disease control rate in the observation was 87.1%, much higher than 64.3% (P<0.05) in the control. Conclusion The application of NAC in the treatment of patients with chronic icteric hepatitis B is efficacious and safe, which might decrease serum bilirubin levels and alleviate liver fibrosis.

Objective The aim of this study was to observe the application of entecavir in the treatment of patients with hepatitis B virus carrier and pulmonary tuberculosis during antituberculotic therapy. Methods 164 patients with hepatitis B virus carrier and pulmonary tuberculosis were recruited in our hospital between May 2017 and December 2018, and were randomly divided into observation and control group with 82 cases in each. All the patients were given 4 HREZ/4 ER, and those in the observation group were given entecavir orally for anti-viral therapy. The liver function index, peripheral blood lymphocyte subsets and serum HBV DNA were detected. Results At the end of eight week treatment, serum ALT and AST levels in the observation group were (44.2±1.1)U/L and (38.8±1.3)U/L, significantly lower than 【(81.7±1.5) U/L and (78.2±1.5) U/L, respectively, P＜0.05】 in the control, all serum HBV DNA became negative in the observation group, while they were 【(7.9±0.6)lg copies/mL, P＜0.05】, unchanged in the control; at the end of eight week treatment, the total absorption rate and absorption of tubercular lesions, and sputum smear negative conversion rate in the observation group were 41.5%, 42.7% and 48.8%, significantly higher than 24. 4%, 28.1% and 34.2% , respectively, in the control(P＜0.05); the percentages of peripheral blood CD4⁺ cells,CD8⁺ cells and ratio of CD4⁺/CD8⁺ cells in the observation group were (39.5±3.1)%, (23.9±1.8)% and (1.7±0.2), significantly different as compared to 【(37.1±2.5)%, (26.3±1.3)% and (1.4±0.3), respectively, P<0.05】 in the control group; the incidences of fatigue, right upper-chondrial discomfort, anorexia and drug-induced liver injuries (DILI) in the observation goup were 3.7%, 2.4%, 1.2% and 1.2%, significantly lower than 15.9%, 12.2%, 4.9% and 53.7%, respectively in the control (P<0.05); at the end of three month treatment, the anti-tuberculosis drug resistance rate, discontinuation of some anti-tuberculosis agents because of DILI and totally discontinuation of anti-tuberculosis therapy in the observation were 7.3%. 4.7% and 1.2%, significantly lower than 18.3%, 12.2% and 36.6%, respectively, in the control group(P<0.05). Conclusions The prophylactic application of entecavir in hepatitis B viral carriers complicated with pulmonary tuberculosis during anti-tuberculosis treatment has a good efficacy in inhibiting hepatitis B viral re-activation, which might guarantee the anti-tuberculosis therapy going and immune functions with little side effects and less drug-induced liver injuries.

Objective To explore the virological and biochemical response in children with chronic hepatitis C (CHC) by using peginterferon-α2a and ribavirin combination treatment. Methods 42 children with CHC were recruited in our hospital between April 2016 and April 2018, and were randomly divided into control (n=21) and observation group (n=21). The patients in control group were treated with recombinant interferon α-1b and ribavirin, while the children with CHC in observation group received peginterferon α-2a and ribavirin combination treatment, and the regimen lasted for 48 weeks. Results The rapid virological response, early virological response, virological response at the end of treatment and sustained virological response in peginterferon α-2a-treated children were 38.1%, 81.0%, 90.5% and 85.7%, significantly higher than 16.7%, 52.4%, 69.1% and 64.3%, respectively, in the control (P<0.05); serum ALT normalization rates at week 4, week 12 and week 48 in the observation group were 59.5%, 73.8% and 83.3%, not significantly different as compared to 47.6%, 69.0% and 81.0%, respectively, in the control (P>0.05); the incidence of influenza-like symptoms and neutropenia in the observation group were much higher than those in the control (P<0.05). Conclusion The combination of peginterferon α-2a and ribavirin in treatment of children with CHC is efficacious with improved virological response, but having some side effects, which should be dealt with in time to complete the regimen.

Objective The aim of this study was to explore the efficacy of combination of tripterygium wilfordii polyglycosides and magnesium isoglycyrrhizinate in the treatment of children with autoimmune hepatitis (AIH) and its effect on serum interleukin--17 (IL-17) and chemokin10 (CXCL10) levels.Methods 57 children with AIH were enrolled in the Department of Pediatric in our hospital between January 2018 and March 2019, and were randomly divided into observation (n=29) and control group (n=28). The children in the control group were treated with magnesium isoglycyrrhizinate injection intravenously, while those in the observation group were treated with tripterygium wilfordii polyglycosides orally at the basis of treatment mentioned above. Serum IL-17, CXCL8 and CXCL10 levels were detected by ELISA. Results At the end of the regimen, serum AST levels in the observation and control groups were (48.4±9.3) U/L and (61.2±12.50) U/L (P<0.05), serum levels of alkaline phosphatase were (60.2±5.1) U/L and (75.7±6.4) U/L (P<0.05), and serum levels of alanine aminotransferase were (59.3±7.6) U/L and (66.4±9.7) U/L (P<0.05); serum levels of immunoglobulin G were (13.8±2.9) mg/L and (16.3±3.4) mg/L (P<0.05), serum levels of immunoglobulin A were (2.4±0.3) mg/L and (2.9±0.5) mg/L (P<0.05), and serum level of immunoglobulin M were (2.6±0.3) mg/L and (3.1±0.4) mg/L (P<0.05); serum levels of IL-17 were (6.8±0.7) ng/ml and (7.3±0.9) ng/ml (P<0.05), serum level of CXCL8 were (10.4±1.2) pg/ml and (13.8±1.6) pg/ml (P<0.05), and serum levels of CXCL10 were (16.3±2.5) pg/ml and (22.6±3.7) pg/m (P<0.05) between the two groups; during the treatment, the incidence of adverse reactions was 12.5% in the observation group and 7.5% in the control group (P>0.05). Conclusion The combination of tripterygium wilfordii polyglycosides and magnesium isoglycyrrhizinate in the treatment of children with AIH is efficacious and safe, which might improve liver function and immune function tests and reduce inflammatory reaction.

Objective The aim of this study was to investigate the change and its clinical significance of peripheral blood lymphocyte subsets in children and adolescents with autoimmune hepatitis (AIH). Methods 42 child and adolescent patients with AIH and 50 healthy children were recruited in our hospital from June 2015 through January 2019, and the peripheral blood mononuclear cell surface markers were detected by flow cytometry. Results The percentage of CD4⁺T cells in children with AIH was 53.1(42.5, 57.8)%, significantly higher than , while that of CD14⁺T cells was 62.2(40.1, 76.8)%, significantly lower than in healthy children, and there was no significant difference in percentage of CD8⁺T cells between the two groups 【25.9(12.5, 32.4)% vs. 18.7(12.8, 28.5)%, P>0.05); the percentages of CD45RA, CD45RO, CCR3 and CD28 on the surfaces of CD4⁺T cells in AIH patients were 26.1(15.2, 32.8)%, 19.2(13.5, 27.3)%, 15.4(2.1, 53.8)% and 51.2(34.4, 56.9)%, all significantly higher than in healthy children; the percentages of CD45RA, CCR3 and CD25 on the surfaces of peripheral blood CD8⁺T cells were 18.0(14.1, 26.8)%, 1.2(0.5, 3.2)% and 0.6(0.3, 7.8)%, significantly higher than 【13.6(8.2, 18.3)%, 0.5(0.3, 0.6)% and 0.3(0.2, 0.5)%, respectively, P<0.05], while that of CD45RO on the surface of CD8⁺T cells was 2.7(2.3, 4.8)%, significantly lower than in the control; the percentage of CD45R0 on the surface of CD14⁺T cells in children with AIH was 34.7(16.3, 57.8)%, much lower than in healthy children. Conclusion The imbalance of CD4⁺, CD8⁺ and CD14⁺T cells in peripheral blood and the abnormal expression of cell surface molecules are closely related to the onset or progression of AIH in young patients and deserve further study.

Objective The aim of this study was to investigate the expression of inflammatory factors in liver tissues of patients with different types of autoimmune liver diseases (AILD). Methods 74 patients with AILD, including autoimmune hepatitis (AIH) in 19, primary biliary cirrhosis (PBC) in 42, and autoimmune hepatitis/primary biliary cirrhosis overlap syndrome (AIH-PBC OS) in 13, were recruited in this study between December 2016 and December 2018, and the expression of interleukin-12 (IL-12), IL-17 and interferon-γ were detected by immunohistological staining. Results Serum ALT levels in patients with AIH, PBC and AIH-PBC OS were (132.5±12.5)U/L, (40.1±8.4)U/L and (166.2±16.3)U/L, serum AST levels were (120.3±11.7)U/L, (52.8±5.6)U/L and (194.7±18.3)U/L, significantly different among them (P<0.05); serum ALP levels were (98.0±9.2)U/L, (323.5±30.9)U/L and (257.1±24.1)U/L, and serum GGT levels were (49.1±4.7)U/L, (236.8±22.6)U/L and (376.7±35.5)U/L, respectively, significantly different (P<0.05); the positive rates of IL-12 in liver tissues of patients with AIH, PBC and AIH/PBC OS were not significantly different (15.8%, 7.1% and 15.4%, respectively, P>0.05), the positive rates of IL-17 were 73.7%, 76.2% and 76.9% (P<0.05), and the positive rates of IFN-γ were 68.4%, 85.7% and 76.9%, respectively, all not significantly different (P<0.05); the positive rates of anti-hepatorenal microsome type I antibody (LKM-1) and anti-soluble liver antigen/liver pancreatic antigen antibody (SLA/LP) in patients with AIH 21.1% and 10.8%, significantly higher than 0.0% and 0.0% in patients with PBC or 0.0% and 0.0% in patients with AIH-PBC OS (P<0.05); serum anti-sp100 positive rate in patients with PBC was 19.0%, significantly higher than 0.0% in patients with AIH or 7.7% in patients with AIH-PBC OS (P<0.05); serum anti- gp210 positive rate in patients with AIH-PBC OS was 38.5%, significantly higher than 0.0% in patients with AIH(P<0.05) and anti-mitochondrial M2 antibody (AMA-M2) positive rate in patients with AIH-PBC OS was 100.0%, significantly higher than 0.0% in patients with AIH or 73.8% in patients with PBC (P<0.05); serum antinuclear antibody (ANA) and anti-smooth muscle actin (SMA) positive rates in patients with AIH were 94.7% and 78.9%, significantly higher than 19.0% and 19.0% in patients with PBC (P<0.05). Conclusion Serum autoantibodies in patients with different types of AILD are cross-positive in some instance, and the expression of inflammatory cytokines are also not differential sometime, Therefore, the clinical diagnosis should be made by the combination of routine biochemical parameters and clinical manifestations.

Objective The aim of this study was to explore the efficacy and safety of exercise prescription in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). Methods A total of 59 patients with NAFLD were recruited in this study, and were randomly divided into exercise-intervened (n=33) and control group (n=26). The patients with NAFLD in the intervention group were givenexercise prescription with aerobic exercise and resistance movement, and those in the control were not. Results At the end of three-month intervention, the body weights, body mass index, whole body fat contents and waist circumferences in patients with NAFLD in the exercise-intervened group were from (81.9±10.4) kg, (28.5±2.4)kg/m², (25.4±4.9)kg and (92.2±6.5)cm decreased to , and the controlled attenuation parameter decreased from (281.5±15.4)dB/m through , while those parameters didn’t changed significantly in the control. Conclusion Our preliminary studies suggest that exercise prescription is safe, efficacious and tolerable in patients with NAFLD.

Objective The aim of this study was to investigate the effect of radical treatment of Helicobacter pylori (Hp) on serum inflammatory factors and lipid metabolism in patients with Hp-positive nonalcoholic fatty liver disease (NAFLD). Methods 168 patients with Hp-positive NAFLD were enrolled to our hospital between June 2015 and June 2019, and were divided randomly into two groups, with 84 cases in each. The patients in control group received polyene phosphatidylcholine and metformin, while those in the observation group received standardized therapy for Hp eradication at the base of treatments in the control. Serum levels of tumor necrosis factor-alpha (TNF-alpha), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and IL-8 were assayed, and fasting blood glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) were also detected. Results At the end of one month after radical therapy, the eradication rate of Hp in the observation group was 94.0%, while no negative cases of Hp was found in the control (P<0.05); serum TNF-alpha in the observation group was (12.6±2.5) ng/L, significantly lower than , hs-CRP was (7.5±1.4) mg/L, significantly lower than , IL-6 was (12.5±2.3) ng/L, significantly lower than and serum IL-8 was (80.4±23.7) ng/L, significantly lower than in the control; blood total cholesterol level in the observation group was (3.1±0.9) mmol/L, significantly lower than , blood triglyceride was (1.5±0.8) mmol/L, significantly lower than , blood low density lipoprotein cholesterol was (0.9 ±0.4) mmol/L, significantly lower than , while blood high density lipoprotein cholesterol level was (2.4±0.3)mmol/L, significantly higher than【(1.8±0.4)mmol/L, P＜0.05】 in the control; serum FINS level in the observation group was (16.0±5.2) uIU/ml, significantly lower than , and HOMA-IR was (3.9±2.4), significantly lower than in the control. Conclusion Radical treatment of Hp might play an important role in reducing blood inflammatory factors, correcting the disorder of glycolipid metabolism and improving liver functions in Hp-positive NAFLD patients.

Objective The aim of this study was to investigate the clinical implications of soluble cluster of differentiation 163 (sCD163) and interleukin (IL)1βmRNA in patients with nonalcoholic steatohepatitis (NASH). Methods 51 patients with NASH and 51 healthy persons were enrolled in the Department of Gastroenterology in our hospital between January 2016 and March 2018, and serum levels of sCD163, visfatin and adiponectin were detected by ELISA, and blood IL-1βmRNA was assayed by RT-PCR. Results Blood glucose, low density lipoprotein (LDL-C) , triglyceride (TG) and total cholesterol levels in patients with NASH were (6.1±1.4)mmol/L,(3.6±1.1)mmol/L,(2.9±0.4)mmol/L and (6.1±0.6)mmol/L, significantly higher than [(4.5±0.3)mmol/L,(2.5±0.9)mmol/L,(2.2±0.2)mmol/L and (4.5±0.3)mmol/L, respectively, P<0.05】 in the control; serum sCD163, IL-1βmRNA, visfatin and adiponectin levels in patients with NASH were (70.7±10.4) ng/ml, (0.5±0.1), (31.1±8.4)μg/ml and (6.8±1.3)μg/ml, significantly different compared to 【(30.8±5.9) ng/ml, (0.1±0.2), (15.9±2.6)μg/ml ad (15.2±2.2)μg/ml, respectively, P<0.05】 in healthy persons; serum alanine aminotransferase, aspartate aminotransferase and gamma glutamyltranspeptidase levels in patients with NASH were(73.5±3.9)U/L, (62.7±2.8)U/L and (108.0±4.1)U/L, significantly higher than 【(33.5±3.9)U/L, (32.7±2.8)U/L and (48.0±4.1)U/L, respectively, P<0.05】 in healthy persons. Conclusion The patients with NASH have abnormal liver function tests, blood glucose and lipid metabolism imbalance, besides, they have elevatedserum sCD163, IL-1βmRNA and visfatin levels, and decreased adiponectin levels, which might hint liver injuries and poor prognosis.

Objective The aim of this study was to investigate whether laparoscopic sleeve gastrectomy (LSG) might improve liver enzyme and glycolipid metabolism disorders in obese persons with nonalcoholic fatty liver disease (NALFD). Methods 73 obese persons with NALFD were admitted to our Department of General Surgery, Second Affiliated Hospital, from May 2016 through August 2018, and all underwent LSG . The patients were followed-up for six months. Results Out of all the patients, 36 were male and 37 were female, with an average age of (31.7 ± 7.4) years; the body weight and body mass index (BMI) at the end of six months after operation were (89.0 ± 16.4) kg and (31.1 ± 4.4) kg/ m², significantly lower than (120.0±23.5) kg and (42.2±6.7) kg/m² before the surgery (P<0.01); serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and glutamyl aminotransferase levels were ( 28.6±11.3) U/L,(19.3±8.6) U/L, (67.2±15.8) U/L and (27.5±13.1) U/L, significantly lower than (61.4±23.2) U/L, (37.3±12.3) U/L,(83.2±21.3) U/L and (54.4±17.2) U/L, respectively, before surgery (P<0.01); serum fasting blood glucose, triglyceride and total cholesterol levels were (5.1±0.6) mmol/L ,(1.0±0.5) mmol/L and (4.3±1.0) mmol/L, significantly lower than (6.0±1.7)mmol/L,(1.7±0.9) mmol/L and (4.7±1.6) mmol/L, respectively, before surgery (P<0.05), while serum albumin and total bilirubin levels were (42.9±2.8) g/L and (10.9±4.9) μmol/L, not significantly different as compared to (42.8±4.2) g/L and (11.0±5.2)μmol/ L, respectively, before surgery (P>0.05). Conclusion LSG surgery could improve liver enzyme and glycolipid metabolism disorders in obese persons with NAFLD, which needs further and long-term investigation.

Objective The aim of this study was to investigate the change of anterior liver fat thickness (ALFT) and waist circumference (WC) in children with metabolic syndrome (MS). Methods The clinical data of 445 children undergoing physical examination in our hospital between February 2017 and February 2019 were analyzed retrospectively. Out of them, 54 children had non-alcoholic fatty liver disease (NAFLD) and 18 had MS. Another 54 children out of 373 healthy children were selected by age- and gender-matching for control. The ALFT, intra-abdominal fat thickness (IAFT), WC and the intima-media thickness (IMT) of carotid artery were measured by sonography, and serum parameter were also assayed. Results The ALFT, IAFT, WC in children with MS were(1.6±0.2)cm,(4.4±1.5)cm and (83.4±4.8)cm, significantly higher than【(1.3±0.4)cm,(3.4±1.5)cm and (76.8±5.3)cm, respectively, P<0.05】 in healthy or 【(1.4±0.3)cm,(3.5±1.6)cm and (80.3±5.0)cm, P < 0.05】 in children with NAFLD; the homeostasis model assessment of insulin resistance, serum high-sensitivity C-reactive protein level, systolic blood pressure and serum low density lipoprotein cholesterol level in children with MS were(5.9±1.6), (1.8±0.2)mg/L, (136.5±14.0)mmHg and (2.6±0.8)mmol/L, significantly greater than 【(3.5±1.7), (1.4±0.2) mg/L, (110.8±12.7)mmHg and (1.7±0.5)mmol/L, respectively, P < 0.05】 in healthy children or 【(4.2±1.5),(1.5±0.3)mg/L,(128.9±13.8)mmHg and (2.4±0.7)mmol/L, respectively,P < 0.05】 in children with NAFLD, while serum high density lipoprotein cholesterol level was(1.3±0.5) mmol/L, much lower than 【(1.8±0.7)mmol/L,P < 0.05】 in healthy children or 【1.4±0.5)mmol/L, P < 0.05】 in children with NAFLD; the multivariate Logistic analysis showed that ALFT (95% CI =1.098-4.198, OR=2.147, P=0.026), WC(95% CI =1.395-4.523, OR =2.512, P=0.002) and IAFT (95% CI =1.332-5.958, OR =2.817, P=0.007) were the independent risk factors for occurrence of MS in children. Conclusion The detection of ALFT by sonography is simple and easy to do, which might help to determine the presence of MS in children with NAFLD.

Objective The aim of this study was to explore blood interferon-gamma (IFN-γ) gene polymorphism in patients with acute-on-chronic hepatitis B liver failure (HBV-ACLF). Methods 60 patients with HBV-ACLF and 60 healthy persons for physical examination were recruited in our hospital from May 2017 through September 2019, blood genotyping of IFN-γ gene polymorphism sites +874T/A and +2109A/G were performed by Taqman probe quantitative PCR, and the distribution characteristics of genotypes and allele frequencies of the two polymorphism sites were observed. The correlation of the polymorphism sites to the occurrence of ACLF was analyzed by x² test and Hardy-weinberg equilibrium test. Results At IFN-γ+874T/A site, the frequency of TT genotype in patients with HBV-ACLF was 48.3%, significantly lower than 56.7%, while that of AA was 31.7%, significantly higher than 13.3%(P＜0.05) in the healthy persons, and at allele frequencies, the frequency of T allele in patients with HBV-ACLF was 58.3%, significantly lower than 71.7%, while that of A allele was 41.7%, significantly higher than 28.3%(P＜0.05) in the control; at IFN-γ+2109A/G site, the frequency of AA genotype, an Dominant allele homozygote, was 53.3%, significantly lower than 66.7%, while the frequency of GG genotype, an Recessive allele homozygote, was 28.3%, significantly higher than 10.0%(P＜0.05) in the control, and at allele frequency, the frequency of A allele in patients with HBV-ACLF was 62.5%, much lower than 78.3%, while the frequency of G allele was 37.5%, significantly higher than 21.7% (P＜0.05) in healthy persons. Conclusion IFN-γ gene polymorphism is possibly correlated with HBV-ACLF occurrence in patients with hepatitis B, and among which A allele in +874T/A locus and G allele in +2109A/G locus might be the risk gene for HBV-ACLF occurrence. Monitoring IFN-γ gene polymorphism in patients with hepatitis B might be helpful in predicting HBV-ACLF happening.

Objective The aim of this study was to investigate the therapeutic efficacy of plasma exchange (PE) in the treatment of patients with liver failure. Methods A total of 47 patients with liver failure were admitted to the Second Affiliated Hospital, Anhui Medical University from February 2015 through August 2018, and all patients underwent three or more PE treatment, and followed-up for 12 weeks. Multivariate Logistic analysis was applied to reveal the impacting factors of survival. Results At the end of 12 weeks, 22 (46.8%)survived, and 25 died; the age, baseline MELD score, PTA and APTT in the fatal group were (47.5±13.4)yr, (33.5±6.1), (23.8±10.1)% and (93.8±40.6)s, significantly different compared to , and the incidence of hepatic encephalopathy in fatal group was 64.0%, significantly higher than 27.3%(P＜0.05) in survivals; multivariate Logistic analysis showed that the age and baseline PTA were the independent factors affecting prognosis of patients with liver failure; the decreased serum bilirubin levels after PE were positively correlated to serum bilirubin levels before(r=0.866, P＜0.05), and the PTA increased most obviously after first PE treatment(P＜0.05). Conclusion Our findings suggest that patients’age and baseline PTA are the independent risk factors for short-term prognosis in patients with liver failure, and the clinicians should take these factors into consideration in clinical practice to deal with in time.

Objective The aim of this study was to explore the efficacy of transhepatic artery autologous bone marrow stem cell (BMSC) transplantation in the treatment of patients with hepatitis B-induced acute-on-chronic liver failure (HBV-ACLF). Methods 94 patients with HBV-ACLF were recruited in the Department of Hepatorenal Medicine of our hospital between May 2017 and December 2018, and were randomly divided into control (n=47) and observation group (n=47). All the patients were treated with comprehensive medical supporting treatment and plasma dialysis filtration (PDF), while those in the observation group were treated with transhepatic artery autologous BMSC transplantation at the base of PDF. All the patients were followed-up for 12 months. The Eastern cooperative oncology group (ECOG) scores and model for end-stage liver diseases (MELD) were evaluated. Results At the end of 24 week and 48 week treatment, the survival rates in the combination group were 72.3% and 53.2%, significantly higher than 48.9% and 31.9%(P<0.05) in the control; at the end of 24 week, serum albumin levels in 34 survival in the combination group was (35.8±3.9)g/L, much higher than 【(32.3±3.5)g/L, P<0.05】 in 25 survival in the control; at the end of 24 week and 48 week, the incidences of ECOG score greater than 2 were 26.5% and 12.0%, significantly lower than 56.5% and 40.0%(P<0.05) in the control; at the end of 48 week, the MELD score was (9.7±1.3), significantly lower than 【(11.4±1.5), P<0.05】 in the control. Conclusion The autologous bone marrow stem cell transplantation through hepatic artery at the base of comprehensive supporting measures might improve the albumin synthesis and raise the survival rates in patients with HBV-ACLF, which needs further investigation of its long-term efficacy.

Objective Acute kidney injury (AKI) is common in patients with cirrhosis and associated with elevated in-hospital mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) classification is a valuable clinical tool because of good prognostic efficacy. However, the International Club of Ascites (ICA) proposed a new approach for the diagnosis of AKI in patients with cirrhosis recently. This study aims to compare the clinical implication of these two classification systems with regard to in-hospital mortality. Methods 245 cirrhotic patients consecutively admitted to intensive care unit (ICU) of our hospital from 2010 to 2015 were retrospectively analyzed, and the demographic and clinical materials were collected. The incidence of AKI was determined according to KDIGO and ICA classification. The primary end point was in-hospital mortality. Results The overall in-hospital mortality in this series was 63.7%, and the incidences of AKI during ICU stay were 63.7% and 58.4% according to the KDIGO and ICA classification, associated with increased in-hospital mortality of 78.8% and 78.3%, respectively; The AKI and urine output were the independent risk factors for in-hospital mortality, and the risk factor for AKI occurrence by KDIGO (OR=1.703) was greater than that of ICA (OR=1.547). The AUROC for in-hospital mortality by ICA and KDIGO were 0.708 and 0.762, respectively, with significant difference (P=0.014). Conclusion The KDIGO classification is an useful scoring system for risk stratification, and it might provides us a more accurate tool for the prediction of prognosis in patients with cirrhosis admitted to ICU.

Objective The aim of this stud was to explore the value of endoscopic ultrasonography (EUS) in the diagnosis of esophageal varices (EV) and gastric fundus varices (GV) in patients with hepatitis B –induced liver cirrhosis. Methods Eighty-nine patients with hepatitis B liver cirrhosis (Child class A in 22 cases, Child class B in 45 cases and Child class C in 22 cases) were included in the Department of Gastroenterology in our hospital between February 2016 and February 2019, and all patients underwent EUS and routine endoscopic examination. The diameters of all varices at the levels of splenic veins and azygos veins in our series were measured by both methods. Results The routine endoscopic examination showed that the prevalence of EV was 46.1%, significantly higher than 28.1% (P<0.05), while the incidence of GV was 30.3%, significantly lower than 39.3%(P<0.05) by EUS; as for the Child classification of liver functions, the prevalence of EV out of patients with Child class B and class C by EUS were 24.4% and 50.0%, significantly lower than 42.2% and 81.8%(P<0.05) by routine endoscopic examination, while in patients with Child class B, the GV prevalence by EUS was 37.8%, significantly higher than 22.2%(P<0.05) by routine endoscopic examination; the diameters of EV and GV by EUS were (7.0±0.7) mm and (6.8±0.6)mm, not significantly different as compared to 【(7.1±0.6)mm and (7.1±0.6) mm, respectively, P>0.05】 by routine endoscopic examination. Conclusion The gastrointestinal hemorrhage risk in patients with liver cirrhosis is high, and the endoscopic examination is the gold approach for the finding of EV and GV. The EUS is a promising supplementary way for the varices examination, especially for GV, which warrants further investigation.

Objective The aim of this study was to analyze the clinical characteristics and risk factors of portal vein thrombosis (PVT) in patients with liver cirrhosis (LC). Methods A retrospective analysis was made on 160 patients with LC admitted to our Department in our hospital from February 2015 through February 2019. The clinical symptoms, laboratory indexes and general data of patients were collected. The multivariate Logistic analysis was applied to evaluate the risk factors of PVT. Results The incidence of abdominal pain, ascites and gastrointestinal hemorrhage, and the platelet (PLT) counts and white blood cell (WBC) counts in 80 patients with PVT were significantly higher than those in 80 patients without PVT; the multivariate Logistic analysis showed that the PLT counts, diabetes and splenectomy were the independent risk factors for PVT in patients with LC (P<0.05). Conclusion The ascites, gastrointestinal hemorrhage and liver dysfunction are the main clinical manifestation in patients with LC and PVT, and the PLT counts, diabetes and splenectomy are the main independent risk factors for portal vein thrombosis.

Objective The aim of this study was to observe the short-term efficacy of ornithine aspartate and a herbal compound, Xingnaojing, combination in treatment of patients with hepatitis B liver cirrhosis (LC) complicated by hepatic encephalopathy (HE) . Methods 62 hepatitis B-induced LC patients with HE were randomly divided into observation (n=31) and control group (n=31). The patients in the control group were treated with Xingnaojing, and those in the observation group were treated with ornithine aspartate at the basis of treatment in the control group. The regimen in both groups lasted for 2 weeks. Serum interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were detected by ELISA, and the cognitive functions were evaluated by number connection test (NCT), digital symbol (DS), mini-mental state examination (MMSE) and Hasegawa dementia scale (HDS). Results At the end of two week treatment, the fatality rate in observation group was 19.4%, significantly lower than 35.5%(P<0.05) in the control; after discontinuation of the regimen, the MMSE score in the observation was (28.1±3.2), significantly higher than 【(22.1±2.8), P<0.05】, the HDS score was (27.7±2.6), significantly higher than 【(19.0±2.1), P<0.05】, the DS score was (60.7±1.9), much higher than 【(43.1±4.0),P<0.05】, while the time of NCT was (51.6±5.9)s, significantly shorter than 【(62.4±6.5)s, P<0.05】 in the control; serum IL-6 level in the observation was (11.8±0.9)ng/L, much lower than 【(14.9±1.0)ng/L, P<0.05】, serum CRP level was (13.6±1.7)ng/L, significantly lower than 【(15.5±1.9)ng/L, P<0.05】, and serum TNF-α levels was (12.0±1.0)ng/L, significantly lower than 【(15.9±1.2)ng/L, P<0.05】 in the control; blood ammonia level in the observation was (54.9±5.6)μmol/L, significantly lower than 【(85.3±8.7)μmol/L, P<0.05】 in the control, while there were no significant differences as respect to total serum bilirubin and albumin levels between the two groups (P<0.05). Conclusion The use of isophanate ornithine and Xingnaojing combination is effective in the treatment of patients with LC and HE, which might inhibit the inflammatory reaction and decrease blood NH3 levels.

Objective The aim of this study was to investigate the prevention of portal vein thrombosis (PVT) in patients with cirrhotic portal hypertension after spleen resection and devascularization. Methods 60 patients with cirrhotic portal hypertension were recruited in our hospital between January 2017 and March 2019, and all underwent splenectomy and periorbital devascularization. After operation, the patients were randomly divided into group A (n=30) and group B (n=30), and the patients in group B were given very short-term anti-coagulant therapy when any parameters suggesting necessary. Results 20 patients (66.7%) out of 30 in group B received anti-coagulant therapy after operation, and at the end of three weeks, the sonography demonstrated PVT in 15 patient (25.0%), 11(36.7%) in group A and 4【(13.3%),P<0.05】 in group B; the portal diameter in patients with PVT was (1.5±0.3)cm, not significantly different compared to 【(1.4±0.2)cm, P>0.05】 in those without PVT, while the blood velocity in patients with PVT was (12.3±1.4)cm/s, much slower than 【(14.5±1.7)cm/s, P＜0.05】 in patients without; serum D-dimer level in patients with PVT was much higher than that in patients without PVT (P<0.05); the platelet count in patients with PVT was (142.6±58.9)×10⁹/L, significantly higher than thatin those without . Conclusion The application of splenectomy and devascularization in the treatment of patients with cirrhotic portal hypertension might lead to the PVT under some circumstances, and anti-coagulant therapy should be given in time to prevent it happening.

Objective The aim of this study was to investigate the clinical significance of cancerous family with sequence similarity 49 member B (FAM49B) gene in patients with hepatocellular carcinoma (HCC). Methods The Oncomine and GEPIA databases were applied to analyze the gene level of FAM49B in HCC tissues and normal liver tissues. HCC dataset was collected from the Cancer Genome Atlas (TCGA) database. The gene levels of FAM49B in patients with different clinic-pathological features were analyed by SPSS 21.0. The impact of FAM49B gene on prognosis was analyzed by Kaplan Meier Plotter. The MethHC database was used to analyze the FAM49B promoter methylation. The String database was used to analyze the network of protein interaction between FAM49B and others, and gene set enrichment analysis (GSEA) was used to predict the possible signal pathways of FAM49B in HCC. Results Studies on Oncomine and GEPIA database showed that FAM49B gene level in HCC tissues was higher than that in normal liver tissues (both P<0.01); the gene levels of FAM49B were different significantly between different gender(P=0.001), with or without cirrhosis(P=0.003) and degree of tumor differentiation(P=0.004), but not between ages, tumor sizes, pathological stages, serum alpha-fetoprotein levels and with or without vascular invasion (all P>0.05); the patients with high cancerous FAM49B level had shorter overall survival than those with low gene level (HR=1.8, P=0.0012); the FAM49B promoter methylation in cancerous tissues was lower than that in normal liver tissues (P<0.005); the proteins interaction with FAM49B included SERPINA1, ISLR and FERMT3, etc.; the samples with high level of FAM49B mRNA showed enrichment of genes in the pathways of apoptosis, cell cycle, regulation of autophagy and P53 signaling pathway (all P<0.05). Conclusion FAM49B is highly expressed in cancerous tissues in patients with HCC, showing a oncogene feature, and those with higher FAM49B gene level is associated with the poor prognosis.

Objective The aim of this study was to explore the value of ultrasound (US), computerized tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of intrahepatic tumor activity in patients with primary liver cancer (PLC) after interventional therapy. Methods 60 patients with PLC were treated with transcatheter arterial chemoembolization (TACE) in our hospital between March 2015 and January 2019. The US, CT, MRI and digital subtraction angiography (DSA) were performed 3 to 5 weeks after operation. The results of DSA were used as gold standard to observe the efficacies of US, CT and MRI in evaluating residue tumor activities. Results Out of 60 patients with PLC, the DSA examination demonstrated 72 lesions 3 to 5 weeks after TACE, and based on which, the MRI showed 65(90.3%) lesions, the US showed 34 (47.2%) lesions, and the CT scan showed 55(76.4%) lesions, suggesting the poor US detections (P<0.05); the sensitivity (Se), specificity (Sp) and accuracy (Ac) of MRI were 87.5%, 95.8% and 83.3%, while those by US were 41.6%, 97.9% and 39.5%, and by CT were 75.0%, 89.5% and 64.5%, indicating that the Se and Ac of MRI scan were superior to US or CT, and the Sp by the three methods were similar (P＜0.05). Conclusion MRI is of high value in evaluating intrahepatic residue tumor activity in patients with PLC after TACE.

Objective The aim of this study was to investigate the clinical value of enhanced CT texture analysis technique in predicting short-term recurrence of liver tumor in patients with hepatocellular carcinoma (HCC) aftertranscatheter arterial chemoembolization (TACE). Methods 70 patients with unresectable HCC were recruited between November 2016 and November 2019, and all of them received TACE and enhanced CT scanning for follow-up. The tumor boundary was drawn layer by layer on the enhanced CT axial image by texture analysis technology, and the mean, entropy, skewness, kurtosis, and nonuniformity were obtained. The area under the receiver operating characteristic (ROC)curve (AUROC) was applied to analyze the predictive value of the above texture analysis parameters for the risk of short-term recurrence of tumors after TACE. Results The tumor showed short-term recurrence in 40 cases, and non-short-term recurrence in 30 cases in our series; the mean of CT texture in patients with short-term tumor recurrence was 20553.8±4094.5, significantly lower than (23407.3±4634.3, P<0.05) in patients without; the entropy and unevenness were 4.2±0.3 and 0.26±0.12, significantly higher than in patients without, while there were no significant differences in skewness and kurtosis between the two groups (P>0.05); the ROC curve analysis showed that the mean, entropy and nonuniformity had certain predictive value for the risk of short-term tumor recurrence after TACE, with the AUC of 0.785, 0.694 and 0.761, respectively. Conclusion The enhanced CT texture analysis technique has an important predictive value for the risk of short-term tumor recurrence in patients with HCC after TACE, which needs further investigation.

Objective The aim of this study was to compare the clinical efficacy of fluorescent laparoscopic hepatectomy (FLH) and conventional laparoscopic hepatectomy (CLH) in the treatment of patients with hepatocellular carcinoma (HCC). Methods 148 patients with HCC were admitted to our hospital between August 2014 and August 2017, and were randomly divided into two groups,with 74 cases in each group. The patients in the control group underwent CLH, and those in the observation group underwent FLH. All patients were followed-up for 3 years. Results The tumor cell positive rate of surgical margins in the observation group was 2.7%, significantly lower than 13.5% in the control group(x²=5.804,P=0.016); there was no significant difference in perioperative period complications incidences such as pleural effusion, incision infection, bile leak and peritoneal bleeding in the two groups (P＞0.05); there were no significant differences as respect to six-month, 1-yearand 2-year survival rates (98.6%, 94.6% and 90.5% vs. 95.9%, 93.2% and 86.5%,P＞0.05) between the groups, but the 3-year survival rate in the observation group was85.1%, much higher than 70.3% in the control (P＜0.05); the 3-year tumor recurrence rate in the observation was 27.0%, significantly lower than 47.3% in the control group (P<0.05). Conclusion The fluorescent laparoscopic hepatectomy could visualize the incision margin of hepatic tumors which might improve the survival rate of patients with HCC.

Objective The purpose of this study was to summarize the enhancement pattern of liver metastases (LM) in contrast-enhanced ultrasonography (CEUS). Methods A total of 76 patients with LM were encountered in our hospital between January 2016 and January 2019, and all of them underwent CEUS and CT scan. The diagnosis of LM was proven by post-operational or liver biopsy with typical pre-operational MRI and / or CT scan. According to the enhancement feature of the lesions in hepatic arterial phase of CT scan, the lesions were divided into poor blood supply (hypovascular, low density in hepatic arterial phase) and rich blood supply (hypervascular, high or equal density). Results The primary foci of liver metastases in our series included colon cancer in 65.8%, breast cancer in 9.2%, lung cancer in 6.6%, gastric cancer in 6.6%), pancreatic cancer in 5.3%, pancreatic neuroendocrine tumors in 3.9% and ovarian cancer in 2.6%; the hypovascular group of LM arisen from colon cancer, lung cancer, gastric cancer, pancreatic cancer and ovarian cancer, and the hypervascular group were from neuroendocrine tumors and breast cancer; the CEUS arterial phase imaging showed homogeneous hyperenhancement, rim-like hyperenhancement, heterogeneous hyperenhancement and isoenhancement; at arterial phase, the incidences of focal homogeneous hyperenhancement, rim-like hyperenhancement, isoenhancement and heterogeneous hyperenhancement in 108 foci in hypovascular group were 52.8%, 35.2%, 3.7% and 8.3%, significantly different as compared to 87.5%, 12.5%, 0.0% and 0.0%, respectively (P<0.05) in 24 hypervascular foci; at portal phase, the incidences of hypoenhancement and isoenhancement in foci with poor blood supply were 99.1% and 0.9%, and at delayed phase, the incidences of hypoenhancement and isoenhancement were 99.1% and 0.9%, significantly different as compared to 70.8%, 29.2%, 79.2% and 20.8%, respectively (P<0.05) in rich blood supply; the initial time of enhancement and the enhancement time to peak in hypovascular group were (17.6±3.8)s and (23.0±4.8)s, much longer than in hypervascular group, while the washout time was(41.1±23.4)s, significantly shorter than in hypervascular group. Conclusion The common LM is poor blood supply foci, with homogeneous CEUS hyperenhancement and quick clearance, and the demonstration of primary foci is helpful for the diagnosis of LM in clinical practice.

Objective The aim of this study was to summarize the contrast-enhanced ultrasonography (CEUS) imaging manifestation of liver abscess (LA). Methods 120 patients with LA were admitted to our hospital from April 2016 through April 2019, and all patients underwent routine two-dimensional ultrasonography and CEUS before abscess puncture drainage. The consistency of CEUS and routine two-dimensional ultrasound in diagnosis of LA was compared. Results Out of the120 patients, 22 cases were at inflammatory stage of abscess, 42 cases wereat early abscess formation and 56 cases were at abscess formation; 107 cases (89.2%) were detected by routine two-dimensional ultrasonography, and among them, the abscesses at inflammatory and at early stage of abscess formation showed irregular or regular lesions with unclear or clear boundary, without liquid dark area in the lesions and having blood flow signals, and those at abscess formation demonstrated the irregular or regular lesions with unclear orclear borders and fluid dark areas without blood flow signals; 117 LA cases (95.0%) were detected by CEUS, and among them, the abscesses at inflammatory stage of abscess and at early stage of abscess formation presented high enhancement at the arterial phase, low enhancement at portal venous and delayed phase with the display range larger than that by conventional ultrasound, and those at abscess formation manifested high enhancement at arterial phase, low enhancement at portal vein and delayed phase, and their display range significantly larger than that by conventional ultrasound; the sensitivity, specificity, positive predictive value, negative predictive value and Kappa value by CEUS were 95.0%, 76.9%, 89.7%, 33.3% and 0.88, respectively. Conclusion The LA CEUS imaging manifestations have their own characteristics, and the sensitivity, specificity and accuracy of diagnosis by it are high, and we recommend its application when the diagnosis is obscure.

Objective The aim of this study was to investigate the risk factors of ischemia-type biliary lesions (ITBL) in recipients of liver transplantation (LT). Methods 312 patients with terminal benign and malignant liver diseases including 143 patients (45.8%) with primary liver cancer were recruited in our hospital between January 2015 and February 2019, and the ITBL was diagnosed according to the results of liver functions, cholangiography and imaging after LT. The clinical characteristics of ITBL in patients after LT were analyzed by donor and recipient-related clinical data, and univariate and multivariate Logistic regression analysis were performed. Results Postoperative ITBL occurred in 37 cases (11.9%), and 19 (51.4%) of them belonged to extrahepatic bile duct lesions; the Logistic regression analysis showed that the amount of infusion plasma (OR=1.175, P=0.006), the 1-week resistive index of hepatic artery (OR=8.891, P=0.030), acute rejection (OR=7.022, P=0.022), and cold ischemia time ≥11.5 h (OR=1.055, P=0.014) were the independent factors led to ITBL occurrence. Conclusion The recipients of LT are prone to developing ITBL, and the clinicians should take the common induced factors into consideration and deal with appropriately in time to achieve an optimal efficacy.

Objective The aim of this study was to analyze the analgesic and sedative effects of dexmedetomidine and propofol combination in patients undergoing laparoscopic cholecystectomy (LC). Methods 248 patients with holecystolithiasis were admitted to the Department of Hepatobiliary Surgery in our hospital between July 2015 and May 2019, and were randomly divided into control and observation group, 124 cases in each. All the patients underwent LC, and the patients in observation group were given intravenous infusion of dexmedetomidine at 0.5 g.kg^-1 10 minutes before the anesthesia induction intubation, followed by intravenous infusion of it at 0.25 g.kg^-1·h^-1 until the operation was completed. The patients in control group were intravenously given normal saline before the induction of anesthesia, and the other anesthetic drugs were the same except dexmedetomidine. The analgesia and sedation were evaluated by numerical rating scale (NRS) and Ramsay scale. Serum dismutase (SOD)and malonicdialdehyde (MDA) were detected by ELISA, and serum total superoxide antioxidant capacity (T-AOC) was also obtained. Results At two, six and twelve hours, the NRS score in the observation group were (2.5±0.7), (2.8±1.3) and (2.6±1.0), significantly lower than 【(3.1±0.6), (3.3±0.8) and (3.9±0.9), respectively, P<0.05】 in the control, and Ramsay scale score were (2.7±0.8), (2.7±1.0) and (2.9±1.0), significantly higher than 【(1.5±0.6), (1.9±0.5) and (2.1±0.4), respectively, P<0.05】; at five hour post-operation, serum SOD level in the observation group was (90.4±10.5) U/mL, significantly higher than 【(82.6±9.8) U/mL, P<0.05】 in the control, serum T-AOC was (15.3±2.4) U/mL, much higher than 【(12.2±2.0) U/mL, P<0.05】 in the control, while serum MDA level was (3.2±0.6) mmol/mL, significantly lower than 【(4.5±0.8) mmol/mL, P<0.05】 in the control; the incidence of adverse reactions such as nausea, vomiting and dizziness was not significantly different between the two groups (2.4% vs. 1.6%, P>0.05). Conclusion The application of dexmedetomidine and propofol combination for anesthesia in patients with cholecystolithiasis undergoing LC is efficacious for improving the perioperative analgesia and sedation, which might be related to the inhibition of oxidative stress and is worthy of clinical verification.

Objective The aim of this study was to investigate the efficacy of ultrasound-guided percutaneous transhepatic cholangiography (PTCD) in the treatment of patients with acute obstructive suppurative cholangitis ((AOSC). Methods 78 patients with AOSC were recruited in our hospital between March 2015 and November 2018, and were randomly divided into control (n=39) and observation group (n=39) . The patients in the control group were treated with conventional laparotomy, and those in the observation group were treated with ultrasound-guided PTCD. Results The operative time, the amount of bleeding, the time of indwelling drainage tube and the hospital stay in PTCD-treated patients were (89.7±7.5) min, (26.3±2.4) ml, (8.8±1.0) d and (9.7±1.5) d, significantly less or shorter than in the control; After treatment, serum levels of procalcitonin, interleukin-6, interleukin-4 and C-reactive protein in the observation group were (5.9±0.8) ng/L, (87.8±7.4) ng/L, (14.7±1.5) ng/L and (2.1±0.5) mg/L, significantly lower than in the control; the complication rate in the observation group was significantly lower than that in the control group (5.1% vs. 23.1%, P<0.05). Conclusion Ultrasound guided PTCD treatment of patients with AOSC is efficacious, which effectively improve the surgery-related indexes and reduce complications, which might be related to mild inflammatory reaction.

Objective The morbidity of autoimmune liver disease (AILD) is increasing year by year, and it is one of the hotspots in research on liver diseases. Western medicine has definite curative efficacy, while it combines with traditional Chinese herbal medicine might benefit patients more by improving the efficacy, reducing side effects, improving patient's quality of life, and prolonging survival time. This article reviews the current progress on herbal and western medicine combination in treatment of patients with AILD.