Objective The aim of this study was to investigate the effects of dihyd rocurcumin (DHC) on apoptotic pathway in palmitic acid (PA)-induced BRL-3A cell apoptosis in vitro. Methods The non-alcoholic steatohepatitis (NASH) cell model was established by PA induction in BRL-3A cells. The survival rate of BRL-3A cells was detected by MTT assay. The cells were divided into control with normal medium, model (0.25 mM PA) and DHC intervention group with 16, 32, 64 μM DHC culture. The content of lactate dehydrogenase (LDH) in cell culture supernatant was detected. The apoptosis was detected by flow cytometry. The cell mitochondrial membrane potential (MMP), activity of apoptosis-related protease Caspase-3 and Caspase-9 were detected and the protein expression of mitochondrial apoptosis-related proteins Bcl-2 and Bax was detected by Western blotting. Results The supernatant LDH level, activities of Caspase-3 and Caspase-9 in model group were (100.1 ± 4.2)%, (1.0 ± 0.2)% and (1.0 ± 0.1)%, much higher than in the control, while the MMP was lower than that in control group ; the LDH, Caspase-3 and Caspase-9 in 32 μM DH-intervened cells were (84.4±2.4)%, (0.8±0.1)% and (0.7±0.1)%, significantly lower than those in the model (P<0.05), whilethe MMP was (0.6±0.1)%, much higher than that in the model (P<0.05); the apoptotic rate in the model group was significantly increased as compared to that in the control, while it decreased greatly as compared with model in DHC-intervened group; the relative expression of Bcl-2 protein in model group was lower than that in control group , while the relative expression of Bax protein was higher than that in control group , but the relative expression of Bcl-2 protein in 32 μM DHC- treated group and 64 μM DHC-treated group were (1.3 ± 0.1) and (1.9 ± 0.2), much higher than those in the model group (P<0.05), and the relative expression of Bax protein were (0.7 ± 0.1) and (0.6 ± 0.1), much lower than those in the model group (P<0.05). Conclusion DHC might relief the apoptosis caused by PA inBRL-3A cells by inhibiting the mitochondria-mediated apoptotic pathway.

Objective The aim of this study was to investigate the effects of herbacetin on hepatic steatosis and intrahepatic oxidative stress in rats with non-alcoholic steatohepatitis (NASH). Methods The high-fat diet was applied to induce SD rats for 12 weeks to establish models of NASH, and at the same time, the herbacetin at dose of 20 mg·kg^-1.d^-1 and 40 mg·kg^-1.d^-1 were administered daily intragastricly. Serum free fatty acid (FFA) , malondialdehyde (MDA) in liver homogenate, and activities of superoxide dismutase (SOD), peroxidase (CAT), glutathione peroxidase (GSH-Px) and heme oxidase (HO-1) were detected. The hepatic protein expression of Nrf2, cytochrome P450 enzyme 2E1 (CYP2E1) and cytochrome P450 enzyme 4A (CYP4A) were assayed by Western blotting. Results The body weight, liver weight and liver indexin model group were (499.2±14.1) g, (15.9±0.6) g and (3.2±0.1)% , much higher than in the control; the body weight, liver weight and liver index in low-dose and high-dose of herbacetin-intervened group were much lower than those in the model (P<0.05); serum FFA level in the model was (521.5±52.3) mmol/L, significantly higher than in the control; the liver homogenate levels of SOD, CAT, GSH-Px and HO-1 in the model were (294.2±35.4) U/mg, (19.5±6.4) U/mg, (362.4±104.2) U/mg and (4.1±0.4) ng/mg, all significantly lower than in the control; the liver homogenate levels of SOD, GSH-Px and HO-1 in low-dose and high-dose of herbacetin-intervened group were much higher than those in the model (P<0.05); the hepatic Nrf2 expression in the model was significantly weaker than that in the control, while the hepatic CYP2E1 and CYP4A expression was much stronger than in the control (P<0.01); the hepatic Nrf2 expression in low-dose and high-dose of herbacetin-intervened group increased(P<0.01), while hepatic CYP2E1 and CYP4A expression deeply decreased as compared to those in the model (P<0.05). Conclusion The herbacetin could improve lipid accumulation and oxidative stress disorder in the liver tissues of rats with NASH, and the anti-oxidation mechanism might be related to the regulation of Nrf2 gene expression.

Objective The aim of this study was to investigate the impact of serum interferon-γ (IFN-γ), interleukin-4 (IL-4) and IL-10 levels on maternal-infant transmission of hepatitis B virus (HBV) in HBsAg positive women. Methods 126 pregnant women with serum HBsAg positive and 55 healthy pregnant women were recruited in our hospital from August 2017 through July 2019, and IFN-γ, IL-4 and IL-10 levels in women’s sera and in neonatal umbilical vein blood were assayed by ELISA. The receiver operating characteristic (ROC) curve and multivariate Logistic regression model were applied to analyze the risk factors affecting HBV mother-to-child transmission. Results Out of our series, the mother-to-child transmission occurred in 15 cases, and 30 cases from 111 women without mother-to-child transmission were selected for control; serum level of IFN-γ in intrauterine infection group was (681.3±141.6) pg/ml, and serum level of IL-10 was (62.3±11.4) pg/ml, both significantly lower than in intrauterine non-transmited group or in the control, while serum IL-4 level was (68.1±22.9) ng/L, which was significantly higher than in women without intrauterine transmission or in healthy women; newborn umbilical vein blood cytokine levels in the three groups were not significantly different (P>0.05); ROC showed that the AUC for predicting mother-to-infant transmission by serum IFNγ levels in pregnant women was 0.877 (95%CI:0.810-0.945),the cut-off value was ≤782.36 pg/ml, the diagnostic sensitivity was 100.0%, and the specificity was 69.4%. Conclusion There is a immune function regulation disorders in pregnant women with HBV infection and the detection of serum IFNγ, IL-4 and IL-10 levels might be used as an indicator to evaluate the risk of mother-to-child transmission of HBV, and provide information for clinical prevention and treatment measures.

Objective The aim of this study was to investigate the short-term efficacy of entecavir and lactobacillus acidophilus compound combination in the treatment of patients with chronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD). Methods 128 patients with CHB complicated by NAFLD were recruited in our hospital between July 2017 and May 2019, and were randomly divided into control and observation group, with 64 patients in each group. The patients in the control group were treated with entecavir and the patients in the observation group were treated with entecavir and lactobacillus acidophilus compound combination. The observation lasted for six months. Blood lipid indexes, heme oxygenase (HO-1), cytochrome P4502E1(CYP2E1) and myeloperoxidase (MPO) were detected by ELISA, and insulin resistance index (IRI) was calculated. The hepatic steatosis was evaluated by sonography. Results At the end of six month observation, serum alanine aminotransferase level in the observation group was (38.2±10.5)U/L, and serum aspartate aminotransferase level was (35.6±9.7)U/L, both significantly lower than [(53.9±13.8)U/L and (48.1±11.6)U/L, respectively, P<0.05】 in the control, while there was no significant differences as respect to serum GGT levels 【(73.9±15.4)U/L vs.(68.2±21.3) U/L, P>0.05】 or serum HBV DNA loads 【(1.9±0.3)lg copies/ml vs.(1.7±0.4)lg copies/ml, P>0.05】 between the two groups; serum total cholesterol level was (4.2±0.5)mmol/L, and serum triglyceride level was (1.7±0.3)mmol/L, IRI was (3.1±1.2), all significantly lower than 【(5.1±0.8)mmol/L,(2.3±0.4)mmol/L and (4.3±1.5), respectively, P<0.05】 in the control; serum HO-1 level was (124.7±13.7)mg/mL, significantly higher than 【(103.2±10.4)mg/mL, P<0.05】, while serum CYP2E1 level was (3.6±0.5)U/L】, and serum MPO level was (49.5±7.3)mg/mL, both much lower than 【(5.1±0.8)U/L and (64.8±9.2)mg/mL, P<0.05】 in the control; the incidence of improved hepatic steatosis in the observation was much higher than in the control (20.3% vs. 7.8%, P<0.05). Conclusion As for the patients with CHB and NAFLD, the administration of entecavir and lactobacillus acidophilus compound might be efficacious, and improve the liver functions and lipid metabolism, which could be related to the improvement of oxidative stress.

Objective The aim of this study was to investigate the short-term efficacy of tenofovir and interferon-α2b (IFN-α2b) combination in the treatment of patients with serum HBeAg-positive chronic hepatitis B (CHB). Methods 89 patients with CHB and positive serum HBeAg were admitted to our hospital between January 2017 and August 2018, and were randomly divided into control group (n=43) and observation group (n=46). The patients in the control group were treated with tenofovir, and those in the observation were treated with IFN-α2b subcutaneously on the basis of tenofovir. The regimen lasted continuously for 48 weeks, and all patients were followed-up for 6 months. Serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and IL-10 levels were detected by ELISA, and serum hepatitis B viral deoxyribonucleotide (HBV DNA) was assayed by PCR. Results At the end of 48 week observation, serum ALT and AST levels in the combination group were (39.2±10.8)U/L and(36.4±8.2)U/L, significantly lower than 【(75.2±15.7)U/L and (56.6±12.3)U/L, respectively, P<0.05】 in the control; serum TNF-α level was (26.6±6.8)mg/L, much lower than 【(35.5±6.8)mg/L, P<0.05】, serum IL-6 level was (15.5±3.3)pg/mL, significantly lower than 【(22.4±4.1)pg/mL, P<0.05】, and serum IL-10 level was (21.4±5.7) pg/mL, significantly lower than 【(29.4±6.5)pg/mL, P<0.05】 in the control; serum HBV DNA loads in all patients in the two groups lost, and there was no significant difference as respect to serum ALT normalization in the two groups (P>0.05), while serum HBeAg and HBsAg negativity rates in the combination group were much higher than in the control (44.2% vs. 11.6%, and 13.0% vs. 0.0%, respectively, P<0.05). Conclusion Tenofovir combined with IFN-α2b in the treatment of serum HBeAg-positive CHB patients might improve serum HBeAg and HBsAg negativity, which could be related to the inhibition of cytokine reaction, but the long-term efficacy needs investigation further.

Objective The aim of this study was to investigate the diagnostic value of ultrasonic elastography combined with serological indexes in evaluation of liver fibrosis in patients with chronic hepatitis B (CHB). Methods There were 358 patients with CHB enrolled in our hospital between January 2015 and June 2018, and all of them received liver biopsies, sonography for shear wave velocity (SWV) and serum HA, AST, ALT and Ⅳ-Col were assayed, aspartate aminotransferase to platelet ratio index (APRI) and FIB-4 were calculated. Multivariate Logistic regression analysis was used to analyze the independent risk factors for hepatic fibrosis occurrence, and the area under ROC curve (AUC) was used to evaluate the accuracy of each index in the diagnosis of hepatic fibrosis. Results There were 42 cases with F0, 96 cases with F1, 86 cases with F2, 72 cases with F3 and 62 cases with F4 by histopathological examination; the SWV in 220 patients with ≥F2 was (3.12±0.65)m/s, significantly higher than 【(1.72±0.51)m/s, P<0.05】 in 138 patients with ≤F1, serum HA levels was (128.1±14.7) μg/L, significantly higher than 【(75.4±10.1)μg/L, P<0.05】, the AST/ALT ratio was (0.96±0.41), much higher than 【(0.80±0.27), P<0.05】, serum Ⅳ-Col level was (36.7±14.3)μg/L, much higher than 【(24.9±9.2)μg/L, P<0.05】, the APRI score was (0.83±0.52), much higher than 【(0.61±0.49), P<0.05】, the FIB-4 index was (1.70±0.98), much higher than【(1.23±0.67), P<0.05】 in patients with ≤F1; multivariate Logistic analysis showed than SWV, AST/ALT ratio, serum HA and Ⅳ-Col levels, APRI and FIB-4 were the independent risk factors for the occurrence of hepatic fibrosis; the accuracy by SWV in diagnosis of liver fibrosis was 86.9%, by HA was 84.2%, and by APRI and FIB-4 were 82.5% and 81.8%, respectively. Conclusion SWV combined with serological markers might improve the accuracy of hepatic fibrosis diagnosis in patients with CHB, which warrants further investigation.

Objective The aim of this study was to investigate the virological response to direct antiviral agents (DAA),erbavir/gragrevir treatment in patients with chronic hepatitis C (CHC). Methods 82 patients with CHC were recruited in this study between March 2017 and March 2018,and were randomly divided into control (n=41) and observation group (n=41). The patients in the control group were treated with peginterferon-α and ribavirin combination,and those in the observation group were given erbavir/gragrevir. The regimen in the two groups lasted for 24 weeks. Serum HCV RNA was detected by RT-PCR,and virologic genotypes were determined by direct sequencing. The efficacy was assessed by early virological response (EVR),end-of-treatment response (ETVR) and sustained virological response (SVR). Results At the end of the treatment,serum alanine aminotransaminase level in the observation group was (47.9±19.7)U/L,much lower than 【(63.5±21.2)U/L,P<0.05】, serum aspartate transaminase level was (55.5±22.3)U/L,significantly lower than 【(81.3±25.8)U/L,P<0.05】 in the control group; the EVR,ETVR and SVR in the DAA-treated group were 48.8%,63.4% and 70.7%,not significantly different as compared to 41.5%,53.7% and 65.8% in interferon-α-treated group (P>0.05); the EVR,ETVR and SVR in 18 patients with non-HCV genotypeⅠ infection receiving DAA were 88.9%,94.4% and 88.9%,significantly higher than 52.2%,60.9% and 52.2% ( P<0.05) in 23 patients with HCV typeⅠ infection,while they were not significantly different compared to 86.7%,93.3% and 73.3% in 15 patients receiving interferon-α treatment (P>0.05); the SVR₁₂ in DAA-treated patients was 87.8%(36/41),significantly higher than 73.2%(30/41,P<0.05) in patients receiving interferon-α treatment. Conclusion The elbavir/gragrevir,a new DAAs,administration in the treatment of patients with CHC have a good short-term efficacy,which warrants further multi-centre,randomized,and control study.

Objective The aim of this study was to summarize the clinical features of patients with malignant lymphoma (ML) and liver dysfunction. Methods The clinical manifestations, imaging features, pathological findings and clinical outcomes were summarized by retrospective analysis. Results The age of 9 patients was 48.47±16.02 (16～78) years; 8 complained of asthenia, 3 had fever, 5 had yellow skin and eye; serum ALT level was 192.3±292.8 u/l, AST was 192.6±222.9 U/L, serum bilirubin level was 120.4±89.5μmol/L; 7 had liver and spleen enlargement; bone marrow biopsies were performed in 5 cases, liver biopsies were in 2 cases, lymph node examination in 2 cases and gastric mucosa pathology in 1 case, all of which indicated B-cell-arose lymphoma; chemotherapy were given in 6 cases and 3 cases died, and 3 cases received regular chemotherapy and followed-up. Conclusions It is necessary to consider the possibility of ML in patients with abnormal liver function and unexplained hepatosplenomegaly. The pathological examination of liver and/or bone marrow could help the confirmation of the diagnosis.

Objective To summarize the feature of liver injuries, therapeutic medicines and disease outcomes of patients with coronavirus disease-19 (COVID-19) infection. Methods 27 patients with severe and critical COVID-19 infection were admitted to our hospital between January 22 and February 22,2020, and their clinical characteristics, liver function tests in different genders and ages,therapeutic medicines and disease outcomes were summarized retrospectively. Results Among the 27 patients with severe and critical COVID-19 infection,22(81.5%) were males and 5(18.5%) were females,aged 29 to 91 years old,with a median age of 56.0(44.0-68.0) years old; among them,16 cases (59.3%) were in the young and middle-aged group (<60 years old),and 11 cases (40.7%) were in the elderly group (>60 years old); serum levels of ALT,AST,GGT,ALP,bilirubin,PTA,direct bilirubin and LDH were abnormal in 26 cases (96.3%) at early stage,and serum levels of total bilirubin and direct bilirubin elevated in 1 patient (3.7%) during hospitalization; there were no statistically significant differences between serum levels of ALT,AST,GGT,ALP,TBIL,PTA,DBIL and LDH between the male and the female group (P>0.05); serum levels of ALT,AST,GGT,ALP,TBIL,DBIL and LDH in the young and middle-aged groups were not statistically significant compared to those in the elderly group (P>0.05); however, the PTA level decreased in the elderly group (P<0.05); 22 cases (81.5%) received combined antiviral agents, 18 patients (66.7%) received combined anti-inflammatory and immune-regulating medicines,and 14 patients (51.9%) received combined hepatoprotective drugs; within 1 month after onset of the pandemic, the survival rate in our series was 96.3%. Conclusion Patients with severe and critical COVID-19 infection are prone to liver damages at early stage of the disease, which might be related to the medications or the virus infection itself should be elucidated further.

Objective The aim of this study was to investigate the changes of serum fibroblast growth factor-21 (FGF21) and adiponectin (APN) in patients with non-alcoholic steatohepatitis (NASH). Methods 41 patients with NASH and 41 healthy persons were recruited in our hospital between July 2018 and August 2019. The fasting blood glucose (FBG), fasting insulin (FINS) and homeostasis model insulin resistance (HOMA-IR) were obtained and serum FGF21 and APN levels were detected. Results The FBG level in patients with NASH was (8.7±1.6) mmol/L,significantly higher than in healthy persons, serum level of FINS was (30.9±9.8) μIU/mL, significantly higher than , the HOMA-IR was (1.9±1.1), significantly lower than that in healthy persons , serum FGF21 level in patients with NASH was (279.7±106.4) pg/mL, significantly higher than in healthy persons and serum APN level was (2.9±0.8) μg/mL, significantly lower than in healthy persons; serum FGF21 level in 10 patients with severe NASH was (285.7±116.4) pg/mL, significantly higher than in 16 patients with moderate NASH or in 15 patients with mild NASH, serum APN level in patients with severe NASH was (2.1±0.5) μg/mL, significantly lower than in patients with moderate or in patients with mild NASH, the FBG in patients in severe group was (9.9±2.6) pg/mL, significantly higher in moderate or in mild NASH, serum FINS level in patients in severe group was (35.9±8.8) pg/mL, significantly higher than in moderate or in mild NASH, and the HOMA in patients in the severe group was (1.5±1.0), significantly lower than in moderate group or in patients with mild NASH; serum FGF21 level in 17 NASH patients with high blood pressure, diabetes or/and hyperlipoidemia was (315.7±99.2) pg/mL, significantly higher than , serum APN level was (2.6±0.7) μg/mL , significantly lower than and the HOMA-IR was (1.6±0.9) ), significantly lower than in 24 patients without. Conclusion Serum FGF21 level is highly increased in NASH patients with hypertension, diabetes, and hyperlipoidemia, and serum APN level and insulin resistance decrease in patients with NASH. The detection of serum FGF21 and APN might help evaluate disease severity in patients with NASH in clinical practice.

Objective The aim of this study was to investigate the short-term efficacy of silybin meglumine and Danning tablet, a herbal medicine, combination in treatment of patients with alcoholic hepatitis (AH). Methods 146 consecutive patients with AH were recruited in our hospital between March 2017 and June 2019, and were randomly divided into control group (n=73) and observation group (n=73). The patients in the control group were given Danning tablets, and those in the observation group were treated with silybin meglumine and Danning combination for 3 months. Serum superoxide dismutase (SOD), alondialdehyde (MDA) and free fatty acid (FFA) were detected. Results Serum total cholesterol (TC) level in the combination group was (4.9±0.7)mmol/L, significantly lower than 【(5.5±1.2)mmol/L, P<0.05】, and high density lipoprotein cholesterol (HDL-C) was (1.3±0.9)mmol/L, much higher than 【(1.0±0.5)mmol/L, P<0.05】 in the control, and serum triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) levels in the two groups were not significantly different 【(1.7±0.3)mmol/L vs. (1.7±0.7)mmol/L and (3.2±0.4)mmol/L vs. (3.4±0.7)mmol/L, respectively, P>0.05】; serum alanine aminotransferase level was (35.9±7.7)U/L, serum aspartate aminotransferase level was (39.5±6.3)U/L, serum glutamyl transpeptidase level was (123.8±6.6)U/L, and serum alkaline phosphatase level was (57.3±12.5)U/L, all significantly lower than those in the control [(63.5±9.2)U/L,(65.5±7.8)U/L,(145.7±7.2)U/L and (78.4±13.1)U/L, respectively, P<0.05】; serum SOD level was (132.9±19.3)nmol/L, much higher than 【(105.5±12.6)nmol/L, P<0.05】, serum MDA level was (9.5±2.3)nmol/L, significantly lower than 【(14.4±3.6)nmol/L, P<0.05】, and serum FFA level was (24.3±3.1)nmol/L, much lower than 【(30.2±3.3)nmol/L, P<0.05】 in the control. Conclusion The administration of silybin meglumine and a herbal medicine combination in treatment of patients with AH might in short-term ameliorate blood lipid metabolism, inhibit oxidative stress and improve liver functions, which needs further multi-central investigations.

Objective The aim of this study was o investigate the short-term efficacy of polyene phosphatidylcholine and bicyclol combination in treatment of gastric cancer patients with chemotherapy-induced liver injury. Methods 78 patients with gastric cancer were admitted to our hospital between May 2017 and May 2019, and all of them underwent radical resection of gastric cancer and received chemotherapy. During the treatment, the drug-induced liver injuries (DILI) was found in 40 patients. Out of them, 19 received with polyene phosphatidylcholine and 21 with polyene phosphatidylcholine and bicyclol combination therapy for liver interleukin-6 (IL-6), malondialdehyde (MDA) function protection for 4 weeks. Serum tumor necrosis factor (TNF-α), and superoxide dismutase (SOD) levels were assayed, respectively. Results At the end of four week treatment, serum alanine aminotransferase level in the combination group was (33.5±7.9)U/L, significantly lower than 【(42.4±8.8)U/L, P<0.05】, serum aspartate aminotransferase level was (34.4±5.7)U/L, much lower than 【(39.4±6.2)U/L, P<0.05】, serum alkaline phosphatase level was (60.6±14.2)U/L, significantly lower than 【(75.3±16.6)U/L, P<0.05】, while Karnofsky performance status score was (64.1±17.2), much higher than 【(48.3±14.5), P<0.05】 in the control; the rate of liver function test normalization in the combination group was 81.0%, significantly higher than 63.2%(P<0.05) in the control; serum TNF-α level in the combination group was (15.2±2.1)mg/L, significantly lower than 【(21.4±3.6)mg/L, P<0.05】, serum IL-6 level was (28.1±4.5)pg/mL, significantly lower than 【(46.2±5.9)pg/mL, P<0.05】, serum MDA level was (5.1±0.8)nmol/mL, significantly lower than 【(5.9±0.7)nmol/mL, P<0.05】, while serum SOD level was (2.3±0.5)U/mL, much higher than 【(1.8±0.4)U/mL, P<0.05】 in the control. Conclusion The application of bicyclol combined with polyene phosphatidylcholine in treatment of patients with DILI could improve liver function recovery, which might be related to the inhibition of oxidative stress and cytokine burst.

Objective The aim of this study was to analyze the short-term efficacy of yinzhihuang, a herbal medicine, and adenosine methionine combination in the treatment of patients with intrahepatic cholestasis of pregnancy (ICP) . Methods 74 patients with ICP were admitted to our hospital between July 2016 and May 2019, and were randomly divided into control (n=37) and observation group (n=37) . The patients in the control group were treated with UDCA and adenosine methionine, and those in the observation group were treated with yinzhihuang at the base of UDCA and adenosine methionine. The regimen continued about four weeks until delivery. Serum tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), IL-18 and transforming growth factor-β (TGF) were detected by ELISA, and itch score was assessed by Ai Ying modified criteria and sleeping was by Pittsburgh sleep quality index (PSQI). Results At about four week treatment before delivery, serum alanine aminotransferase level was (39.7±6.2) U/L, significantly lower than [(58.5±7.4) U/L, P<0.05) , serum aspertate aminotransferase level was (42.9±6.6) U/L, significantly lower than [(63.1±8.3) U/L, P<0.05), total serum bilirubin level was (15.4±4.8) μmol/L, significantly lower than [(19.7±6.5) μmol/L, P<0.05), serum total bile acid level was (13.2±3.7) μmol/L, significantly lower than , the itch score was (1.2±0.3) points, significantly lower than , and the PSQI score was (8.9±2.5) points, significantly lower than in the control; serum TNF-α levels was (29.4±5.3) ng/L, significantly lower than [(38.2±6.1) ng/L, P<0.05), serum IL-18 level was (38.2±6.7) ng/L, significantly lower than [(45.6±7.8) ng/L, P<0.05), and serum TGF-β levels was (4.2±1.5) ng/L, significantly lower than in the control; the incidence of adverse pregnancy outcomes and neonatal adverse outcomes in the two groups were not significantly different (32.5% vs. 35.5%, and 11.7% vs. 12.9%,respectively, P>0.05). Conclusion The application of Yinzhihuang conpound and adenosine methionine combination in the treatment of patients with ICP have a good efficacy, which might significantly improve liver function tests, reduce serum cytokine levels, relieve pruritus symptoms and improve sleep.

Objective The purpose of this study was to investigate the feasibility of non-invasive evaluation by contrast-enhanced ultrasound (CEUS) in patients with radiation-induced liver injury (RILI). Methods A total of 42 patients with abdominal malignant tumors received radiotherapy in our hospital between June 2016 and January 2020. Color Doppler CEUS was conducted for measurement of the time to peak (TTP), the gradient (GRAD) and the area under the curve (AUC) in the livers. Results The TTP in the 42 patients at baseline, two, three and four weeks after radiotherapy were (14.2±2.4)s, (18.5±3.0)s, (23.2±3.2)s and (30.1±4.0)s, respectively, with significant differences between them (P<0.05); the GRAD were (2.1±0.2), (1.6±0.1), (1.0±0.1) and (0.7±0.1), significantly different (P<0.05), while the AUC were (3220.8±120.4), (2910.9±102.5), (2785.5±101.2) and (3248.6±89.5), lacking regularity; at week three and four, serum ALT levels were (45.5±9.8)U/L and (60.8±10.5)U/L, serum AST levels were (44.8±10.2)U/L and (61.2±12.5)U/L, serum GGT levels were (74.3±7.5)U/L and (86.3±8.0)U/L, and serum AKP levels were (96.8±36.0)U/L and (105.8±40.2)U/L, respectively, all significantly higher than at baseline or at week two after radiotherapy(P<0.05), meeting the diagnosis of RILI. Conclusion The measurementof TTP, GRAD and AUC by CEUS scan could be used as an important quantitative index for early diagnosis of RILI in patients with malignant tumors undergoing radiotherapy, which might accurately and objectively evaluate the changes of intrahepatic microcirculation in acute RILI.

Objective The aim of this study was to investigate the efficacy of adenosylmethionine and blue light treatment in neonatal jaundice. Methods 196 children with neonatal jaundice were treated in our hospital between May 2017 and May 2019, and they were divided randomly into control (n=98) and observation group (n=98). The neonates in the control group were given blue light illumination (BLI), and those in the observation group were treated with adenosylmethionine succinate enteric-coated tablets and BLI combination for one week. All the children were followed-up for one week. Serum transferrin (TRF) and C-reactive protein (CRP), creatine kinase (CK) , creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) levels were detected. Results At the end of one week follow-up, in the combination group, serum alanine aminotransferase (ALT) level was (37.1±12.6) U/L, significantly lower than in the control group , serum aspartate aminotransferase (AST) level was(36.2±11.6)U/L, not significantly different as compared to 【(45.1±13.7)U/L, P>0.05】 in the control, while serum bilirubin level was (31.2±3.7) μmol/L, significantly lower than 【(62.5±7.1)μmol/L, P<0.05】 in the control; serum CRP level was (8.6±1.3)U/L, much lower than 【(11.3±1.9)U/L, P<0.05】, serum CK level was (177.7±61.7)U/L, significantly lower than 【(209.6±72.1)U/L, P<0.05】, serum CK-MB level was (3.8±0.4)U/L, significantly lower than 【(5.4±0.9)U/L, P<0.05】, serum LDH level was (350.5±103.1)U/L, significantly lower than 【(392.6±120.2) U/L, P<0.05】, while serum TRF level was (1964.8±91.6)U/L, significantly higher than 【(1687.9±88.2)U/L, P<0.05】 in the control; the incidence of adverse reactions in the observation group was 11.2%, not significantly different as compared to 14.3% (P<0.05) in the control group. Conclusion The administration of adenosine methionine might assist subside jaundice in neonates at the base of BLI treatment, which needs further investigation.

Objective The aim of this study was to investigate the value of red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) model (RNM) for a short-term prognosis of patients with hepatitis B virus-induced acute-on-chronic liver failure (HBV-ACLF). Method A retrospective analysis was performed on 102 patients with HBV-ACLF, and the patients were followed up for 90 days. Univariate and multivariate analysis were applied to evaluate the risk factors influencing the prognosis. A short-term prognostic model, RNM was established. The receiver operating characteristic curve (ROC) was drawn and the area under the ROC curve(AUC) was compared to evaluate the predictive value of every parameter on prognosis of death. Result Out of our series, 48 survived, and 54 (52.9%) died at 90 day treatment; the univariate analysis showed that the infection, RDW, white blood cell(WBC), neutrophil(NEU), NLR, total bilirubin (TBIL), international standardization ratio(INR), creatinine(Cr), and MELD scores in the dead group were significantly higher than in the survival group (P <0.05), while the lymphocyte(LY) counts, albumin (ALB), sodium (NA⁺), prothrombin time activity (PTA) were significantly lower than in the survival group(P<0.05); multivariate analysis showed that RDW(OR=1.410, 95% CI, 1.149 to 1.730), NLR(OR=1.155, 95% CI, 1.001 to 1.333) and MELD scores(OR=1.128, 95% CI, 1.001 to 1.271) were the independent risk factors for poor prognosis; the ROC curve analysis showed that RDW(AUC=0.826), NLR(AUC=0.818), MELD scores(AUC=0.791), and RNM model(AUC=0.888) all had predictive value for the prognosis of patients with liver failure, and the RNM model had the best predictive value. Conclusion A short-term prognosis model for patients with CHB-ACLF based on RDW and NLR, namely, RNM, has a good predictive value for 90-day prognosis, which needs further investigation.

Objective The aim of this study was to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) and double plasma molecular absorb system (DPMAS) plus plasma exchange (PE) in treatment of patients with HBV-induced acute-on-chronic liver failure (HBV-ACLF). Methods 50 patients with HBV-ACLF HBV-ACLF were enrolled in this study and were divided into observation (n=25) and control group (n=25), receiving TDF, DPMAS and PE combination or TDF and DPMAS treatment. Serum interleukin-6 level was assayed by ELISA. Results At the end of 12 week treatment, serum bilirubin level in the observation group was (24.0 μmol/L, INR was(1.1±0.3), both significantly lower than 【(31.6±15.9)μmol/L and (1.3±0.4), respectively, P＜0.05】, while serum albumin level was (34.8±6.1)g/L, significantly higher than 【(30.9±5.2)g/L, P＜0.05】 in the control; serum IL-6 level was (52.7±25.2)ng/L, procalcitonin level was (0.4±0.1)ng/L, platelet-to-lymphocyte ratio was (120.6±24.4), and neutrophil-to-lymphocyte ratio was (1.9±0.5), all significantly lower than 【(67.2±30.8)ng/L, (0.5±0.2)ng/L, (139.3±26.7) and (2.4±0.6), respectively, P＜0.05】 in the control; the survival rate was significantly higher than that in the control group (72.0% vs. 48.0%,P＜0.05). Conclusion TDF combined with DPMAS and PE in treatment of patients with HBV-ACLF is efficacious, which might be related to the reduction of blood endotoxin and improve liver function recovery.

Objective The aim of this study was to analyse the CT liver perfusion imaging parameters in patients with schistosomiasis-induced liver cirrhosis. Methods 40 patients with schistosomiasis-induced liver cirrhosis (Child A in 12, B in 16 and C in 12) and 40 healthy persons were recruited in our hospital between May 2016 and October 2018, and all of them underwent liver perfusion of spiral CT scanning. The blood volume (BV), blood flow (BF) , mean transit time (MTT), hepatic artery fraction (HAF) and hepatic artery perfusion (HAP) were obtained by CT Perfusion 4D software. Results The BV, BF, MTT, HAF and HAP in healthy persons were (45.7±8.4)mL/100g, (212.6±43.3)mL/min·100g, (13.5±2.3) s, (0.2±0.0) and (16.3±8.3)mL/min·100g, while in patients with Child class A were (41.0±15.3)mL/100g, (185.6±38.4)mL/min·100g,(15.2±1.2) s, (0.2±0.0) and (20.5±8.0)mL/min·100g, in patients with Child class B were (38.5±20.6)mL/100g, (126.6±90.5)mL/min·100g,(19.4±11.4) s,(0.3±0.0) and (26.7±2.0)mL/min·100g, and in with Child class C were (23.3±8.7)mL/100g, (129.4±46.6)mL/min·100g, (27.5±2.7) s, (0.4±0.1) and (35.2±12.6)mL/min·100g, respectively, showing significantly different among the four groups (P<0.05). Conclusion CT liver perfusion imaging parameters might be used to evaluate the liver functions and cirrhosis in schistosomiasis-induced liver cirrhosis, which is worthy of further investigation.

Objective The aim of this study was to analyze the efficacy and impact on blood coagulation functions of somatostatin and octreotide combination in the treatment of cirrhotic patients with upper gastrointestinal hemorrhage. Methods 70 cirrhotic patients with upper gastrointestinal hemorrhage were admitted to our hospital between July 2017 and May 2019, and they were randomly divided into control and observation group, with 35 cases in each. The patients in the control group were treated by intravenous infusion of octreotide and those in the observation group were treated by intravenous infusion of somatostatin and octreotide combination for 3 to 7 days. All patients were followed-up for two weeks. Blood prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were monitored. Results At the end of two week treatment, blood albumin level in the combination group was (33.5±3.1)g/L, significantly higher were than 【(31.8±2.3)g/L, P<0.05】, while serum bilirubin and blood ammonia levels (30.9±10.2)μmol/L and (32.5±11.8)μmol/L, much lower than 【(41.4±14.3)μmol/L and (45.2±14.6)μmol/L, respectively, P<0.05】 in the control; the PT was (12.4±1.9) s, significantly shorter than 【(14.1±2.3) s, P＜0.05】, the TT was (18.2±2.1) s, significantly shorter than 【(20.4±2.5) s, P＜0.05】, the APTT was (34.5±4.8) s, much shorter than 【(37.3±5.2) s, P＜0.05】, and the FIB level was (2.4±0.6) g/L, significantly higher than 【(2.1±0.5) g/L, P＜0.05】 in the control; the hemostasis time and hospital stay in the combination group were (20.7±3.1)h and (8.5±2.3)d, significantly shorter than 【(24.6±3.9)h and (10.3±2.5)d, P＜0.05】 in the control, and the incidence of 72 hour re-bleeding was 5.7%, significantly lower than 20.0%(P＜0.05) in the control. Conclusion The combination of somatostatin and octreotide in the treatment of cirrhotic patients with upper gastrointestinal hemorrhage greatly reduce the amount of blood transfusion, shorten the hemostasis time and hospital stay, which might be related to the correction of abnormal coagulation function.

Objective The aim of this study was to evaluate the clinical value of serum C-reactive protein (CRP) and procalcitonin (PCT) levels in predicting spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis. Methods A total of 148 patients with decompensated liver cirrhosis were included in our hospital between December 2014 and June 2018. Polymorphonuclear cells (PMN) in ascites, and serum CRP and PCT levels were detected routinely, binary Logistic regression analysis was applied to evaluate the risk factors of SBP occurrence and the diagnostic efficacy of clinical data in diagnosing SBP was analyzed by using the area under the receiver operating characteristic curve (AUROC). Results There were 90 patients diagnosed as having SBP and 58 had non-infected ascites; the Child-Pugh score in patients with SBP was (11.5±1.4), significantly higher than in patients without SBP, the PMN counts in ascites was 280.0 (61.5,582.0)×10⁶/L, significantly higher than , peripheral blood WBC count was [(7.5±3.2)×10⁹/L, much higher than [(3.8±1.7)×10⁹/L, P<0.05), serum PCT level was 3.91(1.32,9.61)ng/ml, significantly higher than and serum CRP level was (32.0±21.7) mg/L, much higher in patients without SBP; the results of Logistic regression analysis showed that PMN counts, serum PCT and CRP levels were the independent risk factors for SBP occurrence in patients with decompensated liver cirrhosis (P<0.05); the sensitivities (Se) of PMN counts in ascites, serum PCT and CRP levels in diagnosing SBP were 75.6%, 73.3% and 72.2%,and the specificities (Sp) were 68.9%, 75.6% and 88.9%, while when serum PCT equal to 0.45 ng/ml and serum CRP equal to 12.68 mg/L as the combination cut-off-value, the Se and Sp were 66.7% and 90.0%, respectively. Conclusion The measurement of PMN counts in ascites and serum PCT and CRP is helpful in diagnosing SBP in patients with decompensated liver cirrhosis in time, which might guide management of patients in this settings.

Objective The aim of this study was to investigate therapeutic effect and renal function changes of antiviral therapy from lamivudine (LAM)and adefovir dipivoxil (ADV) switch to tenofovir in patients with hepatitis B liver cirrhosis (LC). Methods 130 patients with hepatitis B liver cirrhosis were enrolled in this study between February 2015 and February 2018, and all of them had received LAM and ADV combination therapy for longer than 5 years. The patients were randomly divided into observation (n=65) and control group (n=65) by randomized numbers generated by computer. The patients in the control group received LAM and ADV for further treatment, and those in the observation group were treated with tenofovir for 12 months. Serum levels of 25-hydroxyvitamin , and peripheral blood helper T cell 17 (Th17) and regulatory T (Treg) cells were measured. Serum creatinine (Cr) and urea levels as well as estimated glomerular filtration rate (eGFR) were measured and calculated. Results At the end of 12-month observation and in the tenofovir-treated patients, serum HBV DNA load was (2.3±0.7)lg IU/mL, significantly lower than , Child-Pugh score was (6.3±1.4), much lower than in the control; serum 25-(OH)D₃ level was (26.8±2.1)ng/ml, significantly higher than , the percentage of peripheral blood Treg cell was (3.4±0.6)%, significantly higher than , that of Th17 cell was (2.1±0.3)%, significantly higher than , while the ratio of Th17/Treg cells was (0.3±0.1), significantly lower than in the control; serum Cr level was (0.80±0.07)mg/dl, significantly lower than , serum urea level was (11.27±4.36)mmol/L, significantly lower than , while eGFR was (103.72±11.74)mL/(min·1.73m²), significantly higher than in the control. Conclusion The long-term LAM and ADV combination therapy for hepatitis B liver cirrhosis might damage renal functions, and switch to tenofovir treatment at a appropriate time for further antiviral therapy might protect renal functions and help the patients get benefits.

Objective The aim of this study was to observe the efficacy of ascites concentration and reinfusion (ACR) in treatment of patients with decompensated liver cirrhosis (DLC). Methods 102 patients with DLC and asciteswere admitted to our hospital between May 2016 and May 2018, and were divided into observation (n=60) and control (n=40) groups. The patients in the control were treated with routinesupporting therapy, and those in the observation were treated with ACR at base of general therapy. The maximum systolic and minimum diastolic blood flow velocities of main renal aorta (MRA), interlobular renal artery (IRA) and segmental renal artery (SRA) were measured by sonography. Serum levels of lipopolysaccharide (LPS), thromboxane (TX) , leukotriene (LT) ,aldosterone(ALD)and atrial natriuretic peptide (ANP) were detected. Results At the end of two week treatment,the 24-hour urine volume in the observation group was (1864.9±206.5) ml, significantly greater than 【(1050.7±186.2) ml, P < 0.05】, and the ascites subsidence time in the observation group was (13.8±4.5)d, significantly shorter than【(20.3±8.0)d, t = 5.011,P = 0.000】 in the control; the maximal systolic blood flow velocities of MRA, IRA and SRA inthe observation group were (75.5±9.0)cm/s,(37.2±4.4)cm/s and (56.4±5.7)cm/s, significantly quicker than 【(71.4±8.5)cm/s,(35.2±3.9)cm/s and (52.3±5.0)cm/s, P < 0.05】 in the control group; the lowest diastolic blood flow velocities of MRA, IRA and SRA were (25.7±3.6)cm/s,(16.3±3.1)cm/s and (14.9±2.7)cm/s,much quicker than 【(22.3±3.7)cm/s,(14.2±2.6)cm/s and (12.0±2.6)cm/s, P< 0.05】 in the control group; serum LPS, TX, LT and ALD levels in the observation were(10.6±1.8)pg/ml, (95.2±14.5)pg/ml, (88.4±7.7)pg/ml and (189.6±12.4)pg/ml, significantly lower than, while serum ANP level was (347.1±60.4)ng/L, much higher than in the control 【(13.2±2.1)pg/ml, (104.5±18.7)pg/ml, (94.7±8.5)pg/ml, (198.7±15.8)pg/ml and (271.3±44.7)ng/L, P<0.05】. Conclusion The ACR therapy for cirrhotic patients with ascites is Efficacious, which might be related to the improved renal blood flow and modulation of renal vasoactive factors.

Objective The aim of this study was to evaluate hepatic functional reserve using practical liver volumes (PLV) measured by enhanced CT scan in patients with hepatitis B liver cirrhosis (LC). Methods A total of 60 patients with hepatitis B LC underwent spiral CT examination in our hospital between June 2016 and February 2020. The PLV was calculated by Myrian XP Liver software and compared to theoretical liver volumes (TLV). The LC was divided into four class based on CT imaging. Results The LC in our series was found to be class 1 in 12, class 2 in 25, class 3 in 13 and class 4 in 10; the PLV in patients with class 1 was (996.2±145.5)cm³, significantly smaller than TLV 【(1440.2±106.2)cm³, P<0.05】, the PLV in patients with class 2 was (918.2±116.4)cm³, significantly smaller than TLV【(1408.8±92.0)cm³, P<0.05】, the PLV in class 3 was (852.4±70.8)cm³, much smaller than TLV【(1380.2±104.8)cm³, P<0.05】 and the PLV in patients with class 4 was (724.9±92.3)cm³, significantly smaller than TLV【(1352.1±88.2)cm³, P<0.05】; the PLV in 15 patients with Child-Pugh class Awas (985.2±250.8)cm³, significantly smaller than TLV【(1420.6±125.0)cm³, P<0.05】, the PLV in 31 patients with class B was (820.6±105.4)cm³, significantly smaller than TLV 【(1381.8±110.8)cm³, P<0.05】 and the PLV in 14 patients with Child-Pugh class C was (704.6±70.5)cm³, significantly smaller than TLV 【(1340.5±120.9)cm³, P<0.05】; the PLV in 14 patients with MELD score less than 10 was (960.6±162.5)cm³, much smaller than TLV【(1408.2±92.8)cm³, P<0.05】, the PLV in 28 patients with MELD score of 10 to 20 was (842.6±90.6)cm³, significantly smaller than TLV【(1372.4±108.0)cm³, P<0.05】, and the PLV in 18 patients with MELD score greater than 20 was (782.1±40.8)cm³, significantly smaller than TLV 【(1325.0±130.8)cm³, P<0.05】. Conclusion The actual liver volume measured by spiral CT scan might effectively evaluate the functional reservoir in patients with hepatitis B liver cirrhosis, which warrants further clinical investigation.

Objective The aim of this study was to investigate the clinical characteristics and prognostic factors of primary liver cancer (PLC) patients with serum AFP negative (＜20 ng/ml) . Methods The clinical data of 34 patients with AFP-negative PLC were retrospectively analyzed in our hospital from March, 2013 to March, 2017. The relevant data were processed by SPSS17.0 statistical software, and the overall survival rate was estimated by Kaplan-Meier method. COX regression model was applied to analyze the prognostic factors of patients with AFP-negative PLC. Results During the 3-year follow-up, the 1-year, 2-year and 3-year survival rates of our 34 patients were 91.2%, 85.3% and 73.5%, respectively; univariate analysis showed that there was significant differences in survival period between patients with different tumor size (maximum diameter ≤ 5cm and ＞ 5cm, between patients with and without distant metastasis, between patients with and without portal vein tumor thrombus, between patients with Child-Pugh class C and those with Child-Pugh class B, between patients with high histological differentiation and low histological differentiation , between patients with distant metastasis and without metastasis, between patients with high serum CEA level and normal CEA level, between patients with CR and PD after treated with TACE, and between patients having radiotherapy and those without receivingradiotherapy(P＜0.05); COX analysis showed that portal thrombus formation, poor Child-Pugh class, low histological differentiation, distant metastasis, high serum CEA level, poor response to TACE and no radiotherapy were all the independent prognostic factors of patients with AFP negative PLC (all P＜0.05). Conclusion The prognosis of patients with serum AFP negative PLC is related to many factors, and the patients with complete remission of tumor after TACE and having radiotherapy might even have a better prognosis.

Objective To investigate serum level of dickopff 1 in patients with hepatocellular carcinoma (HCC) and its impact on prognosis after transcatheter arterial chemoembolization (TACE) treatment. Methods 90 patients HCC, 90 healthy persons, 86 patients with chronic hepatitis B (CHB) and 81 patients with hepatitis B cirrhosis were enrolled in this study from January 2016 to January 2018, and all patients with HCC received TACE and followed-up for 24 months. Serum levels of Dickopff-1 and AFP were measured by ELISA. Serum Dickopff-1 levels in patients with different clinical and pathological characteristics were compared. The receiver operating characteristic curve (ROC) was drawn to determine the efficacy of serum Dickopff-1 and AFP in the diagnosis of HCC, and the Kaplan-Meier curve was applied for survival analysis. Results Serum Dickopff-1 and AFP levels in patients with HCC were significantly higher than those in patients with liver cirrhosis or in patients with CHB【(0.8±0.1)ng/ml and (12.3±3.0)ng/ml, P<0.05】 or in healthy persons 【(0.7±0.1)ng/ml and (11.5±2.5)ng/ml, respectively, P<0.05】; serum level of dickopff-1 in patients with HCC reduced after TACE treatment to (1.6±0.6)ng/ml, P<0.05); serum level of dickopff-1 in HCC patients with portal cancer thrombus was higher than that in patients without [(2.9±0.3) ng/ml vs. (2.1±0.5)ng/ml, P<0.05); serum level of dickopff-1 in dead patients was higher than that in survivals [(3.5±0.8) ng/ml vs. (1.2±0.3) ng/ml, P<0.05); the area under the ROC curve (AUC) of serum dickopff-1 or AFP alone in the diagnosis of HCC were 0.860 and 0.618, respectively, which had certain diagnostic value for HCC (Z=6.297, P<0.05) and the combined diagnosis of dickopff-1 and AFP improved the efficacy (AUC=0.892), and the sensitivity, specificity and accuracy of the diagnosis were all the highest; the Kaplan-Meier survival analysis showed that the overall survival of patients with high serum dickopff-1 levels was poorer than that in patients with low serum levels (x²=8.418, P<0.05). Conclusion Serum dickopff-1 levels increase in patients with HCC. The higher the levels of serum dickopff-1 in patients with HCC, the worse the prognosis. It might be used as an indicator of the efficacy and prognosis after TACE treatment in patients with HCC.

Objective The purpose of this study was to evaluate the changes of magnetic resonance (MR) diffusion-weighted imaging (DWI) and dynamic contrast-enhanced scanning parameters in patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) therapy. Methods A total of 76 patients with HCC were treated with TACE in our hospital from June 2014 through June 2019, and all received MR before and after TACE for apparent diffusion coefficient (ADC) , the volume transfer constant (K_trans) and the tissue space-plasma rate constant (K_ep). Results Before the TACE treatment in the 76 patients with HCC, the ADC of tumor foci was (1.1±0.1)×10^-3mm²/s, K^t_rans was (1.4±0.3)min^-1, K_ep was (1.9±1.1)min^-1, significantly different as compared to after TACE, while there was no significant difference between the tumor sizes 【(7.7±3.2)cm vs.(6.5±2.8) cm】 before and after TACE; 59 patients (77.6%) got response to TACE out of the 76 patients with HCC, and in the 59 responders, the ADC was (1.4±0.4)×10^-3mm²/s, much greater than【(1.1±0.3)×10^-3mm²/s, P<0.05】 in 17 non-responders, and the K_trans was (0.8±0.2)min^-1, significantly lower than 【(1.2±0.4)min^-1, P<0.05】 in non-responders, while there were no significant differences with respect to the tumor sizes 【(6.6±3.1)cm vs.(7.4±3.8)cm】, the ADC before TACE 【(1.1±0.2)×10^-3mm²/s vs. (1.0±0.2)×10^-3mm²/s】 and the K_ep 【(1.4±0.3)min^-1 vs. (1.4±0.4)min^-1】 between the two groups (P>0.05). Conclusions The ADC and K_Trans of functional magnetic resonance imaging of tumor foci in patients with HCC after TACE might change specifically, which could help clinicians evaluate the therapeutic efficacy.

Objective The aim of this study was to analyze the clinicopathological features of patients with primary adenosquamous carcinoma(ASC)of liver. Methods The clinical and histopathological data of 6 patients with ASC were analyzed retrospectively, and all patients received hepatectomy and/or TACE. The hepatic tissue protein expression was detected by SP. Results In the six patients, two were women and four women, aged 54-75 yr with an average age of (63.0±8.3) yr; all patients presented with abdominal pain and intrahepatic foci were found by imaging examination; the gross foci mass was grayish white and solid with a relative clear border; the tumor cells were nested or glandular tubular microscopically; the SP detection showed the hepatic CK7, CK19, cam5.2 and Ki-67 positive in six, CEA positive in four, CK20 in three, CDX-2 in two and MUC-1 in one; the overall survival was 6 months. Conclusion The diagnosis of primary ASC of liver depends on the pathological examination, the tumor is malignant and the survival of patients is short.

Objective The aim of this study was to explore the diagnostic accuracy of contrast enhanced ultrasound (CEUS) by liver imaging report and data system (LI-RADS) in patients with space-occupying liver lesions. Methods 60 patients were clinically confirmed with space-occupying liver lesions in our hospital between January 2018 and September 2019, and all underwent CEUS. The imaging was classified according to LI-RADS and the diagnostic accuracy was evaluated when LR-3 or LR-4a was assumed as cut-off value. Results Out of the 60 patients, the histopathological examination showed that there were 4 cases with hepatic cysts, 16 cases with hepatic hemangioma, 8 cases with liver abscess, 9 cases with focal hepatic steatosis, 9 cases with focal hepatic hyperplasia, 8 cases with hepatocellular carcinoma and 6 cases with liver metastases; when the pathological diagnosis was set as the gold standard, the LR-3 diagnosed malignant foci in 22, and benign lesions in 38 patients, and the LR-4a diagnosed malignant in 14 patients and benign foci in 46 patients; the sensitivity, specificity and accuracy by the the former were 85.7%, 78.2% and 80.0%, and by the latter were 78.6%, 93.5%(P<0.05)and 100.0%(P<0.05). Conclusion The LR-4a of LI-RADS from CEUS could be applied to differentiate liver lesions, which have a relatively good efficacy and warrants further investigation.

Objective The aim of this study was to compare the efficacy and safety of endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous transhepatic biliary drainage (PTBD) in the treatment of patients with malignant obstructive jaundice after failure of endoscopic retrograde cholangiopancreatography (ERCP). Methods 75 patients with malignant obstructive jaundice (pancreatic carcinoma in 15, vater ampulla carcinoma in 12, bile duct carcinaoma in 27, gall bladder carcinoma in 9, gastrointestinal cancer in 11, and non-Hodgkin lymphoma in 1) proven by B-ultrasound, CT or MRCP were recruited in our hospital between January 2013 and December 2018. All the patients had failed ERCP, and 40 were retreated by EUS-BD, and 35 received PTBD. Results The operation success rate in 40 EUS-BD-treated patients was 92.5%, not significantly different as compared to 80.0% in 35 PTBD-treated patients , and the operational times were also not significantly different between the two groups [(50.8±28.4)min vs. (54.7±25.2)min, P>0.05); after treatment, serum bilirubin level was(138.7±50.2)μmol/L, significantly lower than (162.4±60.2)μmol/L, while serum albumin level in EUS-BD-treated group was (34.8±3.7)g/L, much higher than [(32.1±4.6)g/L,P<0.05] in TPBD-treated group; the incidence of post-operational complications in the former was 7.5%(3/40), including biliary hemorrhage in 2, acute cholangitis in 1, and it was 22.9%(8/35, P<0.05) in the latter, including biliary hemorrhage in 3, subhepatic capsular hemorrhage in 1, bile peritonitis in 1, bile leakage in 1 and biliary tract infection in 2. Conclusion The alternative application of EUS-BD or PTBD in failed ERCP patients is feasible, and might temporarily improve jaundice subside.

Objective The aim of this study was to investigate the prediction of survival by donor’s serum cytokines in recipients of liver transplantation (LT). Methods Thirty-five patients underwent LT in our hospital between March 2015 and March 2017, and both the donor’s and recipients’ sera were obtained. Serum interleukin-1β(IL-1β), IL-2, IL-6, IL-10, tumor necrosis factor-alpha (TNF-α), brain natriuretic peptide (BNP) and procalcitonin (PCT) were assayed. The area under ROC (AUC) was drawn to predict the survivals by serum cytokines. Results At the end of three months of LT, 28 recipients survived, and 7 died; donors’ serum IL-6, IL-10, BNP and PCT levels in survived recipients were (76.9±13.5) pg/ml,(32.4±8.7)ng/L,(2806.1±357.5)ng/L and (7.4±1.8)ng/L, not significantly different as compared to 【(80.2±15.3) pg/ml,(28.6±7.9)ng/L,(2794.6±348.7)ng/L and (8.0±2.5)ng/L, respectively,P > 0.05】 of donors’ in the died recipients; serum IL-1β,IL-2 and TNF-α levels of donors’ in the survived recipients were (84.2±20.7)ng/ml,(95.1±17.6)pg/ml and (24.6±6.9)ng/L, significantly lower than 【(136.0±39.4)ng/ml,(119.2±31.1)pg/ml and (39.7±10.4)ng/L, respectively, P < 0.05】 of donors’ in died recipients; serum IL-1β,IL-2,IL-6,IL-10,TNF-α,BNP and PCTlevels in survived recipients were (118.3±39.6)ng/ml,(104.3±25.9)pg/ml,(78.3±16.1)pg/ml,(29.7±8.9)ng/L,(32.2±8.1)ng/L,(2776.3±240.5)ng/L and (7.6±1.1)ng/L], all not significantly different compared to 【(122.8±35.5)ng/ml,(105.7±23.4)pg/ml,(81.2±17.8)pg/ml,(30.3±8.1)ng/L,(30.1±7.6)ng/L,(2801.4±238.6)ng/L and (8.2±1.9)ng/L, respectively, P > 0.05】 in died recipients; the ROC analysis showed that theAUC of serum TNF-α in predicting the prognosis of LT were greater than 0.750 (0.612～0.907), and in 17 recipients with serum TNF-α≥33.5 pg/ml, 11 (64.7%) survived in 2-year follow-up, while in 18 with serum TNF-α<33.5 pg/ml, 17 (94.4%) survived (Log rank x²=9.272,P=0.002). Conclusion The detection of serum cytokine levels in donors might predict the survival of LT recipients, and monitoring serum TNF-α levels is recommended in this settings.

Objective To investigate the impact of hepatectomy or percutaneous transcatheter arterial chemoembolization (TAE) in treatment of patients with hepatic hemangioma on quality of life thereafter. Methods A total of 179 patients with hepatic hemangioma were admitted to our hospital between December 2015 and December 2017, and among them, 131 patients underwent hepatectomy (group A) and 48 patients received TAE (group B). The differences with respect to liver function index, renal function, operation time, intraoperative blood loss, postoperative complications, postoperative hospitalization stay and costs were compared. The patients' quality of life was assessed with the gastrointestinal quality of life index (GLQI).The materials were recorded in Epidata database. The statistical process was finished with SPSS 25.0 software. Results Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and creatinine levels in group A were significantly higher than those in group B (P <0.05) one week after operation; the operation time, intraoperative blood loss, postoperative hospital stay, and medical fees in group A were significantly higher or greater than those in group B (P<0.05); there was no statistical difference in total GLQI score between the two groups (P>0.05) at presentation, but the overall changing trend of the total GLQI scores after operation was significantly different between the two groups, which showed a continuous increase after operation in group A, and 12 months after operation, the total GLQI score was significantly higher than that in group B (P<0.05). Conclusion Hepatectomy has an exact curative effect on patients with hepatic hemangiomas, with a less incidence of adverse reactions, and might help improve patients’long-term quality of life.

Objective The purpose of this study was to compare the clinical value of magnetic resonance imaging (MRI) and color Doppler ultrasound (CDUS) in the diagnosis of patients with cholangiolithiasis. Methods The clinical data of 136 patients were retrospectively analyzed in our hospital from November 2016 through November 2018. All patients underwent MRI and CDUS examination before endoscopic retrograde cholangiopancreatography (ERCP) was conducted. The detection rate and diagnostic efficacy of MRI and CDUS in different parts and different sizes of stones were compared to determine their clinical value. Results Out of the 136 patients, the ERCP showed that 115 patients had cholangiolithiasis, 65 patients with single and 50 with multiple stones, and for them, the detective rate of MRI were 89.2% and 100.0%, significantly higher than 76.9% and 56.0% (P<0.05) by CDUS; the ERCP demonstrated that the size of 1.0 cm, 0.5 to 1.0 cm and less than 0.5 cm of stones were in 49, 57 and 9 patients, and for them, the detective rate of MRI were 100.0%, 91.2% and 77.8%, significantly higher than 79.6%, 63.2% and 33.3%(P<0.05) by CDUS; the MRI detected stone from gall bladder, extrahepatic bile duct, intrahepatic bile duct and common bile duct in 21, 30, 20 and 37, while the CDUS examination only found in 18 (85.7%), 18 (60.0%), 17 (65.4%) and 25 (65.8%) patients; the total detective rate of stones in our series by MRI was93.9%, much higher than 67.8%(P<0.05) by CDUS, and the misdiagnosing rate by MRI was 4.9%, and that by CDUS was 10.3%. Conclusion Although the overall diagnostic efficacy of MRI for cholangiolithiasis is higher than that of CDUS, the clinical application of MRI and CDUS is closely related to the locations and sizes of stones, and the clinicians should select them appropriately to improve the diagnosis.

Objective The aim of this study was to summarize imaging features of xanthogranulomatous cholecystitis (XGC) and its histopathological manifestations. Methods The clinical material of 20 patients with XGC proven by surgery and pathology was retrospectively analyzed, and the imaging incluing CT and MRI, and histopathological features were summarized. Results The CT scan showed that the gallbladder was enlarged in 90.0% of the patients, 100.0% gall bladder thickened, including 35.0% localized and 65.0% diffuse thickening. 20.0% of the patients presented with enhanced intra-gall bladder nodules at the arterial phase and 75.0% with multiple low-density nodules at the venous phase. All patient had cholecystolithiasis. 75.0% of the patients demonstrated unclear gaps between liver and gallbladder. 40.0% of the patients presented with continuous, while 60.0% with interrupted enhancement of gallbladder mucosa line; the MRI indicated the gallbladder enlargement was found in 91.7% of patients, and 100% with the gall bladder wall thickened, among which the localized thickened in 50.0% and the diffuse thickened in 50.0%, presenting with "sandwich biscuit sign"; 100.0% of patients showed multiple abnormal nodular signals in thickened gallbladder wall, and 100.0% with enhanced intra-cystic nodules with low signal at enhanced venous phase. All patients had cholecystolithiasis. The gaps between liver and gallbladder were unclear in 91.7% of patients. 58.3% of patients presented with continuous, while 41.7% with interrupted enhancement of gallbladder mucosa line. 25.0% had reticular changes at mucosal stripping. The histopathological examination showed that fibrosis withinflammatory cell infiltration in gall bladder tissues, and granulomatous formation with abundant foam-like cell gathering at the bladder walls. Conclusion The patients with XGC have a unique imaging features, which might help making a correct pre-operational diagnosis and management.

Objective Ascites is a common manifestation of decompensated liver cirrhosis. The incidence of refractory ascites (RA) in patients with cirrhosis is about 5% to 10%, and the survival of patients with RA is low. A number of studies at home and abroad have reported the progress of treatment on RA. We reviewed the current treatment of RA in patients with cirrhosis.